• Home
• Spinal Conditions
• Peripheral Joint
• Sports Injury
• Workplace Health
• FAQ
• About MCR

Subscribe

Rapid Upper Limb Assessment (RULA)

Neck and upper back pains are often attributed to poor posture. For most people, how do we tell if our posture needs attention? Thankfully there is a simple test you check yourself off.

Read more

Glutes and Piriformis Stretch

 

Neck-Related Headaches

Have you ever had the feeling that your headache is somehow related to the pain in your neck?  How that it is such a coincidence that every time your headache is preceded by the stiff neck that you are experiencing?  You are not imagining it! It is what the medical community calls cervicogenic headaches, which means headaches originating from the neck

What are the usual complaints from people who suffer from cervicogenic headaches?

Most sufferers complain of a deep dull ache starting from the base of the skull to the top of the head, usually over just one side of the head.  It may be present on both sides if the neck pain and stiffness are on both sides of the neck.  Other complaints include feeling pressure at the back of the eye and discomfort in the jaw. 

Another symptom that confirms the diagnosis is the presence of tenderness when pressure is applied over area of the cervical spine immediately under the skull.  In some cases, when pressure is applied for long enough, sufferers feel some relief from the headache.

What are some of the activities that aggravate this condition?

Typically, activities that require the neck to be in a sustained strained position for a prolonged period of time will aggravate this problem.  The neck posture is often faulty, the head is turned or tilted to one side or sufferer is adopting the “poke chin” position.

Example of such activities including reading, using the computer especially the laptop, putting on make up, looking up for too long or watching movies or theatre when seated on the side of the hall.

Why do these activities aggravate the headache?

When we adopt the “poke chin” posture, we apply compressive stress to the upper part of the cervical spine, namely, C1 and C2 levels (C1/C2 refers to the first two cervical vertebrae in the spine).  Similarly, when we turn our head to one side, we compress the C1-2 level on the same side.  This happens as most of the movement of the head occurs at these 2 spinal levels.   So if we sustained these postures or repetitively perform them, these 2 levels will start to degenerate and the cartilage wears out over time. This in turn results in stiffness of the upper cervical spine.

What is relevance between the C1-2 levels and headaches?

The nerves that exit C1-2 and sometimes C3 supply sensation to the back of the skull to the top of the head and in some people to the jaw area.  The nerves that exit from the right side of the neck will supply only the right side of the head, likewise for the left.

When these joints are stiff or mal-aligned, the nerves at the affected levels will be irritated causing pain. So when one has a right-sided upper neck pain or stiffness, the pain is always referred to the right side of the head.

What can we do?

We need to improve the cervical joint alignment and mobility at the C1-2 levels and to remove the compressive forces, which is to adopt good posture. This will reduce the irritation to the nerves.

If the cervical facet joints are slightly rotated due to contractile forces of tight muscles surrounding the neck, the affected joints are already in some amount of compression and may not allow full functional or physiological range.  In this situation, physiotherapists can apply the “MUSCLE ENERGY TECHNIQUE” to realign the joint position.  This technique uses the muscles to reposition the joint.

Once the joint is in a neutral position, the actual stiffness (hypomobility) can then be accurately assessed.  Stiffness can be treated by various techniques, such as passive mobilization through the MAITLAND technique or with the clients’ active movement with the MULLIGAN SNAG technique.  If the joints remain stiff even after a few sessions of mobilization, MANIPULATION can be applied.  Once the ideal mobility has been achieved, the client will be expected to maintain it by self mobilization with a strap.

Once the mobility is improved, the headache will be resolved.  The client can remain pain free for a long time provided the original cause of poor posture is solved.  Good ergonomics here is paramount.
 

 

 

Last and Ring Finger Numbness in Cyclists

Does your last finger and EXACTLY half of your ring finger feel numb or experience a tingling sensation? If yes, there is a good chance that your ulnar nerve (see diagram) is compressed.

Read more

Slam Dunking Starts at the Bottom

Can you jump higher when standing on the basketball court or on a rocking canoe? For most people, it is easier to jump higher when standing on firm ground. As a rule, the more stable the foundation, the higher you can jump. And that foundation includes your ankles.

The Kinetic Chain

The ankle is a part of a kinetic chain that forms from your foot, through your ankle, shin, thigh, and all the way to your hips. Power needs to be generated and transferred effectively through this chain, particularly in an explosive vertical jump, for maximum impact. A chain is only as strong as its weakest link. We generally tend to focus more on building the thigh’s explosive power and less on building the smaller muscles supporting the ankle. The muscle around the ankle is important, not so much for power generation, but for holding the ankle joint to ensure the best kinetic energy transfer. For higher jumps and more consistent play, we will take a look at injury prevention and management tips, and strengthening tips for the ankles.

