What is the most effective number of visits for the treatment of headaches?

Having a chronic headache is tough. It drains you of your energy. It affects your work and puts a damper on your social life.

Having a headache on a regular basis is tough to handle.  You just want to get a reprieve from them.

I love treating headaches.  I find they respond very well to spinal manipulation along with active release techniques or acupuncture.

Check out this research paper which compared  different doses of spinal manipulation and it’s effect on chronic cervicogenic (neck based) headaches.

 Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial

The  purpose of this study was to identify the dose-response relationship between visits for spinal manipulative therapy (SMT) and chronic cervicogenic (neck based) headache  (CGH) outcomes; to evaluate effect spinal manipulative therapy by comparison with a light massage, which was used as a control.

The found that there was a linear dose-response relationship between SMT visits and days with CGH. For the highest and most effective dose of 18 SMT visits, CGH days were reduced by half, and about 3 more days per month than for the light-massage control.

Healthy shoulders with shoulder circles (CARs)

To keep our joints healthy we need to move them, on a daily basis, throughout their full range of motion.

 

Shoulder Circles

Start this exercise with your palm facing your hip. By only moving the shoulder raise it up in front and overhead.There will come a point where you can’t move any further. Rotate the palm to the out side and continue to rotate backwards. As you continue through the circle the biceps rotates downward to be facing the floor. You should end with your palm facing away from your hip.

You can also perform this movement in the opposite direction.

Do your best to not rotate your torso or side bend.

A healthy shoulder should be able to move through a perfect or near perfect vertical circle. You won’t see this in the video

To gain an idea of how vertical your arm travels stand near a wall. As you perform the movement if you feel the arm touch the wall take a moment there and try and see if you can lift the arm away from the wall and continue on with the movement without touching the wall.

Perform this exercise on a daily basis.

If you experience pain with this movement you should book an appointment to have it checked out

Why do I hurt? DIMs vs SIMS

When you are injured the degree of pain is not proportional to the degree of damage. There are more variables that are involved than tissue damage. The body, brain, interprets how dangerous the situation is. It looks at the present situation (ie, physical, emotional, environmental, psychological variable), past injury situations, and it looks at the future consequences of the injury. It evaluates the situation and then outputs what degree of threat it is.

One person may stub their toe and just keep on going. Another person, who had previously broken their toe, may be writhing in pain.

For some, they may tend towards anxiety, depression, or they may catastrophize the situation. This increases the danger and thus more pain will be experienced. A draw back to this is that these “Danger in Me” thoughts cause people to avoid what they need to do. This slows their progress in rehab, reducing their enjoyment and quality of life.

My job, with my athletes, is to reduce the anxieties or worries of their pain. Also, I am to help put themselves in situations where they can work the injured area in a “Safe in Me” environment. Building themselves up to the point where they can enjoy their sport, activity or life again.

 

 

Shoulder Blade Circles (CARs) for neck pain, back pain or shoulder pain

Shoulder blade scapular circles/carsThe shoulder blades or scapulae have muscles that extend to the neck, thoracic spine, ribs and shoulder.  The shoulder blades, therefore, can influence these other regions. Having control/mobility over the scapula would thus be a potential area to work on if you are having problems in these other areas.

I often have my athletes and my desk athlete’s perform scapular circles if they have any problems in these regions. They are easy to do and can be done anywhere.

Shoulder blade / scapular circles (CARs)

Shoulder blade circles/scapular circles (CARs) can and should be performed with the arms in any position.

To show the movement of the shoulder blade I will perform this movement, in the video, with my arms out in front of me. I will only move one arm so you can see how much the shoulder blade contributes to the movement. Keep in mind you can perform this exercise with both shoulders simultaneously.

I often start my athletes off with their hands resting on their laps. This tends to be the easiest way to start. As they get more accustom to controlling the movement of the shoulder blade the arm can be placed in different positions.

start by pulling the shoulder blades together. Once you’ve hit your max then keep the shoulder blades and raise them up as high as you can. Once you have reached your max then round/reach the shoulder blades forward as far as you can, keeping the should blades up. then when you reach the end point keep it there and drop the shoulder blade down.

Perform this movement slowly.

Take about 30 to 60 seconds to complete one circle.

Dr Notley

 

Neck Circles (CARs) for neck mobility

This is another one of my exercises that I give to athletes/patients in the controlled articular rotations (CARs) category. The training method and acronym is popularized by Dr Andreo Spina. It was taught to me at a Functional Range Conditioning course in Winnipeg.  I call them “circles” to my patients because it’s easier for them to understand.  What I like about CARs is that they are easy, yet challenging, and expose to my athletes areas of mobility that they are lacking in.  I recommend performing this exercise on a daily basis to help self assess your mobility.

 

Neck Circles (CARs)

The intent of this exercise is to actively pull the neck through it’s full range of motion. Challenging all angles that the neck can move through. Scribing out the largest circle possible with your neck.

Imagine, as you perform the exercise, that you are fighting against an invisible person trying to push you away from your end range of motion.  Often, when athletes are performing this move, they miss part of the circle. They cut the circle short when they bring the neck behind the shoulders.  To maximize the range of motion, as you get your ear to your shoulder reach the head back as far was you can before you start to look upwards.

Take 30 seconds to a minute to perform one rep repetition. repeat multiple times a day.

Pinching pain, tingling/numbness, and dizziness are not desirable.

Dr Notley