Issue link: https://www.massageandbodyworkdigital.com/i/465652
98 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 5 process pushed back into my palpating thumb, indicating that the C7 facet was not opening on T1. In the early stages of Mona's FHP, it's unlikely this C7–T1 facet fi xation excited enough mechanoreceptors to elicit a pain response. Over time, however, gravitational exposure (14.7 pounds per square inch) destroyed her neck's antigravity tent system, leaving the brain no option but to try to restore stability by building extra bone through spurring. Bone spurs are not problematic unless they encroach on nerve roots exiting the intervertebral foramina, but the combination of spurring, facet sticking, and nerve impingement eventually overwhelmed Mona's nervous system, causing the brain to splint the area up with protective spasms. Mona's type of desktop FHP has been the norm in bodywork practices for decades. Now, we're beginning to see it replaced with a biomechanically different condition. NICK'S TEXT NECK Nick's X-ray (Image 4) shows how text FHP differs from desktop FHP. Here, the occiput has rolled forward on the atlas, and the head and neck are hanging by the ligaments and extensor muscles. In prolonged text-neckers, the O-A joint's articular cartilages dehydrate and sometimes degrade. When the occiput is unable to glide freely back on the atlas, people like Nick may experience pain when looking up. (Assessment tip: look for a high eye on the side that is not gliding back.) The same principle holds true for other C-spine joints. During seated palpation, if the deep groove muscles are fi brotic, extend the client's neck over your fi nger-thumb fulcrum to test the ability of the superior facets to glide down and close on their inferior neighbors. If resistance is met, gently spring the joint anteriorly, attempting to induce cervical curve. Lack of spring during this test tells you the joints are stuck open from prolonged texting and the superior vertebra is unable to close on its inferior neighbor. ASSESSMENT BASICS With desktop FHP, check for O-A, mid-, and lower-cervical joints that are locked closed. When assessing text FHP, look for the opposite: O-A, mid-, and lower-cervical joints that are locked open. Note 1. Kenneth K. Hansraj, "Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head," Surgical Technology International 25 (2014): 277–9. Erik Dalton is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfi ng, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. O-A joint locked in fl exion from text-neck forward head posture. Images courtesy Erik Dalton. 4 O-A and C7–T1 joints locked in extension from desktop forward head posture. Images courtesy Erik Dalton. 3 MYOSKELE TAL ALIGNMENT TECHNIQUES O–A C7–T1