Cervical techniques

[mynameismud]

Hello all! I am new to the forum and am so glad I found it. What a great resource! Hopefully I might be able to offer some helpful advice too

I have never felt very comfortable with cervical massage. Posterior cervicals yes, but when it comes to the SCM and scalene musculature, I feel like there must be a better way. Grasping the SCM is usually diffcult on most people because it is so tight, and many clients don't like the way that feels. It can seem a bit invasive to some people, especially those who are new to massage. For the scalenes, I usually work right along the superior border of the clavicle, medial to lateral strokes, with the client rotating their head to the tight side to help soften the area. That only seems to produce a little softening though. Any suggestions would be greatly appreciated. Thanks, and take care.

 

[Finnegan]

Welcome, again! :wink:

It took me a bit to get comfortable working the anterior cervicals too.

Here is what I can suggest:

Working the SCM, with the head rotate away from the side you want to work, have the client lift the neck toward the ceiling. This will give you a good visual of where the SCM is. Have them relax. I do two things. I will use the pincer technique using my thumb and the side of my index finger to slowly work the length of the SCM (both heads) and the attachments. I will also use my fingers to wedge around on both sides and glide down on the SCM.

For Scalenes and SCM, I also will use my thumb (I know, thumbs!). I will turn the clients head back towards me, I move more to the side of the table and I get my thumb right in there. I strip up and down, finishing with down along the scalenes attachment to the clavical.

I always finish with a good ear to shoulder stretch and for really tight clients I will stretch the scalenes with the head dropped off the table.

Pay attention to both Origin and insertion (I always call them both attachments).

Get with someone who won't mind you poking (your therapist perhaps) around and get used to where you can and can't be (carefully of course). Once you are more comfortable with the area itself, you will be more comfortable working in it.

 

[Tanner]

Thank you for your advice. You're right about needing to experience the work more myself. The anterior cervicals are one of my chronic problem spots and I have never felt entirely at ease with therapists getting there hands in there and digging around. Nasty trigger points! But I will try those techniques and keep on practicing!

 

[Dien]

I like to work the anterior cervicals while the client is still face down. One advaneforum.xxxe is that since the direction of the pressure is upwards, the client doesn't have that feeling of you pressing into their throat. The scalenes are easy to reach this way and I can work the SCM attachments also. I glide my fingers back and forth across the top of the clavical, stopping to do TP work whenever necessary. I also work the attachments just under the jawline and ear.

By the time I turn them over, most of the work is done.

 

[Pompal 09.]

If you are having a hard time with the SCM, increase the cervicals into flexion to create some slack in the muscles and start from there. Working on the main body of the scalenes will obviously help more than just the clavicle portion of the muscle.

Try some traction on the client. This works great. Another way to stretch the neck is to move the client towards you, so their shoulders and head are off the table and slowly lower their head into extension off the table. Great for the Anterior Neck muscles. Also, rotate and then lower the head for more of the Medial scalenes. Works great, but don't do this on a client with a positive VBI test and low blood pressure would be a caution.

Jay Hillman

 

[StrongGIRL]

The technique that masthera gave is excellent for deeper work. where you rotate the head away from the side you are working, haev the client flex so you can visually locate the SCM. once you have done that, you can squeeze the muscle just below the mastoid process with an superior (towards the head) pressure. then lower the head, rotate it towards the side you are working on, and tilt it away from the side you are working on. This will lengthen the muscle while you have your pressure on it. excellent for working adhesions and contractures.

Another (not as aggressive) way to get at the SCM is to have the client rest his head and rotate his head away from the side you are working. If you stand on the side of the table that his head is rotated, you can reach over and access the scm on the opposite side and massage it with c-scooping or other massage techniques.

 

[Baby ANimal]

I like to do most of the work on cervical spine with the client supine. It is close to the end of the massage, when they are the most relaxed. I slide my hands under the client's spine, and lift up, supporting the neck with both hands, and slide slowly to the occiput, putting a slight traction on the head. (Think arching the neck.) Gravity does a lot of the work, and my clients love it. I will repeat this 3-4 times, then support the neck with one hand, the head on my wrist, and rotate the head. I stroke with soft knuckles, (more like just with the back of my fingers) with moderate pressure, down the scalenes to the glenohumeral joint. Then a stretch by pressing the joint, toward the elbow, not to the table. This is easiest on my back if done while seated, but can be done standing.

