Referred pain

[FiFi]

A recent client, who has had neck surgery (fusion C3 and 4 years ago) told me yesterday that for a very long time, when she is lying supine and lifts her feet off the bed to do exercises the PT recommended, it hurts behind her left eye. She demonstrated it and I watched to make sure she wasn't lifting her neck off the table when she lifted her legs, and she didn't seem to be. But could it be that she is lifting it enough to cause her SCM's to radiate pain to the eye? Her SCM's are always tight. I tried to do the exercise myself, but my lower back is out and I can't lift squat right now.

 

[ddrum]

Referred pain

Hi Sandra,

Explore the dural tube for restrictions. Releases/traction from the head or sacrum may reproduce her symptoms and lead you to alleviating the cause.

 

[Kimmy V]

Referred pain

Sandra -

When a supine client lifts a leg, the hip flexors are the prime movers. There is also (normally) co-contraction of the quads and rectus abdominus. In less-athletic clients you will often also find co-contraction of the SCM and scalenes, even if the head doesn't lift. This is more common when the hip flexors are tight/short - anterior pelvic tilt will be present when the client is standing. These clients will also often have some forward head projection and shoulder protraction indicating tight/short pecs (especially pec minor), plus tight/short SCM and scalenes.

If these apply to your client, you can give her some relief by opening up her pecs, serratus anterior, SCM, and scalenes - allowing her shoulders to relax back and down, and allowing her head to come back into alignment with her shoulders. You will get longer-lasting results if you also address the tight hip flexors and anterior pelvic tilt.

Hope that helps! Good luck with your back!

 

[jerem]

Referred pain

One quick question for you - did your client grit her teeth or hold her jaw tight while lifting her legs off the table? Perhaps she is clenching her jaw hard enough to radiate pain through the trigeminal nerve and into the optical nerves, etc.

Here's a personal story to illustrate my reasoning:

I have a now healed frx in my R zygomatic arch [boxer's frx my Dr called it] that causes my quite a bit of discomfort - no, read that pain, that radiates into my R eye orbit and eye itself because of the interconnection of the trigeminal nerve and the optic nerves in the area. Whenever I am stressed to the nth degree, I MUST force myself to stop clenching my jaw so that my eye can stop hurting long enough for me to work. Taking the Rx med Tegretol to stop the eye/zygomatic arch pain requires 2 full days asleep in bed... not happenin' much around here when there's a living to be made.

 

[Persephone]

Referred pain

Hi Sandra,

Explore the dural tube for restrictions. Releases/traction from the head or sacrum may reproduce her symptoms and lead you to alleviating the cause.

Hi Walt! Thanks for your reply and good to see you! When I got started, it took so much time opening up the head, neck, and pecs that I told her to come back next week for work on the pelvic area. I called her the evening of her massage and she said she was feeling much better already.

 

[Caleb]

Referred pain

Sandra -

When a supine client lifts a leg, the hip flexors are the prime movers. There is also (normally) co-contraction of the quads and rectus abdominus. In less-athletic clients you will often also find co-contraction of the SCM and scalenes, even if the head doesn't lift. This is more common when the hip flexors are tight/short - anterior pelvic tilt will be present when the client is standing. These clients will also often have some forward head projection and shoulder protraction indicating tight/short pecs (especially pec minor), plus tight/short SCM and scalenes.

If these apply to your client, you can give her some relief by opening up her pecs, serratus anterior, SCM, and scalenes - allowing her shoulders to relax back and down, and allowing her head to come back into alignment with her shoulders. You will get longer-lasting results if you also address the tight hip flexors and anterior pelvic tilt.

Hope that helps! Good luck with your back!

Thanks Jason! Her pecs are always really tight, but she usually only books a 30 min session. This time, an entire hour was spent getting those areas opened up. Her SCMs and pecs were extremely tight. Am planning to address the hip flexors next session.

And my back is muuuch better. A good massage, advil, and ice pack worked wonders.

 

[B.Lieve]

Referred pain

One quick question for you - did your client grit her teeth or hold her jaw tight while lifting her legs off the table? Perhaps she is clenching her jaw hard enough to radiate pain through the trigeminal nerve and into the optical nerves, etc.

Here's a personal story to illustrate my reasoning:

I have a now healed frx in my R zygomatic arch [boxer's frx my Dr called it] that causes my quite a bit of discomfort - no, read that pain, that radiates into my R eye orbit and eye itself because of the interconnection of the trigeminal nerve and the optic nerves in the area. Whenever I am stressed to the nth degree, I MUST force myself to stop clenching my jaw so that my eye can stop hurting long enough for me to work. Taking the Rx med Tegretol to stop the eye/zygomatic arch pain requires 2 full days asleep in bed... not happenin' much around here when there's a living to be made.

Thanks Anastasia! Yes, she does clinch her jaw as she has mentioned she was going to buy a mouthpiece to wear even during the day because she finds herself clenching her jaw due to recent stress, so we have been addressing that area too. (as much as my limited knowledge will allow, that is)