Massage & Bodywork

SEPTEMBER | OCTOBER 2017

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Weakness in the longus colli is common, and this muscle is often affected by whiplash injuries. Poor postural control and cervical stabilization may result and contribute to chronic hypertonicity of the sternocleidomastoid and anterior scalene muscles as they attempt to compensate. In extreme cases, cervical instability and symptoms of vertigo may occur. Dysfunction of the longus colli is observed as forward-head posture with associated hypertonicity, adhesions, and trigger points in the compensating muscles. Clients also demonstrate difficulty or inability to perform segmented cervical flexion against gravity without thrusting the chin forward. Manual techniques that address the compensatory pattern, as well as the underlying injury to the longus colli, help restore function. In some cases, referral for neuromuscular retraining and therapeutic exercise may be necessary for maximal recovery. Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at christy_cael@hotmail.com. Editor's note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice. 46 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 7 FUNCTIONAL ANATOMY Resources Liu, Xiao-Ming et al. "Does the Longus Colli Have an Effect on Cervical Vertigo? A Retrospective Study of 116 Patients." Medicine 96, no. 12 (2017): e6365. Physiopedia. "Deep Neck Flexor Stabilisation Protocol." Accessed July 2017. www.physio-pedia.com/Deep_Neck_Flexor_Stabilisation_Protocol. Client Homework: Deep Flexor Activation 1. Lie on your back with your knees bent, feet flat, and head slightly supported. 2. Keep your neck elongated and your jaw relaxed as you tuck your chin and look downward. 3. Attempt to lift the head by leading with the forehead and keeping the chin tucked. 4. Hold the position for a few seconds, then gently lower your head back down. 5. Completely relax the neck muscles, then repeat. Palpating Longus Colli Positioning: client supine. 1. Sitting at the client's head, locate the sternocleidomastoid with the fingertips of one hand. 2. Slide the fingertips medially into the space between the sternocleidomastoid and the trachea. (Caution: the thyroid gland and carotid arteries are located in this region. To avoid causing the client discomfort or damaging these structures, be careful to palpate just medial to the muscle.) 3. Curl the fingertips and palpate deep against the vertebral body to find the vertical fibers of the longus colli (between C1 and T3). 4. Have the client gently resist flexion of the neck to ensure proper location.

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