Chapter 21 NECK AND HEAD INJURIES 319 Chapter 21 NECK AND HEAD The neck (cervical vertebrae) is the upper end of the back s vertebral column, on top of the mobile thoracic, and lumbar, and fused sacral vertebrae. Upper vertebrae (mid back and neck) viewed from back The two chapters 21 (neck and head), and 22 (shoulders, arms and hands) are similar in as much as they deal with extremities at the end of the body s mechanical chain. Thus if you have a sore neck or a sore shoulder, etc., read both chapters. The neck and head sit atop a long line of mobile structures that start with the feet and many neck problems associated with tight muscles and compromised disks, as well as problems to joints like the TMJ (jaw joint), result from imbalances in the feet, pelvis or mid/thoracic back that occur earlier in the chain. Even the apparently obvious causes, for example from a whiplash injury, are potentially misleading because they often are not the complete story. As discussed earlier, people respond to challenges in different ways evidenced by noting how two people sitting side by side in a front car seat, hit from behind, experience different injuries.
Chapter 21 NECK AND HEAD INJURIES 320 So with that in mind, how does one create the healthiest neck and head to make whiplash injuries, disc fusions and headaches less likely? The Neck and Head: Anatomy and Function Predispositions: The neck often becomes tight when the head is forward of the trunk (or looking at it another way the trunk behind the head). This results in the muscles and fascia behind the neck having to work overtime to keep the head from falling further forward. The neck area is also often overworked because the mid/thoracic back has become so tight that it doesn t rotate, leaving the neck to do more than its share of rotation. Both of these situations (poor posture/tight muscles, and excessive rotation) often lead to headaches, cervical disc degradation and fusions. Tight muscles around the head can also often lead to headaches and poor sleep, which in turn lead to tighter muscles and poorer sleep, etc. The bone that surrounds the brain is actually not one bone, but several with joints (sutures) between them commonly considered fused/immobile. I find it useful to think of these joints as slightly movable, allowing expansion and contraction of the brain. When I do bodywork on the head I slightly move the sutures/joints to create some movement, relieving muscular and facial tension. If a person sleeps always with the same (for example right) arm under a pillow, the neck/upper back muscle (trapezius) on the right side often becomes tight from continual shortening. When a person has one leg longer than the other, either anatomic (length of bones or thickness of joint spaces are different perhaps inherited, environmental, or from surgery) or functional (hip bone of the pelvis is rotated usually from a muscular imbalance, perhaps from sitting one way for too long or from an accident), most of the time the shoulder on the longer side will be lower (spine is a C shape). Occasionally the shoulder on the longer side will be higher (spine is an S shape). Regardless, if one shoulder is higher than the other the neck muscles on the higher side will be shorter and those on the lower side will be longer, and both sides will be tighter. When feet excessively flatten, the shin and thigh often excessively medially rotate, and the pelvis usually rotates in a forward direction resulting in a larger lumbar curve. This forward rotation also occurs independent of poor foot posture. Nevertheless, for whatever reason you have them, these imbalances usually make the body less aligned, tighter and less mobile, leaving the head offset and the neck moving too much. The temporomandibular joint (TMJ) is the joint where the lower and upper jaws meet. The joint shape minimally defines movement (even less than the knee joint discussed earlier), which allows the mouth to chew and move in many directions, but also means that most of its movement is dictated by soft tissue structures. An imbalance in the rest of the body, such as walking in a more side to side direction that occurs when one s feet excessively flatten, puts tension on the TMJ. As a result, some TMJ dental specialists require the patient s feet to be balanced before they will work on TMJ devices. I would even go farther and suggest that TMJ problems will significantly diminish when people develop a more upright posture and softer, fuller movement.
Chapter 21 NECK AND HEAD INJURIES 321 And even though this is not mechanical in nature not drinking enough water is a huge risk factor for headaches. Step in the right direction to improve mechanics An underlying theme throughout the book has been the importance of developing healthy central structures in order to have healthy peripheral ones, such as the neck and head. With that in mind, the first step to relieve neck tension, is to place the pelvis and chest under the head so the head sits easily on top of the spine. Reverse the excessive forward thoracic curve by sitting, standing and sleeping aligned, as well as lying on the Gravity Arc, four inch foam roller or pillow, as mentioned earlier. In this upright position, soft tissue structures don t need to constantly work to keep the head from falling even more forward. Upper vertebrae (mid back and neck) viewed from right side Learn to move softly and fully, especially by establishing movement in the mid back/thoracic region. When you walk, keep the head facing straight ahead by gently rotating the neck a small amount from side to side relative to the (moving) shoulders. Remember when you start moving differently, it will often feel awkward and it may even be difficult. Be confident you are going in the desired direction, and you will gradually make progress.
Chapter 21 NECK AND HEAD INJURIES 322 Sleep in varied positions (review different sleep positions in chapter 7) so you do not consistently shorten any particular neck muscle. Receive bodywork/massage on the muscles and fascia of the shoulders, neck, jaw, face, around the ears and including the top of the head to relieve tension and chronic head pain. Remember that these areas are often tight because of tightness in the abdominal and rib areas, making it difficult to stand up straight, so also receive bodywork/massage/stretching to open those front areas. Adjustments done by a thoughtful chiropractor can often release vertebrae that have become stuck in a misaligned position. Cervical vertebrae viewed from front Breast bone (sternum) is solid center grayish vertical structure. Left and right collarbones (clavicles) attach to it Take relaxing walks, and meditate to address what might be underlying emotional challenges from the past. From my experience in doing body work, I have found the hips/pelvis, stomach, ribs, mid back and neck in particular hold emotional trauma. Meditating is an excellent way to let go of tension in general, and neck tension especially which helps relieve headaches related to tight neck muscles. For several years in the late 70s I meditated every day, and I noticed how much calmer I was, and spent less energy worrying.
Chapter 21 NECK AND HEAD INJURIES 323 Earlier I posed the question, is it healthier to drink enough or eat enough? The answer is that you must do both, just as improving mechanics (in this case releasing muscular tension) and emotional health (becoming calmer) are complementary to one another. Analogies aside, one of my strategies to actually drink enough water is to carry two glass pint bottles in the car, and I drink a whole pint when I am thirsty, especially just before a workout. Being sufficiently hydrated not only lessens the likelihood of headaches, but also enables you to work i.e., mountain bike, run or play with your children at the end of a long day, a lot longer.