Issue link: https://www.massageandbodyworkdigital.com/i/70551
This trigger point pain referral pattern is one reason why headache pain is common in office workers. The suboccipital muscles respond best to deep and specific static compression techniques. The position demonstrated in Image 2 is an effective position, but there are a number of other ways to access these suboccipital muscles. Muscle tightness in the cervical region can also contribute to distal upper extremity neurological symptoms because of nerve compression. When the scalene muscles become chronically tightened from forward head posture they can compress branches of the brachial plexus, producing neurological sensations in the forearm and hand. An office worker with neurological sensations in the hand is sometimes assumed to have carpal tunnel syndrome (CTS), but it is important to distinguish through assessment these conditions with similar presentations. Inadequate evaluation could cause ineffective or erroneous treatment. In this case, the symptoms originate from a problem in the cervical region, not a peripheral nerve in the hand. A key benefit of a more comprehensive soft-tissue treatment like massage is the value in treating the entire kinetic chain of the upper extremity. Recognizing the continuity of soft tissues throughout the entire cervical and upper-extremity regions and treating these is important. For example, in a client with forward head posture, there is almost certainly shortening of the pectoralis major and minor, along with other anterior shoulder girdle muscles that should be treated as well. Muscles of the cervical region that are under chronic isometric load may be treated effectively with techniques such as deep longitudinal stripping, myofascial approaches, pin and stretch, or static compression for active trigger points. Active engagement methods are useful for accessing the larger anterior shoulder girdle muscles. SHOULDERS Office workers often hold their shoulder muscles, along with the back and neck, in prolonged periods of chronic isometric contraction, which can produce trigger points throughout the upper back and arm. Trigger point pain referral patterns then cause pain in other areas of the upper extremity, which produces tension in these other muscles, making them more susceptible to overuse disorders. A cycle of tension, trigger points, and dysfunction can be produced that becomes a chronic, painful problem for the individual. Office workers often feel tightness in the upper trapezius 2 This is one of several effective positions for accessing the suboccipital muscles. and levator scapulae muscles, and these muscles are targeted for treatment to reduce the chronic tension. However, many of the other accessory muscles around the shoulder also play key roles in muscular complaints associated with office work. It is extremely common to find trigger points and chronic tightness in the teres minor, infraspinatus, subscapularis, teres major, and even serratus anterior muscles as well. Chronic tightness or trigger point activity in these muscles can often mimic other painful conditions such as rotator cuff tears or shoulder impingement. Tightness and muscle imbalance can lead to biomechanical dysfunction around the joint. Lack Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 105