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A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 33 "I get true migraines, primarily on the left, about three or four times a month. The daily headaches are tension headaches in the back of my head and neck, and down my shoulders." I instructed her to lie supine on the massage table. I began by exploring the cervical musculature, starting with the splenius and semispinalis muscles. She reported these muscles as quite sensitive. While I could tell by her response that she wanted me to stop and direct my focus there, I informed her that I would rather take an inventory of multiple muscles first, before concentrating on any one area. As I moved to the shoulders, I could sense her shift, in either pain or anticipation. "I know you are going to find lots of problems there," she stated, as I moved toward the upper trapezius. I indeed found multiple areas of sensitivity in the right trapezius. In fact, too many. Examining the left trapezius, I found just as many sensitive areas as I did on the right. Resisting the urge to focus on the obvious, I went a different direction. Palpating carefully and slowly, I examined the masseter attachments under the maxilla. Mrs. E. winced noticeably. "Wow, that's surprisingly tender," she said with surprise in her voice. Finding several areas of sensitivity in the masseter, I moved to fully explore the temporalis. Several areas were exquisitely tender, all of which were surprising to Mrs. E. "Why is that so tender?" she asked. "Do you think that has anything to do with my headaches?" "It very well may," I responded. "With your permission, let's try something. I'd like to treat the muscles of your jaw very thoroughly, first inside the mouth* and then repeat the external treatment again." While it is well known cervical muscles can cause headaches, it is less well known that muscles of the jaw can cause sensitivity in the neck. Mrs. E. agreed, and I could tell she was very intrigued by the process. We found several very sensitive areas of the masseter and temporalis during the intraoral treatment, but the improvement was remarkable. After repeating the external treatment of the masseter and the temporalis, I returned to the neck and shoulder muscles, which were markedly better. Mrs. E. had a surprised look on her face. "I've never had less tenderness in my neck and shoulder muscles. Why is that?" she asked. "While it is well known cervical muscles can cause headaches, it is less well known that muscles of the jaw can cause sensitivity in the neck. That is quite possibly true for you, as your neck sensitivity diminished without directly treating it. There is good science behind this, but the proof is in the pudding. Let's not treat anything else today and see what happens." The results were indeed stunning. I saw Mrs. E. 10 days later; she had not had a single headache since our initial session, and that progress has been sustained. She experiences an occasional migraine, but the daily tension-type headaches have almost completely disappeared—a significant change in her quality of life. Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars, president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois, and president of the Massage Therapy Foundation. His clinic, seminars, and research endeavors explore the science behind this work. Visit, or email him at TABLE LESSONS *NOT ALL MASSAGE REGULATIONS ALLOW FOR INTRAORAL WORK BY MTs. CHECK YOUR LOCAL LAWS FOR SCOPE OF PRACTICE CONSIDERATIONS IN YOUR STATE.

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