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Dr. Gangemi: Hey, this is Dr. Gangemi. In this Sock Doc
video, I want to talk about some common neck injuries and some neckaches and ailments that
many people get. Helping out today is Dr. Melissa
Weinberger from New York. Welcome to the studio.
Dr. Weinberger: Thanks.
Dr. Gangemi: Also known as my treatment room. I want to
discuss the neck today. A lot of people get whiplash
accidents, or something traumatic done to their
neck, or maybe they wake up with a good old crick in the neck as we like
to say down here in the South. You can't turn your neck
comfortably one way or the other. Or, you had an
accident, and next thing you know, you're having
some muscular dysfunction in the neck, or you had to wear
a cervical collar for a while because of the whiplash from a car accident.
Many people are stuck with these injuries for a long
time. They never have full range of motion again after these accidents, or they have
a headache, or some other reoccurring, daily
nagging problem ever since they got in that accident, that nobody's ever
been able to fix.
We're going to talk a little bit about self assessment, or how you can maybe look into
some other ways to check out some trigger points in the neck
muscles, and where the muscular issues might be coming from. To start
with, when you have whiplash, and you have this flexion
extension type of injury where your head goes back,
especially if you didn't have your headrest at
the right spot if you're in your car. Then as your head comes
back, it snaps forward at the neck flexor muscles, they engage
to try to center you back, as a counter reaction to
the force of however you fell. A lot of people end
up straining the muscles and the tendons and the
ligaments in the front of their neck, even though the back of their neck
might be where it's hurting.
Nobody wants to go in and actually check out the
trigger points in the front of their neck because
they're afraid of the carotid arteries, and other
arteries, and nerves in here, and just hurting someone. Obviously your
throat and your esophagus are in there, and choking them.
You don't often see massage therapists or other
practitioners, unless they are very skilled, want to go in and actually treat the front
of the neck muscles. That's actually the one thing you often need to do
to relieve a lot of these problems and correct them once
and for all.
You can put your arms up like this, and then she's
going to lift her head up and turn to one side. Let's
say that was hard for her to do, and so this is
her sternocleidomastoid muscle, pretty much your major neck flexor. If
that was hard for her to do, we're going to take a note of
that and look into how to relieve some of that pain. Or
if she turned to the left, and if the same thing
happens. So in other words, if her head is shaking, or if you do
this and your head is shaking, and you're unable to turn comfortably,
or this neck muscle is not firing properly, then
what you're going to want to do is assess this
neck muscle. I'm going to show you how to treat the
trigger points in here. Also, you can just look straight up, and if someone
has a problem while they're lying on their back, looking at their feet, then we're going
to look at these muscles in the front. I'm going to
show you how to do that after, but first she's going
to turn over.
Similarly here, you're going to put your arms up. So
this is what you'll be doing at home. Put your arms
up like this. She's going to look straight up, like
looking forward. What you're going to want to do here is not raise
your shoulders too much, so you keep your shoulders down
but lift your head up, and then turn it in to one
side. If you're having trouble keeping your neck up here, or if these neck muscles hurt
here, we're going to look at the right posterior side. If she turns
to the left, then the left posterior side here in the neck, okay?
Actually, I'm going to start there, and you can put
your head down for a second while you're here. Typically, if you have pain in your neck while
you're lying prone, face down here, and if you lift up and turn to one side
like she just did. Although that's these muscles in the back of your neck here, usually
you're going to find the trigger point somewhere lower down
on the back here, usually in the rhomboids or the mid or lower traps, or
even the lats. You're going to look somewhere in
this area, again, for these muscles here on the same
side.
So, if she lifts her head up and brings her arm back
up, and turns to one side, and if it's hard for her
to do that or if it hurts, what you're going to do
is look for trigger points down here. Put your head down. If you have a
friend helping you out on this, they can kind of poke around
here and look for a trigger point and work them
out. Or, if it's you, then what you can do is you
can use a ball or something. Sit up for a second. Or, I've
been using these Massage Blocks recently from a guy who makes these
cool little devices that help with trigger points,
and she would put this down on something flat. Let's say this was the left back side of her
neck here, where if she was having problems with,
then she's going to look for that trigger point somewhere here in the left
side of that mid-back... and work out that trigger
point there. Just enough for comfort. She can just lay on
it and see how it feels. You kind of feel it working the muscle, right?