 

[froglady]

What a great thread! I love it!

 

[I Can Get Sexual Too]

Thank you all for the helpful advice. I have tried several of the techniques mentioned, and am sure I will continue to increase my confidence with working this particular area of the body.

Take care!

 

[asdf1234]

I have never felt entirely at ease with therapists getting there hands in there and digging around.

One of my teachers made a big point of this, that we often have trouble working the areas where we ourselves need the most work/feel uncomfortable going/etc.

Took me a long time to deal well with scalenes. Now I love working that area. But for the first half of massage school, I used to claim that I didn't even have any I simply "couldn't" feel them on myself.

When we got to them in Deep Tissue class, that was an intense morning. I worked with a trusted friend who holds deep space, and we found much grief stored in my neck. I cried on the table during the session, "hid" under the sheet for a while during break, and finally got up and dressed and did some energy exercises to get rid of the buzz hanging around my head.

Anyway, maybe once you start truly receiving the work the rest will fall into place. Best of luck.

 

[mireliz]

EgoMagickian, what a great experience...thanks for sharing.

 

[jenius]

I know this is an 'old' thread, but I thought I'd mention a technique of sorts for working the 'neck' muscles (not posterior per se but they are impacted as well).

If a client has come with tight traps I and scalenes, I start the client in a chair facing away from me. I work the transverse processes of both sides of the cervicals and then address the lamina grooves on either side. I then rest my forearms on the shoulders to the client's comfort level. I then use my forearm to a gradual and very slow forward myofascial slide in as straight a line as possible, then reverse so that I slowly pull my forearm back across the same area. I then address the other attachment site by the very careful placement of my elbow (again, the level of engagement comfortable to the client) at the first rib and then have the client laterally flex at his/her own pace and to the degree they're comfortable with.

I like working the neck this way. It's very effective in addressing these muscles and you're able to achieve a great deal more engagement. Then once the client is supine, the above posts offer a more thorough approach.

Just my .02 cents worth. What are your thoughts?

 

[~Mia~]

I like to start out with myofascial work. I find that helps loosen things up. Even GTO (golgi tendon organ) techniques are great. I find these techniques loosen up the tissue so that I don't have to massage as much as I would if I didn't do them. Then after the massage work I like to end with some MET/PNF work to further stretch the muscle. We were taught to never/be very cautious of putting a patients neck into extension and especially extension and rotation because the vertebral artery is being occluded and they may have a stroke!! eeks!! For people with heart problems I definitely don't put their head into extension and rotation because although they may not have a stroke on your table (that would be bad) but they could have one later that day/week..etc.
Just my thoughts

Aamna

 

[quitemetalrebel]

saclenes

Orthobionomy. The book can be bought online. It's positional release. Without a doubt the best technique because it causes no pain or damage to other strucutures.

 

[marybeth!]

Hi everyone, my first post.

I would recommend that motion palpation of the spine via chiropractic motion palpation seminars are wonderful, then approach cervical mechanics with Muscle Energy and Rolfing/ART and grade 3/4 jnt play to start.
I often correct C1/C2 as C1 should rotate 5 degrees before C2 kicks in....usually they take off together...thats not correct.
I use a hook on the lateral mass of C2 to hold it back at neutral then I ask them to rotate. You often have to encourage C2 to go the full distance at the end range too. Again I use the lateral mass to push it along in this instance.

I must relay the importance of using breath and swallowing when doing anterior cervical work as it is important to use functional active movement by the patient as well as the basic cervical ROM. Guided Active Movement is the access to deep release and success for both the patient and the therapist.

We must realize that the cervical region has three layers of fascia and that the fascia of the neck is continuous with the tongue and the roof of the mouth via the soft pallet and the muscualar attachements to the sphenoid bone.

SCM responds best to finger pinch/muscle rolling and although I never liked that technique thats what works best for the SCM.
For fascia work have the client in full rotation and strip the SCM from superior to inferior...this integrates the cervical fascia...
never use oil with fascial work...go dry or use a smiddgen of cocobutter.

