Often times, people seek physical therapy treatment with the complaint of “pain,” which can be in various locations and described with even more varying adjectives. However, another common report we hear is “stiffness,” but what does it mean to be “stiff?”
Most people have experienced some type of headache in their life, whether it has been a mild sensation of tension, pressure, or a full blown migraine that is life altering. Sometimes we are able to muster our way through our daily tasks. Other times, though, the severity can render us unable to do anything but find a dark and quiet room in an attempt to abait the pain. There can be an underlying cervical issue that can be directly related to our symptoms. Cervicogenic headaches (CGH) and migraines are not the same, but CGH can become a trigger for a migraine.
Headaches and migraines can also be worsened by musculoskeletal tightness and stress. Chronic or frequent headaches generally have been associated with poor posture and prolonged loading of the cervical spine outside of a neutral position which creates musculoskeletal imbalance. Typically there are muscle groups that are stretched and weak and muscle groups that are tight and overworked. How many times have we been caught looking down at our phones, squinting and leaning in to see a computer screen from eye fatigue, or bending our head to hold the phone during that hour long conversation all the while probably slouched while sitting in a chair? I can hear the echo of my grandmother… “ Sit up straight, put your shoulders back.” She was right!
Treatment for cervicogenic headache should target the cause of the pain in the neck and varies depending upon what works best for the individual patient. Treatments include physical therapy and exercise, and may require medications or further intervention by a specialist.
Physical therapy is an avenue for those suffering from headache and migraine symptoms to undergo comprehensive assessment and treatment for possible underlying cervical involvement. You will also be prescribed an exercise program that is safe and effective in reducing severity, frequency and duration of symptoms. It includes an ongoing exercise regimen that seeks to restore joint mobility, alignment, and strength. These corrective exercises can be utilized as prevention and even as treatment for headaches. It gives you independence and an added tool in your tool box to manage your symptoms.
So maybe you should take the time to check in with yourself. Do you have frequent headaches? Does your upper back and shoulder muscles feel tight or are they easily fatigued? Do you have neck pain? Do you hear the echo of your grandmother in your ear about your posture? If you answered yes to these questions, then you should consider physical therapy as a way to evaluate and help address your headache issues.
When people ask me what I do for a living, I generally say I’m a physical therapist, but sometimes I will divulge that I am a pelvic health physical therapist. This is usually met with lots of questions. Yes, I can treat neck pain, knee problems, general weakness, and all the usual things that you normally think a physical therapist can treat. However, I also have additional training that allows me to treat specific dysfunctions in the pelvic area like bowel and bladder incontinence, pelvic pain, and tailbone pain. These are often conditions that people think they need to just live with, but that is absolutely not true!!
I hear this statement all the time: “Sometimes I leak urine, but I’ve had kids so that’s normal right?”
No. Urinary incontinence is very common-ranging from 0.3-44% in the literature, but it is not normal even after having children. Urinary incontinence can occur in all ages and fitness levels. It can be the result of a strong urge from the bladder or it can be caused by cough, laugh, sneeze, or other movements that will increase the pressure in the abdominal area. Both types of leakage can be helped by a physical therapist with this additional training.
Everyone has a group of muscles that make up the bottom of their pelvis called the pelvic floor muscles. These muscles are key players in the ability to maintain bowel and bladder continence and just like any other muscle group, they can get weak over time. Most people have heard the term “Kegels” which is just another name for a pelvic floor muscle contraction.
Another statement I hear a lot is that “Well, I’ve tried Kegels in the past and they didn’t help!”
Only about 50% of people verbally cued to do a pelvic floor contraction are doing it correctly. So about half of the people who have tried to strengthen their pelvic floor on their own are not utilizing these muscles correctly. These muscles also have to have the correct dosage of exercise to be effective. If these muscles are overworked, urinary incontinence may get worse. If these muscles are underworked, the muscles never get stronger and these symptoms never improve. Maybe the muscles are strong enough, but the timing of the muscle contraction is not occurring when it is needed to prevent incontinence. Maybe these muscles are working too hard because another muscle in the hip or core is weak and the pelvic floor is trying to make up for that weakness.
Sometimes it is not as easy as doing Kegels at every red light to fix a problem like this. A physical therapist with training to assess this condition can help to figure out what is causing the muscles to work inefficiently. Spine and Sport is excited to be able to offer pelvic health services in our Oak Ridge by myself and West locations by Lauren MacGuire to help patients across the greater Knoxville area find solutions to their pelvic health problems.
