Blog

How we develop neck pain

Xray computer pic

It’s that moment, totally engrossed in a project at work, that without you really noticing it a gradual tightness creeps into your neck.

Focused on getting the project out, you override the short-term ache, but are left at the end of the day with stiffness in your neck and irritability. A few projects later, and from nowhere you develop a cracking headache.  What to do, other than take a paracetamol and keep on going?

Stepping out to play a game of squash you tweak your neck and find yourself in agony. But how did all this start?

In our busy day to day lives, sending emails, working away at a computer all day, and kicking back to chill with Netflix in the evenings, it’s easy to forget how much we rely on our eyes. Out of all the senses, we now use our eyes the most, and the effect of this on our body health is huge.

Leading with our eyes

One of the commonest causes of neck pain is compression at the top of the spine, brought on by dominant eye focus.

If you want to know if you are an eye-dominant person, there’s a simple test.


The Eye Dominance Test

Step 1: Stand on one leg, & see how your balance is.

Step 2: Stand on one leg and close your eyes. If your degree of wobble increases, your balance is coming from your ability to fix on the horizon and not your body’s internal sense of balance and perception.


What are the implications of this?

The biggest impact of bringing the head forward is tension, pain and compression at the top of the spine. This is in the area where the top two vertebrae of the spine (C1 & C2) meet the base of the skull at the occipital bone.

OAA.pngThis structural pattern leads to:

  • headaches
  • neck stiffness
  • transferred pain down into the arms
  • pain around the eyes
  • pain on one side of the face
  • indirect lower back pain (as a result of counter balancing the head held forward)

Another key effect is the build up of pressure at the junction between the head and the body. One of the important anatomical structures here is a hole located at the base of the skull called the foramen magnum through which the nerves, spinal cord and blood vessels travel down from the brain to the body. When this hole is squeezed, these soft tissue structures are impacted and there is an effect on brain function, alertness and body regulation. This can all come into play, simply from this shift in daily posture and neck position.

How to bring about change

Fear not however as these areas of compression can be resolved. The body has a remarkable ability to change. One of the most effective ways of relieving your neck tension is through massage and physical therapy.

In my private practice, from my knowledge and experience in Craniosacral therapy and Myofascial release (a type of massage), I use a highly effective combination of gentle hands-on techniques to release these deeply bound constrictions. This brings about long lasting change – relieving stiffness, improving circulation and restoring pain-free movement. Cranio1

When working with clients, it is a delight to see these shifts over a number of sessions and the ripple effect it has throughout their lives.

If you would like to find out more or would like advice on the symptoms you are experiencing to see if you could benefit, please get in touch.

Why I love Craniosacral

Calm

“Craniosacral what?”

I came across Craniosacral Therapy 9 years ago now. Working as a Physical Therapist in Oxford, I would cross over with clients leaving their sessions in a deep state of relaxation which you could almost tangibly feel in the air. Out of all the complementary therapies, this seemed to be the one with a disproportionate impact. How could such a light touch approach bring such successful results?

Within my work as a Rolf Practitioner, I found that the greatest change occurs in clients when there is a listening through the hands, with previous trauma held within the tissue able to unwind. I became known as a gentle Rolf practitioner, (as this practice is infamously known to be excruciating), with a number of clients saying “hey this is like Craniosacral Therapy”. But it led me to think… what is this thing called Craniosacral?

Craniosacral TherapyCraniosacral Therapy

In a Craniosacral session, the client, fully clothed (and normally wrapped in a cosy blanket… ) lies on the treatment table. The practitioner places their hands typically at the feet, head or sacrum, and their light touch enables the client to let go.

My time training at The Craniosacral Therapy Education Trust in North London was a phenomenal 2 years learning about the natural mechanisms of the body and the way in which a re-charge and re-booting of the system occurs when we drop into a deeply relaxed space.

The practitioner’s role is to facilitate that process, which with tools and an in-depth knowledge on the physiological function of the body, can help the client drop into this slower rhythm of re-charge.

