Monday, May 14, 2012

Mrs. R. Case Study Part 3 - Goals and Causation



Primary Goals for the Client:

1. Pain free mobility of the neck, especially anterior restrictions which cause chronic headaches.

2. Improved range of motion in the low back, hips, and upper legs.

3. Flexibility of the leg adductors, psoas, quadriceps, and hamstrings.

4. Reduction of medically prescribed pain medication to alleviate interactions and side effects. (next Dr. visit is June 9, 2012)

5. Improve overall postural stability and soft tissue function to allow for exercise, improved strength, proprioception, and grip.

As a longer term goal, the client wishes to have 4 babies over the next 5-7 years. In her current state, that would be devastating to her body, causing, in my opinion, many further years of intense pain and dysfunction. From the very beginning of Erik Dalton's text on Myoskeletal Alignment, he addresses the foolishness of  "chasing pain", because that simply soothes a symptom but does not address lasting causal patterns. The "Baby Situation" with Mrs. R. is the big goal to me for that reason. I'm not fixing pain with massage treatments, I'm providing lasting balance in her body, so that she can do exciting, satisfying, mentally, spiritually, and physically transcendent things, without soft tissue dysfunction standing in her way.


What's causing #1? The levator scapula, scalenes, and sternocleidomastoids on both sides are very tight and continually pulling the neck and head forward. The pectorals, major and minor and also hypertonic, pulling the shoulders forward and consequently, adding more pressure to the forward head posture.






Check out this interactive DIAGRAM which includes pronunciation of the major muscles of the neck.



 The upper traps and suboccipitals are also out of balance with the anterior neck muscles. This imbalance along with car collisions have caused herniation of at least 2 discs in the cervical vertebrae.


There is poor grip and sharp pains shooting down the arms of the client which could indicate nerve impingement by the cervical spine or soft tissues.The ulnar nerve, for example, is probably responsible for shooting pain on the pinky side of the hand. Tight muscles surrounding that area, where the ulnar nerve passes between the clavicle and the top ribs, could be pulling bony structures out of alignment.


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