Issue link: https://www.massageandbodyworkdigital.com/i/1492048
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 27 entering through the lateral side of the neck rather than going in from the front. Notice in Image 3A how the technique begins with my client's head fully left- rotated. This allows me to "snake" my soft finger pads under the sternocleidomastoid. Then I right rotate the client's head back to neutral and slowly extend the neck while my soft fingertips gently resist by pinning the scalenes to bone (Image 3B). I love this technique, and I've never had trouble intruding on the nerve roots or vascular structures. It's a bit tricky at first, so I recommend practicing it in a supervised setting. SUPERIOR CLUNEAL NERVE Branches of the superior cluneal nerve run from the spine through small fascial tunnels over the top of the pelvic brim and down toward the upper buttock (Image 4). Due to their location, I've been guilty of accidentally sliding an elbow up on the pelvic brim and squashing the nerves when performing low-back work. Eventually, I figured out a better way to treat clients with low-back stiffness without intruding on the cluneal nerves. Notice in Image 5 how I use my right olecranon to push the tissue medial to lateral while resisting this motion with my left hand. This offers a nice stretch and allows the elbow to glide through the tissue and open the tunnels with greater precision. SUMMARY Using the techniques outlined here can help us avoid eliciting the dreaded jump ref lex or yelp that occurs when we accidentally collide with a client's nerve. There are, of course, several other areas where it's possible to "get on your client's 2 4 5 To avoid getting on my client's sciatic nerve, I position him sidelying and work the piriformis insertion at the greater trochanter. With my client's head fully left-rotated (3A), I "snake" my soft finger pads under the sternocleidomastoid, right rotate back to neutral (3B), and slowly extend the neck to stretch the scalenes. It's easy for a misplaced elbow to compress the cluneal nerves where they pass over the bony pelvic brim. To avoid bruising the cluneal nerves, my right olecranon slowly pushes the lumbar tissue medial to lateral while my left hand resists this effort. nerves," and I sincerely hope you haven't discovered any of them yet. To help you steer clear of sensitive spots in general, here are my three take-home messages: (1) Be innovative when positioning clients on the therapy table, (2) use movement enhancers to calm the nervous system, and (3) don't chase the pain. Erik Dalton, PhD, is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, he has maintained a practice in Oklahoma City, Oklahoma, for over three decades. For more information, visit erikdalton.com. 3A 3B