In this deeper state of calm, the underlying issues of tension and unease show themselves and are able to settle and re-balance.

Finding Calm

It is a beautiful process to witness. Re-finding the broader horizon in a physical sense and re-tuning to a bigger perspective has a phenomenal effect on the body and its health. The observations and lifelong work of Dr. Andrew Still, Dr. William Sutherland & John Upledger in the path of Craniosacral Therapy have been fundamental.

Its role and the finely tuned skills of Craniosacral Therapy provide a space for the body to re-regulate and optimise health in a gentle and non-invasive way. After learning these skills, it is a privilege to see the effects they have in helping support patients and their recovery following cancer (in working with Pauls Cancer Support Centre) and in supporting the re-adjustments for ex-military servicemen suffering from PTSD with Veteran Outreach Support.

This practice and body of research provides an essential resource for re-finding health, a place to re-balance, rest and re-store function within the busy lives we lead.

Waking the Tiger

One of the classic books on the processes underlying trauma “Waking The Tiger” by Peter Levine provides a comprehensive introduction to the mechanisms of the nervous system, and levels of response connected to “fight and flight”, and “freeze”.

Peter Levine

Peter Levine began his work in the 1960’s when he became interested in the mind-body connections. After graduating in medical biophysics, he spent time in Esalen, California, and met Dr. Ida Rolf (founder of Structural Integration) and Fritz Perls (founder of Gestalt Psychotherapy). In the early days, he was referred a patient who entered a deep state of relaxation, triggering a release process where she returned to the traumatic event and was able to access a fight & flight response, where previously she had been frozen. This re-regulation of the nervous system, led Peter Levine to develop Somatic Experiencing – a therapeutic method for re-regulating trauma.

This book provides a good introduction and foundation around understanding trauma, its symptoms and underlying processes, for both practitioners and anyone interested within this field.

Here’s a link to the book and further resources below.


Interview with Peter Levine in Psychotherapy.net in 2010

www.somaticexperiencing.com

Our relationship to pain

“Ouch that hurt!”

When sitting in the dentist’s chair earlier this week getting my braces adjusted, the twisting and tightening of the wire sent a wave of pain/intense sensation up from the top incisor teeth through the maxilla and front of the face.

In that moment of having pain “done to you”, I found actively pushing into the pressure counter-intuitively reduced the pain. Like a chipmunk hanging off a log by its teeth determined to never let go, it was this active pushing into the force that made the pain go away.

What is our relationship to pain?

Feet

Without it we are numb to the environment, it is one of the greatest warning signals we have. Look at conditions where a person has never been able to feel pain such as congenital insensitivity and the associated problems with that. Pain in some ways makes us alive, but how can we engage with it and can it paradoxically bring vitality and presence? Does it have a use?

From Peter Levine’s work in re-regulating the body following trauma, (see Waking the Tiger), he notes that individuals during the event that become active and find solutions when faced with life-threatening events, use the fight and flight response to naturally dissipate the high energy of the situation through the body during the event. In cases, where this does not happen the body can become stuck in either a “freeze” or “fight or flight” state creating long-term health conditions and symptoms of PTSD.

Meeting the pain

A recent talk with CLOD Ensemble on “Enduring Bodies” featured the immersive theatre work of Martin O’Brien. Martin suffers from cystic fibrosis and creates live and filmed theatre pieces of endurance and self-inflicting pain. He may use a scalpel to slice into his skin, or go through the ritual of coughing up phlegm for hours (as required in earlier treatment of his cystic fibrosis). He found that by actively engaging the pain shifted, he had a different relationship to it and a sense of regaining control.

It brings to mind the phrase “suffering is optional, pain is inevitable” (An ancient saying,  – the source undefined/disputed). It is said that suffering is only resistance to pain, the key to it, acceptance.

