therapy-notes

NMT Protocols – Trapezius

This protocol treats trapezius in a supine position. The lower trapezius is more accessible than the supine position. This position also leaves the hood of the upper trapezius accessible for rolling between the fingers and thumb. Both techniques are not easily applied in the more common supine treatment of upper and middle trapezius.

Therapy Notes – Lower Trapezius

Mobilization of a dysfunctional atlas is key to balancing the cranium on the neck and normalizing the spinal accessory nerve. This routine has internal and external approaches to mobilizing the atlas. Start with cranial work around the jugular foramen. This includes mobilizing the atlas and releasing the suboccipital muscles. Continue with treating the lamina groove. …

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Therapist Notes – Splenius Capitis

Splenius capitis originates from the lower cervicals and upper thoracics and inserts on the occipital and temporal bones so that it is in a perfect position to counter sternocleidomastoid to pull the head around. It also serves as a wrap to hold the lateral neck muscles against the neck during movement. The splenii muscle trigger point …

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Therapist Notes – Semispinalis cervicis

This is almost always relieved when atlas is mobilized. That can be done with a number of techniques including cranial, intra-oral and anterior cervical NMT. Anatomy Review. This protocol loosens the suboccipital region, which, as a rule of thumb, is the first step in treating around the cervical spine. This pain pattern is often used …

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Therapy Notes – Stiffness up the side of the neck

This trigger point comes from the levator scapula muscle which twists as it lifts the scapula. That twist is increased and increases pain along the length of the muscle as the neck is turned. The exact location of the trigger point varies with the tilt of the shoulder and such but is somewhere on or just above …

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Therapist Notes – Stiffness at the base of the neck

This trigger point comes from the splenius cervicis muscle. The trigger point is actually near C7 at the base of the neck but does not release easily or completely when the costovertebral joint of T3 is displaced. The lower cervicals should be mobilized before attempting to release the tendons in the pocket between the upper …

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Therapist Notes – Anterior Suboccipital Muscles

Actual treatment of the rectus capitis anterior can be done more easily by mobilizing the atlas from the transverse process and following up with ice and stretch. If the trigger point is more chronic and requires direct work on the muscle, more advanced intra-oral or anterior throat techniques are needed. Muscle Energy Techniques and Strain-counter-strain …

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Therapist Notes – Pain inside shoulder blade when slouching while seated

Pain between the shoulder blades is seldom rhomboids unless the client has trapped the rhomboid muscle against a hard surface or they have extremely imbalanced extrinsic back and extrinsic chest muscle. When the problem is postural, the shoulders and upper back are notably rounded or the upper back is very straight and shoulder blades are …

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