Clients are treated daily for numerous symptoms resulting from cervical trauma. Some of the diagnostic terms assigned to cervical conditions by the medical doctors and chiropractors include:

* hyperflexion/hperextension of the neck
* neuritis due to disc displacement
* cervical sprain/strain, cervicalgia (neck pain)
* cervical disc degeneration
* torticollis
* cervical myoFasciitis
* subluxation of cervical vertebrae
* injury to cervical nerves
* vertebral artery
* compression syndrome
* nerve root degeneration
* neuralgia
* fibromyalgia.

Whether due to auto accidents, sports injuries, work related injuries or general life patterns, the clients all have pain as a result. Usually pain from cervical conditions is not limited to just the neck. The whole body can be involved, and the treatment protocol takes this into consideration.

One of the most common areas of the body affected by neck problems is the head. Headaches, TMJ, sinuses, bells palsy, fascial tics, and neuritis of fascial and cranial nerves are commonly seen accompanying neck problems. The cranial bones usually are compressed, and their rhythms are distorted. Consequently, soft tissues are tightened, nerves are impinged and the mandible (jaw) is misaligned. The cranial compressions can also impact other body structures. The temporal bones are usually rotated resulting in distortion of the iliums. The occiput is usually tilted posteriorly and locked down on the atlas/axis resulting in local inflammation of soft tissue, nerve impingement, muscle spasm, a shortened dural tube, and locked distortion of the sacrum.

Chiropractors and osteopaths adjust the alignment of the vertebrae and other bones, but are limited in soft tissue corrections. One reason for this is that the soft tissue which is involved with every misalignment is normally not addressed. The position of every vertebra is affected by muscles, ligaments, tendons and other connective tissue.

There is an abundance of evidence today to support the contention that most neck injuries primarily involve soft tissue. Soft tissue damage in the neck can result in: acupressure points blocked from normal function, fibrous scar tissue, spasmed muscles due to misalignment, pain in trigger point referral zones, ischemia and the resulting waste products, inflammation of tissues and nerves, structural distortion caused by spasmed muscles and tightened connective tissue, nerve entrapment caused by tightened soft tissue, overstretched/overcontracted soft tissue (muscles, tendons, ligaments, fascia, and nerves), torn muscle fibers and fascia, and splinting of soft tissue to immobilized injured areas.

The treatment protocol for the neck takes into account the doctor’s diagnosis, the client’s subjective reported symptoms, palpation exam, body reading and applied kinesiology. The doctor provides the medical diagnosis and any contraindications, and is consulted when questions arise. The client defines the location and type of pain, describes how the injury occurred and its immediate effects, and demonstrates his or her emotional state through conversation and body language. The palpation exam allows the therapist to locate and evaluate painful areas as well as check the range of motion to assess which muscles and soft tissue restrict movement. Body reading allows the therapist to identify the stuructural misalignments of the neck and in the rest of the body. This is important because without noting this, the therapist could only work sore areas that could actually increase structural misalignment, especially if the soreness is due to soft tissue compensating for a misalignment.

I have found that the best therapy for head, neck, and shoulder combines structural cranial techniques; acupressure; trigger point therapy; milking effleurage strokes that reduce swelling, inflammation, and ischemia; directed myofascial unwinding to release the holding patterns; and individual fiber strokes that release fibrous tissues including myofascia, scar tissues, and adhesions. The ultimate goal is normalizing the structure of the neck, which provides improved function leading to successful rehabilitation.

Structural Cranial Techniques decompresses the cranium, mobilizes the occiput/atlas/axis, releases the sphenobasilar synchondrosis (SBS) torsion responsible for the core distortion which is found throughout the body and is related to all neck problems, reduces the distortion found with TMJ problems, and starts the unwinding of tightened muscles and emotional holding patterns. It has been my experience that cranial compression is involved with nearly all headache pain.

Accupressure reestablishes normal energy flow throughout the head, neck, and shoulders to facilitate healing damaged tissues; mobilizes energy that has been blocked creating hyperconstricted tissues; reduces pain along the meridian pathways; mobilizes emotional energy that has been blocked by soft tissue; increases muscle function; decreases stress; decreases inflammation; and releases spasmed musculature.

Trigger Point Therapy reduces trigger point pain and pain in the trigger point referral zones; reduces inflammation and swelling; reduces ischemia; reduces spasmed musculature; and lengthens shortened muscles.

Milking effleurage strokes prepare tissues for deeper work; relax stressed muscles; lengthen shortened muscles; mobilize superficial fascia; flush fluids and toxins (ischemia); and reduce inflammation, pain, and muscle sensitivity.

Directed Myofascial Unwinding initiates myofascial release of myofascial holding patterns as they relate to the overall structure, groups of muscles, and individual bunches of muscle fibers within a muscle. Since this myofascial unwinding is directed, the therapist is able to be selective about the structural results. Consequently, the therapist is not limited by the randomness found when no direction is given to the body as it unwinds. It has been my experience that random myofascial unwinding does not affect the most restricted and bound tissues, while the less restricted tissues mobilize quickly. Optimum effectiveness occurs when the treatment goals include efficiently releasing the tightest restrictions, which are usually core to the problem. This is accomplished with directed myofascial unwinding.

Individual Fiber Strokes release the chronically shortened myofascial fibers that hold distortions in the structure, limit the range of motion, and severely restrict proper function of the muscle. These fibers include scar tissue, adhesions within and between muscles and layers of fascia, bunching and thickening of fibers around muscle attachments, and bunching and thickening of tissues around joints.

The combination of all these therapies effectively addresses and treats the myriad of neck problems presented by the clients, and are incorporated in the treatment protocols.

Treatment Goals
* Normalize structure of neck
* Normalize trigger points, trigger point referral zones, and related contractions of muscles
* Mobilize cranium including the occiput and OM (occipital/mastoid) sutures
* Mobilize splinting immobilization
* Increase range of motion
* Diminish ischemia, fluid, and inflammation
* Release muscle spasms
* Release nerve entrapments from adhesions, spasms, and scar tissue
* Normalize energy flow through acupressure meridians
* Increase energy flow through damaged tissues for healing
* Release character armor
* Reduce client’s emotional charge
* Alleviate client’s pain

Clients generally report immediate improvement of acid reflux or hiatal hernia symptoms after just one session. This improvement may be reported as less pain and discomfort, less intense or fewer occurrences, or a general calming of the area. I usually work one session per week until the client is symptom free for a week, then schedule for 10 days until symptom free, two weeks until symptom free, and space out accordingly after that.

- Don McCann, MA, LMT, LMHC – founder Structural Energetic Therapy, Inc.