Pain pathways

In an article written by Colm McDonnell, he explores the effects of passive stretching versus active pandiculation (the contraction of muscles in a stretch), and the nerve signal pathways associated with these. In a passive stretch the nerve signal travels from the muscle up to the spinal cord, crosses the motor neuron synapses there and returns with an automatic response to the muscle to reduce the stretch.

In contrast in pandiculation the contracted muscle sends a sensory nerve signal through the spinal cord up to the sensory motor cortex in the brain. Here the response can be to increase or lessen the contraction and comes as a voluntary/conscious response from the body.

The role of pain in bodywork

In the Rolf Method of Structural Integration, it is known by many for being painful – partly from some of the infamous tales of people stumbling out of excruciating sessions at Esalen, California with Dr. Rolf back in the 1970’s. For me when I first received Structural Integration, a heavy handed approach caused me to tense, grit my teeth, block my diaphragm and shut down to Rolf Workget through the sessions. Needless to say there was very little change from those sessions.

In great contrast, I later came across a practitioner with a light and precise touch, and through the 10 series, experienced a very different opening up. Over the 10 sessions, I “grew” over 1.5 inches as my structure unfolded, seen in the photos before and after, and has led me to be known as a gentle Rolf practitioner.

Touch and pressure is a key level of interaction with the outside world. The amount of pressure is like the volume at which we speak. If we shout all the time it’s not so great, equally a constant whisper in some circumstances is not heard. It is about communication between client and practitioner.

In light of these more recent experiences in the dentist chair, an added factor comes across. The importance of engagement from the client and their nervous system from the inside out. Accessed not just through guided movement during session work, but a level of contact, engagement and possible muscle activation into the pain.

It opens up an exploration within bodywork and other physical practices (yoga, pilates), when we meet those dark, stuck, muddy places in our body, that alongside the release and silent watching, there are other options to play, wiggle, contract, move, or even dance into other areas of the body, to help our system flow through the pain and sensations which arise.

Research
Congenital Insensitivity: Science Museum London – Pain less Exhibition 2013
Waking the Tiger: by Peter Levine
CLOD Ensemble, Performing Medicine
Stretching vs. Pandiculation: What’s the difference and why does it matter? – Colm McDonnell

Relieving tension headaches

HeadachesThere are a number of types of headache:

  • tension headaches
  • sinus headaches
  • cervicogenic headaches (due to compression at the back of the neck)
  • migraines

Tension headaches are episodic and can vary in frequency.

What are you experiencing during a headache?

The brain itself can not feel pain, however there are pain receptors (nocireceptors) in the lining surrounding the brain tissue (pia mater) and the membrane that lines the skull and centrally divides the cortex (dural membrane, shown in blue on the diagram).

Dura mater

For tension headaches, pain registered in the layers of the pia and dura mater can relate to compression and reduced movement of the cranial bones.

The cranial bones are not fixed but instead exhibit micro-movement. These small movements help ensure the natural circulation of the cerebro-spinal and extracellular fluid in our body. In cases where there is asymmetrical movement of the cranial bones, such as at the sphenoid or temporal bones, a build up of pressure and imbalance can be felt. Through light touch the Craniosacral practitioner helps restore the balance, as the body re-regulates to its natural patterns of circulation.

Cranio1

Everyone is Unique

Tension headaches are the most common form of headache experienced in the UK (NHS Choices). Craniosacral Therapy is highly effective in helping lessen the symptoms of tension headaches.

However, we all have wonderfully different bodies, just because someone else has benefited from a therapy does not mean that your body will be the same and vice versa. The most important approach is to try a session directly and see if it works for you. The dynamics of the cranial bones and tension patterns behind the pain vary from person to person.

For those new to Craniosacral Therapy a set of 3 sessions is recommend to allow time for your body to fully respond.


Related Articles:
– Did you know that the cranial bones move?
– Easing Migraine Pain – John Upledger
– Can Craniosacral Therapy help with headaches?

