Massage & Bodywork

JULY | AUGUST 2016

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Key Points: SCM Differentiation Technique Indications • Neck pain or stiffness. • "Cold" whiplash (3–6 weeks or more since injury; no muscular spasms). • Positional or postural issues, such as head-forward position or torticollis. • Headaches: both tension-type and migraines. • Jaw pain, tension, and temporomandibular joint dysfunction. • Other indications, as described in the text. Purpose • Increase elasticity and layer differentiation of the deep cervical fascia, especially under (medial to) the SCM. • Reduce and reeducate SCM tonus by refining proprioceptive coordination of SCM engagement in movement initiation. Instructions • After other preparatory work, use gentle, specific, and static (not sliding) pressure medial and deep to the SCM. • Cue active client movements, as described below. • Monitor the client's comfort and ability to fully relax, and modulate pressure and pace accordingly. Movements • While maintaining SCM relaxation, the client slowly looks left and right with just the eyes. • Once the ability to move the eyes with relatively relaxed SCM is established, add slow, gentle neck rotation, looking for ways to move the head without overcontracting the SCM. • Possible cues: "Let the back of your head turn as much as the front," "Leave your head heavy," "Use your eyes instead of your muscles to start the movement," etc. • Repeat with the client sitting or standing. Homework • Practice head rotation with relaxed SCM when side-lying, seated, and standing, with special attention to initiation of movement without overcontraction of the SCM. For More Learning • "Neck, Jaw & Head" and "Whiplash" in the Advanced Myofascial Techniques series of workshops and video courses. • Advanced Myofascial Techniques, Volume 2, chapters 8–10 (Handspring, 2016). Start with your client side-lying, without a pillow if that's comfortable, as this allows you to work the upper SCM in a slightly lengthened (eccentric) state (Images 4 and 5). Because the technique does not involve sliding on the skin, too much oil or lubricant will make this technique difficult to perform. Follow the video link and the instructions on page 109, and pay special attention to gentleness, patience, and increasing client awareness, rather than just on tissue effects alone. Finish by repeating the technique in a seated position to help the client apply a new awareness to an upright posture. Performed correctly, this technique will leave your client enjoying lighter, easier, and more comfortable movement. Notes 1. C. M. Shifflett, Migraine Brains and Bodies (Berkeley: North Atlantic Books, 2011). 2. Yvonne Chan and John C. Goddard, K. J. Lee's Essential Otolaryngology, 10th ed. (New York: McGraw-Hill, 2012): 559–60. 3. Topical Issues in Pain 3: Sympathetic Nervous System and Pain, Pain Management, Clinical Effectiveness, ed. Louis Gifford (Bloomington, IN: AuthorHouse UK, 2013): 34. 4. A. Stecco et al., "Ultrasonography in Myofascial Neck Pain: Randomized Clinical Trial for Diagnosis and Follow-Up," Surgical and Radiologic Anatomy 36, no. 3 (April 2014): 243–53. Til Luchau is a Certified Advanced Rolfer, the author of Advanced Myofascial Techniques (Handspring Publishing, 2016), and a member of the Advanced-Trainings.com faculty, which offers distance learning and in-person seminars throughout North America and abroad. Contact him via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. 4 The SCM Differentiation Technique involves delicate, comfortable, but specific finger placement around the medial border of the SCM, feeling for fascial elasticity and differentiation between the muscle and its underlying structures. Use active client eye movements, followed by slow, active neck rotation, all the while monitoring the client's ability to leave the SCM largely relaxed. Images courtesy Advanced-Trainings.com. 5

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