Injury Prevention and Management

The first thing is not to get injured. Nothing causes performance deterioration faster than injury-related down-time. The ankle needs to be properly supported to withstand the rigors of the game. Ankle braces and supports unfortunately tend to be difficult to use as their thickness makes them uncomfortable to play in. One good option is to use sports tape. A rigid sports tape in a simple Figure-of-Eight pattern provides good support without excessively restricting movement. More complicated taping patterns may be too restrictive for play. And as tapes are quite thin, they are more comfortable to wear. Sports tape also play a role in proprioception, which is the awareness of movement derived from muscles, tendons, and joints. In this, sports tapes allow you to have a better sense of your muscle movement and exercise it accordingly during game time while preventing sprains in the process. It is possible to have strong muscles supporting the ankle and still get sprains if the muscles react too slowly to the changing environment like a fast moving basketball game; like a carfs air-bag going off after the crash.

If you do get an ankle sprain, apply the R.I.C.E.R principles – Rest, Ice and Compression Elevation and Referral. Don’t massage the area. Ice helps constricts the blood supply to minimizing swelling. Massage has the exact opposite effect to increasing blood supply. After which, your rehab specialist can start treatment to speed up recovery.

Strengthening Tips

Muscles supporting the ankle must be able do to two things – provide enough support (strength) and react fast enough when needed (proprioception)

Proprioception Training

The best way to simulate proprioceptive retraining, as well as work on range of motion and strength, is with a wobble board.

Strength Training

Plyometrics is a form of “explosive-reactive” power training. It involves powerful muscular contractions in response to a rapid stretching of the involved musculature. Injury can result from the incorrect use of plyometrics. So make sure you seek the advice of a professional who is trained and experienced in this method of training before starting on a serious plyometrics routine. Some common routines that are useful for basketball include Quick Feet Drills, Cross Jump Drills and Multi-directional Jump Drills.

Quick Feet Drills

Quick feet drills using a rope ladder are a form of plyometric activity. Sideways movements are functional for most sports.

Progressing to multi-directional patterns using the rope ladder, moving from left to right while contacting each square with both feet, then back, from right to left continuing the sideways pattern. The thigh muscles work to control the movement. This sideways exercise puts a controlled load through the ligaments of the knees and ankles

‘Clunking’ Shoulders - Part I

Clunking or clicking shoulder is a common complaint with swimmers where the shoulder ‘clicks’ when under strain. It is also common to other sports where the overhead arm motion is thrown repetitively with force like badminton, tennis and cricket bowlers. Inflammation is a symptom, not a cause. This shoulder condition is often misdiagnosed as a rotator-cuff impingement or tendinitis (inflammation). But this is not entirely accurate as rotator-cuff impingement is simply a symptom, not the cause of the problem. You will still need to find out what is causing the inflammation in the first place.

Read more

« Previous Page

Language Translation




Ask the Specialists

Should I get a massage immediately after a marathon?

It is increasingly common for organisers of long-distance endurance events to have ‘massage areas’ set up at the end of the race. Generally, at Strong... Read more »



If you have an question, feel free to drop us line. If the answer to the question is something more than a few people would be interested in, we will feature it.




Advertisement


 

• Popular Articles

  • Posterior Pelvic Pain (Sacroiliac Joint Pain) in Pregnant Women
  • Nerve Stretches
  • Myofascial Release
  • Pain Relief Medications: An Overview
  • Sports Taping - Knee
  • Sports Taping - Wrist
  • Iliotibial Band Friction Syndrome
  • Pregnancy - Changes and Aches
  • Lumbar Supports Not Particularly Effective for Low Back Pain
  • The Buckling Knee
  • Patellar Tendinitis
  • Sports Taping - Ankle
  • Lumbar Spinal Stenosis
  • Manual Therapy - Spinal Vertebra Mobilisation
  • Neck-Related Headaches
  • Hamstring Exercises for Long Distance Runners
  • Piriformis Syndrome - Sciatica
  • Does Bad Posture Lead to Scoliosis?
  • Shin Splints from the Periosteum
  • Whiplash - Part I

Musculoskeletal Consumer Review © 2007 - 2009 by Core Concepts Pte Ltd       Terms and Conditions | Policy

Musculoskeletal Consumer Review © 2007 - 2009 by Core Concepts Pte Ltd