Research
Tension-type Headaches: The International Classification of Headache Disorders
Bashaum (2014) – “If the brain can’t feel pain, why do I get headaches?” – Society for Neuroscience

Restorative Postures for relaxation

These tips have been featured on GOOD ZING – an online resource for health and wellbeing. For more advice from other health professionals visit: www.goodzing.com.

Here are 3 simple ways to help release and support your body, focusing on:

  • easing lower back pain
  • relieving compression in the neck
  • opening the chest

back-pain

1) Releasing the Pelvis

This can help ease lower back pain and re-balance the pelvis.

Time: 5 mins

What you’ll need: A chair which is a similar height to your knees.

What you’ll do: Lie down on the floor & bring your lower legs up to rest on the chair seat. Make sure you have a right angle between lower leg & upper leg, and your knees are directly above the pelvis.

After a few minutes, the natural effect of gravity gently relaxes the pelvis. Recommended time 5 -15 mins.


dsc_0289

2) Relieving compression in the neck

This a wonderful gentle stretch for relieving tension at the top of the neck. You may have been working hard at a computer for a number of hours or be suffering from a mild headache, by creating gentle pressure from a tightly rolled towel and the natural weight of gravity, you can elongate and help release this area to restore balance & calm.

Time: 5-10mins

What you’ll need: A tightly rolled towel (approximately 5cm in diameter)

What you’ll do: Lie down on a yoga mat or a clean hard floor. Bring your knees up, with feet on the floor, so that your lower back is supported. (An alternative is to support your knees with pillows).

Lift your head, bring your chin towards your chest (this helps lengthen the back of the neck) and place the rolled towel under the base of your skull (where the back of your head meets the top of your neck).

Sometimes this area can feel tight and slightly tender. Let your head rest and gently release over a number of minutes. It is important for the towel to be rolled tight so that it provides gentle but firm pressure. You may like to adjust it as your neck lengthens.

If you feel a sharp pain at any time, please consult your Doctor.


stress

 3) Opening the chest

Time: 10-15mins

What you’ll need: A towel rolled length ways (approximately 5cm in diameter and 0.8m in length).

What you’ll do: Lie down on a yoga mat, with your knees raised and feet on the floor. Place the rolled towel underneath your spine (from the tail bone to the neck). Lower your weight down on to the rolled towel, making sure that it supports and runs along the spine.

It will bring gentle pressure along the spine and raise it. The shoulders & sides of the torso relax down to the floor with the weight of gravity, creating a slight opening in the chest and front of the body. This is good for gently increasing breath and calming anxiety.


If you found these useful, please share. You can also find out more tips on health & body mechanics from the newsletter – Expression of Health Newsletter.

Endometriosis, Fibroids & our female body

Recent awareness around health conditions affecting the female reproductive system have been highlighted in the press this week.

Firstly with accounts and individual experiences of women going through endometriosis, and secondly experiences from fibroids.

BBC Newsbeat: Endometriosis treatment “unacceptable”

BBC: “Fibroids: I worried I might not be able to have kids”


Endometriosis: is when the tissue that forms the lining of the uterus, the endometrial lining, grows in other areas of the pelvis. It can cause pelvic pain, abnormal menstrual cycles and infertility.

Fibroids: are benign tumours of the uterus that can grown in various locations on and within the uterine wall or in the uterine cavity.


Both of these conditions do not have a set cure and the experience of them can vary depending on the individual, location of the condition & its level of development.

Raising public awareness is a brilliant step forward, as frequently these experiences can be swept under the carpet, in the same way that conversations and awareness around menstruation is limited in social scenarios.

It is important not to feel alone. There are a myriad of solutions.

Interestingly it is reported that in a great number of cases, self-learning has been key in further understanding the condition.

There is one book in particular that stands out in this field.womens-bodies

Women’s Bodies, Women’s Wisdom, written by Dr. Christiane Northrup gives a wealth of information and context. She combines her knowledge as a gynaecologist for 40 years with individual stories and gives a greater perspective on a wide variety of conditions.