 

[sir galahad]

I attended an Erik Dalton seminar last month in GA. He showed such an effective scalene & scm technique that was super simple, its part of what he calls the dirty dozen.

It can can be done with client supine - but side position is best (Head rests on pillow with neck neutral).
SCM. Position yourself to rear of cl. Ask them to slightly lift their head,side towards cieling, so scm contracts. Use both of your curled hands (claw) side by side to finger curl from scm near sternal attachment, other hand grasps along with all fingers to mastoid. Client now relaxes - leaving your fingers hooked well under scm. The best part is you tell the client to rotate head away downward, under their control. Very strong stretch on scm- all done by the clients own slow turning.

Anterior scalene: Same positioning. Place one hand over clients forehead, for security and counter-resistance later.

Other hand, straight fingers placed behind posterior of scm. Slide scm forward as your fingers sink under scm towards cervial spine. You will land on attachments of scalenes fairly easy, as long as you keep up under the scm which you push forward. Dig a little with finger tips. Also have client bend head forward against your bracing hand, which will fire the scalenes under your other finger tips. Hold isometric contraction 5 secs. Relax head and continue with fingertip massage.

 

[TheRealAcid9]

client supine, stand at head of table and lift your knne up onto table and have client's head rest on it...putting their head in flexion to do scalenes and longus coli, rotate head away to each side to work scm with pincer and friction strokes ....took Ralph Stephens course at AMTA convention last weekend and this is so easy to do...I could do anterior neck all day long

 

[louise d]

When we got to them in Deep Tissue class, that was an intense morning. I worked with a trusted friend who holds deep space, and we found much grief stored in my neck. I cried on the table during the session, "hid" under the sheet for a while during break, and finally got up and dressed and did some energy exercises to get rid of the buzz hanging around my head.

I'm reactivating this old thread, because I recently had an emotional release on the table, and remembered Ego's post. The interesting part is that I have no idea where my emotion's coming from. It's been triggered twice, both times by work that approached my windpipe. The first time, I felt extreme fear during a technique that put pressure on the front of my neck. This recent time, I ended up crying when a practitioner was doing some work in my mouth near the back of my throat. I have no memory of any trauma/event associated with this area. Yet, both times, it was a powerful emotional response.

Ego, did you know where your emotions were coming from? Do you think it's necessary to know?

 

[jimmy4burnet]

I don't think it's *necessary* to know where the emotions come from, but it can be nice and sometimes helpful. You can process it sucessfully without knowing, if you're okay with that.

Some schools of thought say that trauma from birth even, can still live in your tissues and emotions. If you had a long labor, or perhaps had the umbilical cord around your neck, that could be a source.

I am mentioning this because usually no one knows about this possibility. I know it's not a popular idea (that babies remember stuff from the traumatic birth scene) but I believe it to be true.

 

[LifeIsPeachy]

Ego, did you know where your emotions were coming from? Do you think it's necessary to know?

As a practicing CranioSacral Therapist with training in SomatoEmotional Release, I see this a lot. I have personally experienced and witnessed emotional releases that seem to come from 'nowhere'. (Remember nowhere is now here)

It is not always necessary to know where the emotions come from or why they are coming up. I would only pursue it further (as a client or practitioner) if it seemed the emotion was tied in with the presenting health issue. So, you mentioned that both times it was work approaching your wind pipe. If you are having trouble with your windpipe that continues to come back after each session, then as a therapist I might want to guide you a bit deeper into the emotional issue to see how it is tied in to your windpipe.

A good majority of the time clients do not have any memory of a trauma/event until we explore it a bit with some dialogue/imagery. Even then a lot of times, he/she may not know where the emotion comes from, but we work to acknowledge it and release it from the tissues and the cellular memory.

Also, I agree with shivashiva. I have personally processed emotional issues from when I was still in my mom. I personally believe that our cells have a consciousness that in some way remembers everything from the moment we become an ovum and a sperm cell. (That's a whole different thread) So, sometimes emotions can be from a time when we don't have the 'brain' to put it into a contextual memory.

Did that make any sense? It's hard to put into words.

Hope that sheds a little light on this topic.
Brian