or by pain upon inhalation, as the scalenes assist breathing by elevating the first two ribs. Treating the scalenes can be done with deep tissue, directional massage, hot stones, myofascial release, stretching, and trigger point therapy. Therapists can apply deep tissue massage to the scalenes with a thumb or the first two fingers, working from insertion to origin. As with the SCM, deep tissue, directional massage, myofacial release, and trigger point therapy (if trigger points are indicated by pain to the upper arm or thumb and index finger) for the scalenes should be done from the head towards the body, although it is not expected that the insertion at the ribs will always be reached, particularly if an athlete has well-developed upper trapezius or pectoralis muscles. Particularly tense scalenes are a prime candidate for the application of long, flat hot stones to reduce tension. Any stretching technique is also suitable for the scalenes, although CRAC stretches are particularly beneficial since CRAC stretches utilize opposing scalene groups to relieve their own tension. The upper trapezius muscles originate at the occipital protuberance and medial superior nuchal line and insert at the spine of the scapula, the acromion, and the lateral one-third of the clavicle. In relation to other neck muscles, the upper trapezius muscles are strong, and it is uncommon for them to be sprained or strained. When a strain does occur near the trapezius muscle’s origin, the injury is actually to the suboccipital muscles, which are much weaker. However, the upper trapezius can become extremely tense due to their long and broad nature. Tension in the upper trapezius is best treated with petrissage, hot stones, and trigger point therapy, with petrissage and hot stones targeting the belly of the muscle. Conversely, trigger point therapy (if trigger points are indicated by pain in the posterior neck or temples), will usually be found near the insertion at the acromion and lateral third of the clavicle. Levator scapulae, below the upper trapezius, originates from the transverse processes of C1 to C4 and inserts at the superior angle of the scapula. Among other actions, the levator scapulae unilaterally flexes the head and rotates the head to the same side. This muscle can be treated with directional massage, myofascial release, trigger point therapy, and some stretches. Once again, directional massage and myofascial release will be done from the head towards the body. Trigger point therapy may be more beneficial, though, as trigger points are exceedingly common near or at the muscle’s insertion. Stretches for the levator scapulae should involve mostly passive stretches, as AC Concussion Concussions result from a blow to the head and are common in contact sports. Although there are several grades of concussion, the general symptoms include amnesia, confusion, difficulty concentrating, depression, disorientation, dizziness, headaches, fatigue, feelings of lost time, a loss of balance, pressure or pounding in the head, sensitivity to light or noise, tinnitus, nausea, vomiting, and vision problems. In some cases, a concussion will be accompanied by a loss of consciousness, though a loss of consciousness does not necessarily indicate more severe symptoms. Due to the number of symptoms involved with a concussion, it is not always diagnosed. However, athletes who suspect a concussion should be diagnosed by a physician as undiagnosed and untreated concussions often increase the chance of returning to their sport and suffering a secondary concussion which may be more traumatic to the brain and possibly even fatal. Among the massage techniques listed in Section I, none will provide any specific relief for the symptoms of a concussion. Craniosacral massage therapy, in which the large bones of the skull (the frontal, parietal, occipital, and temporal bones, Delayed onset muscle soreness This condition is considered less of an injury than a byproduct of the effects of physical exertion, specifically, activity in which muscles are contracted through what would otherwise be a muscle’s relaxing, lengthening movement. An example of this type of activity would be when a runner is running downhill or when a weight lifter is slowly returning to the start position of a bicep dumbbell curl. Delayed onset muscle soreness (DOMS)
and CRAC stretches involve the contraction of too many muscles to be practical, time management wise. Finally, the suboccipital muscles are eight muscles (four on each side) that lie just inferior to the skull’s occipital bone, deep to the upper trapezius. These muscles serve to rotate, extend, and laterally flex the head. By themselves, this muscle group is relatively weak, making it prone to sprains and strains. When these muscles are injured, the resulting pain is almost always accompanied by inflammation and is tender to the touch. (As always, avoid hot stones if inflammation is present.) The application of ice before massaging the suboccipitals will do much to ease the athlete’s discomfort when performing the necessary cross fiber friction along the inferior portion of the occipital bone and moving towards the mastoid process. Trigger points can routinely be found by applying finger pressure in this area (as if trying to reach under the occipital bone), which will result in a pain referral to the area behind and above the ear. The suboccipital muscles are not particularly well-suited for stretches. While it is not uncommon for neck muscles to be injured during competition, sometimes an injury is more serious and involves an injury to the cervical spine itself, such as a herniated disc. Massage therapists are only qualified to work on soft tissue structures such as muscles, tendons, and ligaments. Therapists should never attempt to fix a herniated disc by pushing the disc back into place. In such cases, therapists may either massage to relieve the tension in muscles surrounding the herniated disc or otherwise follow a course of action outlined by the athlete’s physician. Additional treatment and prevention NSAIDs will help alleviate the inflammation associated with a suboccipital injury. Kinesio tape has been shown to be a very effective aid for the upper trapezius and levator scapulae. Tension in the upper trapezius and scalenes can be reduced with the application of heat, such as a hot towel around the upper shoulders and neck. Cervical injuries are most common in contact sports such as football, hockey, and wrestling, as well as several non-contact sports such as diving and power lifting. It is estimated that among football players alone, a minimum of 10-15 percent of players will suffer a neck injury some time during their career due to the greater body weights colliding against each other at high velocity. respectively) are manipulated to help move cerebral spinal fluid through the ventricular system of the brain and spine, has shown some promise in preliminary studies to alleviate the internal pressure sometimes associated with concussion symptoms. However, craniosacral work for concussion victims should only be done by therapists trained in that modality. The best thing for athletes to do who have suffered a concussion is to rest, both physically and mentally. This includes taking time off from their sport and any invigorating or weight-bearing exercise, as well as avoiding tasks which require too much attention, such as school/ course work or playing video games. Additional treatment and prevention The athletes should take acetaminophen (Tylenol) for pain management and not aspirin or ibuprofen (Motrin or Advil); they should avoid blood thinning medications. Athletes should also avoid heavy meals with alcohol. Concussions are most common in contact sports such as football, boxing, hockey, and soccer. normally occurs when athletes change their training program or dramatically increases their training intensity. (DOMS is also very common in clients new to physical activity.) The abnormal stress of changes to a training program causes micro tears in the muscle fibers which often causes minor inflammation. Although medical research does not yet understand the precise mechanism for why this type of activity causes soreness and pain,
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Book Code: MTX1323
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