neck massage by day, neck brace by night?

[Merry]

this is a less a question about the quality of my treatment (which was, of course, perfect, smile) than about the effect of a neck brace on treatment outcome. i had a recent client with severe neck pain on the left--lev scap seemed to be the cause. He was going to a chiro who was adjusting him, though he didn't feel better. He'd had it perhaps a month. Was having great difficulty turning his head to the left or right because it caused too much pain. The chiro had given him a neck brace that he was wearing at night to stabilize the neck so it wouldn't feel pain in the middle of the night. He was trying to lie on his back at night, with the brace.

I worked the lev scap along with other relevant cervical and shoulder muscles (not pecs though) and because of what I felt release expected him to feel some distinct relief immediately. He felt great when he got off the table and later that night, but the next day he felt terrible again. He came back a week later and his neck felt worse to me than the first time--so tight I couldn't get access to the deeper muscles. I do understand that if I missed some of the important muscles they may have pulled things back out of whack --I'm just wondering if it's also possible the neck brace somehow undid my work from the first session. Any thoughts? Thanks!

 

[paladin]

p,s,

(I'm a new therapist--someone with more experience may have been able to access the deeper muscles during the second massage. I referred him out after the second massage.)

 

[animation videos]

Sanantonio,

Did you also try to release subscapularis? Have had several clients with similar problems to your client's and have had moderate success getting further in releasing the area when working with subscapularis, pecs major and minor, rhomboids, teres major and minor and the serratus groups as well.............. just a thought.

J

 

[I am Poppy: TTC #2]

These days, immobilization can be considered harmful in many aspects. I have read from many sources, but can only find two right now in my library but I'm sure I could find more if I looked.

In 'Rehabilitation of the Spine' there is an article by Craig Liebenson (he studied neurology and manual medicince with Karel Lewit and Vladimir Janda) in which he writes

"prolonged immobilization results in compromise of the musculotendinous, ligamentous-articular, osseous, cardiovascular and central nervous systems."

" Prolonged immobolization after an injury can lead to scar tissue formation and lowered fatigued tolerance of injured tissues"

The article continues with reference made to studies showing prolonged immobilization actually interferes with the natural healing processes. It is indicated but only for short term.

The other source I found was in 'Manipulative Therapy in Rehabilitation of the Locomotor System' by Karel Lewit. In it he states that in "acute lesions of the locomotor system, muscle spasm clearly indicates that rest and immobilization is required. .... Immobilization itself becomes a problem, however, once a condition becomes chronic, and if we aim at full recovery immobilization presents an outright obstacle."

It would seem to be the case with your client that wearing the brace long term is actually impeding his progress. Since we are only massage therapists you certainly can't tell him to go against his chiropractor's wishes. However, you could present him with the research and let him make his own decision.

It would be great if you could present it to the chiropractor and you can discuss it together but it is rare (in my experience) to find a chiropractor who is open minded to listen to the findings of a massage therapists or anyone who hasn't had the extensive training in the medical field.

 

[Keith]

Is there structural damage such as a whiplash injury or something that is causing the need for a brace? I was in a severe car accident that caused some pretty serious injuries to the ligaments and tendons in my beck and a neck brace kept me sane, and surgery free (they WANTED to put three pairs of pins in my neck - Um NO! I'm 17 - leave my neck alone! *laughing*).

Chiropractic kept me in line for a short time only because of the damage, massage therapy help my soft tissue from developing damaging scar tissue as I healed and pilates/yoga/strengthening exercises were the other leg of the tripod that STRENGTHENED my neck (and back and core)to finally enable me to be pain free. It took about a year before I slept all night without waking up in pain.

But - blast it all - I didn't have to do the surgery and NOW 10 years later I feel great and have NO rom restrictions in my neck that the pins would have created (at the minimum).

But it really did take all three pieces to make the final difference - alignment, tension relief and strengthening.

Blessings,
Angela <

PS The neck brace was for me, for six weeks, my hated love - I HAD to have it. I despised it.

 

[mindtrap]

Thank you so much everyone. SUCH thoughtful responses. Anastasia, I realized when you wrote that twice now I've had this experience with someone with a month or longer lev scap problem-- I worked the muscle groups closer to the pain on the first session and, when there wasn't relief, I only got to the pecs and other 'peripheral' muscles in the second session. Wondering what I've been thinking.

Angela, I don't think there's been any structural damage; he only keeps it on at night to keep the head from turning side to side, which causes the pain, which wakes him up. So glad your neck got the care it needed!

kathryn, what sueforum.xxx resources--thank you! In the chiro's defense, the client is only wearing it at night so that the pain doesn't wake him up or have him tense up. I just have had good luck with necks, and I realized when he said he'd worn the brace that night (despite the neck feeling less pain), how contrary that was to my image of his neck releasing overnight, both in response to the massage, and also as he lies on his back and compensates from daytime hunching.

Thanks so much! I feel closure .

 

[jayant]

Thank you so much everyone. Such thoughtful responses. Anastasia, I realized when you wrote that twice now I've had this experience with someone with a month or longer lev scap problem-- I worked the muscle groups closer to the pain on the first session and, when there wasn't relief, I only got to the pecs and other 'peripheral' muscles in the second session. I'm going to stop that! Thanks--I'll be more thorough next time.

Angela, I don't think there's been any structural damage; he only keeps the brace on at night to keep the head from turning side to side, which causes the pain, which wakes him up. So glad your neck got the care it needed!

kathryn, what sueforum.xxx resources--thank you! In the chiro's defense, the client is only wearing it at night so that the pain doesn't wake him up or have him tense up. I just have had good luck with necks D), and I realized when he said he'd worn the brace that night, how contrary that was to my image of his neck releasing overnight, both in response to the massage, and also as he lies on his back and compensates from daytime hunching.

Thanks so much! I feel closure. :