Are you plagued by headaches? Do you get headaches once in a while and don’t know why? Do you get headaches during or after a tough tour? Then please, read on, it might be one of the best things you have ever done!
With the nature of the work involved in firefighting and paramedicine, such as over haul with a pike pole, carrying the trauma bag, or repeatedly lifting patients over and over, the potential for headaches increases significantly. Throw in everybody’s abnormal, normal posture, and we are prime candidates for chronic headaches.
Let’s start at the beginning. Abnormal, normal posture? Look at yourself in the mirror from the side. Odds are, your shoulders are what we call rounded, your earlobes are forward of that bump on the top of the shoulder (forward head posture), and your face is probably still looking straight ahead (neck extended). Right? Well this creates a prime condition called cervical dysfunction.
Cervical dysfunction? Basically, what it means is you are shortening the muscles at the base of the skull, making the 2 big muscles at the front of the neck (sternocleidomastoid) work too much, and the deep flexors of the neck are just going along for the ride, getting weaker and shorter. Not to mention your trapezius and levator scapula (the muscle that elevates your shoulder blades) working over time on a normal basis. If the front of your neck hurts with crunches, then odds are, you have this! Why is this bad? This creates a perfect environment for these little things we call trigger points to activate. What the heck is a trigger point?
Trigger points are a taut band of skeletal muscle located within a larger muscle group. These taught bands are tender to the touch and can refer pain to distant parts of the body, including the head. You can experience regional, persistent pain resulting in a decreased range of motion in the affected muscles. Typically, we know where in the muscle these points are located, but it is whether or not these points are active or latent. When active in the muscles of the neck, pain is referred all over the head and neck, including the most common points of a headache, like along the temple or behind the eye. The following diagrams demonstrate where the referral patterns of pain are (red areas) with the most common trigger points associated with cervical dysfunction (x's).
Heat and what we call accupressure, or pressing with your finger on the trigger point origin (not where the pain is) can help alleviate this pain very quickly. Although the pain may increase with the acupressure (this is a good thing, you know you hit the right spot!), over time the pain will decrease or go away. Once this occurs, you may let go and voila! The pain is gone! You may require someone else to press on the trigger point depending on how flexible you are. This is a quick and easy method I have had great success with in the clinic when treating acute headache pain. Ultimately, you will need to see your Athletic Therapist for follow-up in order to correct the cervical dysfunction, which can ultimately be the cause of the trigger point activity (unless it was due to trauma, which can happen as well). Yes, exercises and a FLEXIBILITY program are the requirements of the day. That will be the only way to correct the dysfunction.
Next article in the series: Flexibility for neck health.