There are a myriad of solutions and she helps to share and explain the possible options in an approachable and relevant way. (Please note: this is not a replacement for seeking medical advice, but a great resource to support along the way.)

Recent media and raising an awareness around these conditions is a great step to further supporting women. Communication, social awareness & becoming aware of the options available are key in this area of health.

How caesareans could affect evolution

BBC: Caesarean births ‘affecting human evolution’ – by Helen Briggs

Recently published research explores the idea that the practice of caesareans over the past 50 years has led to an increase in narrow pelvis size within the population. This is due to the babies born via caesarean, carrying the narrow pelvis gene surviving when before they would not. It leads to a positive cycling effect, where there is an increase in the number of mothers with a narrow pelvis size and thus a further increase in caesareans.

It is an interesting idea. The paper itself, written by Dr. Mitteroecker of the University of Vienna is based on mathematical models shaped from the data of caesarean births since the 1960s.

“The incidence of obstructed labor in humans is strikingly high. Most of these cases result from the disproportion of the newborn’s head or shoulders and the mother’s pelvic dimensions.”

The actual increase in this observed pattern is from 0.030 (in the 1960’s) to 0.036 in recent years. (In effect an increase of 6 babies per 1000 being born by caesarean).

There are of course a whole range of factors that influence whether a caesarean is carried out during birth. Caesareans can be pre-elective or the result of complications during the birth process.baby-being-held

Through studying Craniosacral Therapy, it is fascinating to discover how compressional patterns to the baby’s head can be stored and influence the shape of the cranial bones as they ossify over the first 2 years of life. It is possible through light-touch of Craniosacral Therapy to feel these compressional patterns both in new-borns and in adults, and help to re-establish a functional balance of cranial movement.

It is from this approach that many conditions such as migraines, fatigue and sleep issues can be lessened and in some cases fully resolved.

Did You Know…
The act of sucking in babies helps re-balance the pressure inside the skull. If a baby hits its head, a primary response is to feed, not only does this comfort the child, it also helps support an internal re-balance.

The ideas proposed in seeing evolutionary changes through shifts in medical practice is an interesting one to observe. To some extent it must make an impact as there is a connection between biological adaptation and the circumstances. However, this comes alongside many other social and cultural factors that influence the number of caesareans made.

Original Paper:
“Cliff-edge model of obstetric selection in humans” – Mitteroecker et al. (2016)
 Proceedings of the National Academy of Sciences of the United States of America

The Posture of High-Heels

This issue has recently been in the press and discussed in parliament around the controversy of whether it can be compulsory for companies to make employees wear high heels.

BBC – “Fine Firms for sexist dress rules, say MPs”

It has led people to wonder what really are the affects of high heels on the body?

Immediate thoughts go to the feet themselves and to the effects of having tight shoes, pressure on the toes from a narrow point, or even blisters from mis-fitting designs. What is important is to realise the bigger impacts that walking on a raised level does to the body as a whole.

The dynamics of the foot

There are three main weight points to the foot. These structurally create a triangle above which lies the main arch of the foot.

Foot.jpg
The three main structural points of the foot

These are illustrated by John Lodge in the book “Rolfing: Re-establishing the Natural Alignment & Structural Integration of the Human Body for Vitality and Wellbeing” by Dr. Ida P Rolf.

Looking at the ball of the foot, there are two key weight points on the inner and outer side. It is important to rest your weight equally between these two points.

You may find that more weight goes on the outer or inner, depending on your foot dynamics. More weight will be on the outer point if you have a tendency to turn your feet out or vice versa.

The ideal is to have even strength and weight between these two points – this enables a horizontal functional plane of movement when you flex your foot and walk.

Effects on the body

Depending on your body structure, high-heels can lead to lower back pain, shortened hamstrings & neck pain. Here’s why..

  1. Shortening the back-line

Did you know that the back of your body is connected by one sheet of fascia (connective tissue) running from the soles of your feet all the way up to the top of the head.

