Massage & Bodywork

September/October 2012

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trying to tell you to stop moving the body part in response to the joint inflammation. Also, the joint receptors are firing away, and because of the laxity of the ligaments, there is a loss of stability resulting in the muscle overcompensating to keep you from moving it. I also tell my clients that there is a pleasure center in the brain that is stimulated by the adjustment. The self-adjustment may work by releasing endorphins, the body's natural opiates, into the bloodstream. The endorphins find the pleasure center, and there is a profoundly good feeling produced following the manipulation. However, eventually OMS is created, developing a need to pump more and more endorphins into the system. At the same time, there is more of a contrast between the good feeling and the pain. The client becomes aware only that his neck is tense and hurting, not that he is hurting himself by perpetuating the addictive process. I attempt to instill in my clients is that they need to admit they have a problem. It may sound strange for a chiropractor to tell his patient that cracking the neck is the problem, but part of being a chiropractor is also knowing when not to adjust. Instead of a 12-step program, there is a two-step program, and the treatment is always the same. First and foremost, the client must stop self-manipulating the spine. All the ligaments and muscles are screaming to stop, and the inflammation is rampant. I tell my clients that ligaments are meant to stabilize the spine, not to be continually stretched and never given a chance to heal. It takes roughly four weeks to stop feeling constant pain, as it reduces by about 25 percent per week. During this time, the client may need anti-inflammatory treatment. (I suggest taking homeopathic muscle-relaxant medicine and applying ice to the neck when the urge to crack the neck appears.) It generally takes another four weeks to fully get over the need to self-manipulate, so the rule of thumb is absolutely no self-manipulating for two months. The first week is always the hardest, especially for those who work in front of a computer. I also try to wean my clients off of coffee during this time, because a stimulant can cause more nerve irritation and muscle tension. There are lots of work cues and postural stresses that will make the self-manipulator want to start cracking again, too, and they may also need a new pillow for home use. Another option is OPTP's McKenzie Cervical Roll, which can be placed inside the pillowcase of most conventional pillows. Step two is to get rid of the inflammation and spasm. Massage and stretching of the upper trapezius/levator scapulae, scalene, sternocleidomastoid, and especially the splenius cervicis musculature, is indicated. Long axis traction with postisometric stretching of those muscles also helps with trigger point therapy and muscle tension release techniques. During rehabilitation, it is OK for the client to stretch the neck, just not to go to the extreme range in order to elicit the crack. As massage therapists, your work with the client's soft tissues can relax muscles and relieve tension in the crack-addicted areas, helping subdue the client's urge to crack. After the first month of no cracking, the client's range of motion improves markedly and pain subsides; within two months, my guess is that your client will be happier, pain-free, and, best of all, no longer addicted to "crack." W. David Bond, DC, DNS, DAAPM, has been a practicing chiropractor in Southern California since 1988. He is the founder and director of the Essential Chiropractic Center in Sherman Oaks and specializes in chiropractic pain management and soft-tissue/myofascial treatments. Contact him at www.essentialchiropracticcenter.com. Visit the newly designed ABMP.com. Log in. Explore. Enjoy. 95 first

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