You would just pull the trigger point there, and work out
any tight muscle you're going to feel in your mid to
lower back, or her mid thoracic area, I should say, in here for any neck extensor type problems.
You're not going to actually work any of these muscles in here
for the type of pain that I'm talking about, but go down here.
Again, you can use a tennis ball, you can use a golf
ball, or whatever you'd like.
So then, for the front of neck muscles. When she was
laying on her back and she had her head up, and
it was the big, more meaty, head rotation type
muscles, if that's what's straining you as you're lifting your head up
and turning to one side, then what you're going to do is
look for the trigger points here in these muscles. All the way down to where it attaches
to your sternum and your collarbone. One thing you
can do is actually just pinch the muscle like this, and look for any
tender spots. If I'm doing that on myself, that shouldn't be
tender at all, and if it is then you just hold it. If
you're doing it to someone else, be careful, or have them do it
themselves. Just like that. Really, none of them should be
too tender. You could do them both together, and see
how they feel. If you're on the muscle, there's no
problem, just be careful that you don't dig in too much.
You could hit one of your carotid arteries and get a little woozy.
The other things you can do, even though you've got
to be really careful, you could just come down in a
broader sense on these neck flexors on either side. Especially just the inside of that sternocleidomastoid,
again, SCM, and see if there's any tender spots in
here. Again, on the same side that you had a problem with
as you were lifting and turning your head. So
you're turning your head to one side, and it's that opposite
front neck muscle, okay?
A couple of other things to mention. With neck
problems, a lot of people have shoulder girdle instability. I talk all about this in the
shoulder video, and look for subscapularis type injuries.
That's that muscle underneath and in the front of your scapula,
your shoulder blade here, sort of your armpit. If
you go in and poke in there, it'll a lot of times
relieve a lot of scapula pain that might be throwing this whole
area off, actually causing you to have neck pain. So that's in
the shoulder video, on how to assess your subscapularis
muscle. Again, maybe referring pain to your neck.
The last muscle I want to address is the one called
your lavetor scapulae, which goes from the back of
your neck here, to the top of your shoulder blade, and actually does this type
of motion, like that. A lot of people think they're getting upper trap pain,
like tenderness and tightness from maybe sitting
at the computer too long, but it's actually their
levator scapulae muscle. Where you want to correct
that, if you want to stand up and turn around, is you would have somebody,
or you can kind of get yourself. You bring your fingers
to the top of your scapula there, and look for
tender points here, or, on the back side of your
neck here. That's if you just have pain moving your scapula, your shoulder blade,
like that, up and down, like shrugging your shoulder.
Come here and poke in your neck. Do you want to
show them how you would do that, like for a trigger
point? So there, on the top of the scapula, or here in the neck. Any
tenderness in there, and sort of just rub it out. That
would be more like you have a sore neck. So more
so there for that scapula, rather than if your
head's back. Again, that's going to be more in the mid back.
The other thing, real quick, for people who, like
I said when I started. If you ever wake up with neck
pain, or you wake up and you can't turn your neck,
you think you slept wrong. A lot of people think they woke up and
they slept wrong for whatever reason. It's usually, as long as
you slept in your same bed and not on someone's couch or on the floor in a weird position.
Typically if you wake up with neck pain, it's actually
from something you did the night before, usually
what you ate the night before. So think about what you ate, maybe you went
out to eat, if you drank too much alcohol, if you had some
fried foods, a lot of processed foods, sugar, that
sort of stuff. That's the number one reason why someone
wakes up with a stiff neck in the morning. It's how that food is now
affecting your digestive tract, it puts a lot of stress on
the spine from the weight in the belly, and actually unfortunately tracks the cervical
spine downward and puts a lot of tension on those
tendons and ligaments of the spine. So you end up with a stiff neck in
the morning.
So, that's how you check it out and treat it, and
hope it helps. Thanks for helping out.
Dr. Weinberger: Sure.