An easy way to stretch this iYoga forward bends to bend down and touch your toes (whilst keeping straight legs).

If you do this, and then roll the soles of your feet one-by-one on a tennis ball for 3 minutes, when you bend down a second time, you will be able to stretch much further because you have released the plantar fascia at the bottom of the feet, which in turn releases the back of the body.

Walking on a raised height such as a heel, leads to a shortening along this back-line, which includes a shortening of the hamstrings and over-development of the calf muscle gastrocnemius.

Research: “On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle” – Zöllner et al. (2015), Journal of Theoretical Biology.

Structural Geek: Did you know..?
There is a structural connection between the calcaneous (heel bone) and the sit bone (ischial tuberosity). Issues at the heel & Achilles can directly relate to tension dynamics & flexibility around the sit bone.

2. Tilting the pelvis forward

The effect of tilting the pelvis forward can lead to lower back pain around the lower lumbars (L4 & L5) as the natural secondary curve in the spine is accentuated, with the tail bone lifted up.

With this rotation of the pelvis, compression also occurs at the top of the spine in the back of the neck, as there is a compensation effect to balance the structural blocks above.

3. “Toe-foot” vs. “Heel-foot”

There are different styles of walking and running where either the toe or the heel is the first part of the foot to make contact with the ground.

This has been explored heavily by running experts. In “Born to Run” written by Christopher MacDougall he connects “fore-foot” running to the original movement pattern of humans. There has since been further debate, with suggestions that variation occurs relating to individual body patterns, however “fore-foot” running has been clearly linked to lower injury rates.

Similarly when walking in high heels, it is best to bring weight onto the ball of the foot, rather than on the heel, with the ball meeting the ground first. This will bring your body slightly forward & you may feel your calf muscles working more. However it avoids impact coming up through your heel & the 2-beat heel-toe tap to each step.


Alongside these long-term physical effects of wearing high-heels, socially it’s fun to strut out in a beautiful pair of heels sometimes. In balancing these factors, here are some key tips to help support your overall health alongside strutting your stuff.

Key tips:

  • Explore the point of weight through the ball of your foot (When wearing heels, does more of your weight go through the outer or inner point of the ball?)
  • Exercise: discover how stable your feet are.. Standing with barefeet, holding on to something to steady your balance, focus on the two weight bearing points in the ball of your foot and very slowly lift your heels up. Keeping straight legs, and aiming to keep contact evenly between the 2 points, see if there is a rolling out or in as you reach your maximum height. To strengthen you ankles, do 20 slow heel lifts, you may even feel the muscles in the top of your hamstrings and back work accordingly.
  • When wearing high heels, check are you making contact first with the ball of the foot, or a heel-toe pattern?

If you love to wear high heels everyday, here are some things to think about (especially if you have tight hamstrings, experience lower back pain or find it uncomfortable walking with barefeet).

  • Change heel height – this let’s the muscles in the back of your legs, and the back of the body, adjust to different heights.
  • At weekends or down time, have time in flat shoes or bare feet, this helps enable a natural re-lengthening.
  • Go to a yoga class – downward dog and other postures lengthening the back of the body will help strengthen your legs & body as a whole.

In conclusion, high heels have a strong influence on posture and the musculoskeletal system. It is great that recent issues have brought light to re-explore these relationships. High heels if worn long-term can lead to structural and health issues. However, when worn short-term and with footwear variation, they can be an alternative doorway into becoming aware of your own body patterns, listening to when you need to stretch out and finding ways of strengthening and supporting your body, to adapt to short-term variations.

Additional reads:

BBCiWonder -“How can I stop high heels damaging my body”

The Guardian: “Heel striking – is it really the enemy of good running form?” by Sam Murphy

References:

Rolfing: Re-establishing the Natural Alignment & Structural Integration of the Human Body for Vitality and Wellbeing – by Dr. Ida P Rolf

Anatomy Trains – by Tom Myers