ReehabMax Physiotherapy

Cervical Facet Joint Syndrome
Cervical facet joint pain occurs when there is inflammation in the zygapophyseal joint capsules or when the capsule gets torn which in turn irritates the median branch nerve that supplies to the joint capsule which lies between two cervical vertebrae(zygapophyseal joint), it's often noticed in patients with facet joint pain neck extension ( looking up) is very painful.
Nerve block injections are given to treat facet joint pain but they are mostly used for diagnostic purposes to confirm the diagnosis because the effect of injections will last only for 2-3 weeks then the pain reoccurs.
Physical therapy treatment is considered the best treatment to relieve pain from facet joint .

Role of Accessory Muscles in Case of COPD( Chronic Obstructive Pulmonary Disease)
Due to the suppressed functioning of the primary muscles of inspiration like the Diaphram and external intercostal muscles, the accessory muscles of respiration like SCM, Scalene, trapezius, and pectoral get fatigued which leads to Acute Exacerbation ( shortness of breath and increased production of mucus).
Relaxation of accessory muscles and respective nerves plays a major role in symptom improvisation.

Had a positive COVID case with affected air entry on the right side of the nostril, as she had tightness on the right side of the neck, especially around the scalene and omohyoid, because of the tightness of these muscles phrenic nerve got affected, after working on phrenic nerve, she felt better and there was equal air entry on both the nostrils.

It's often seen after treating the affected side, that symptoms appear on the nonaffected side due to the compensation pattern developed by the non-affecting side, it's always good to work on both sides to get effective results.

Principles Of Exercise Physiology.
Many people believe even after stopping the exercise they feel good but that changes will last only for a short period. Because when we stop exercising the adaptations developed in response to exercise and muscles revert to their original state. Muscles need study training for the better performance.

Adhesions are commonly formed in the scalene muscles in the neck, which irritates the cervical nerve roots or brachial plexus. This happens because the brachial plexus, subclavian artery and vein pass between the anterior and middle scalene which leads to the tingling or numbness of the Fingers especially in the radial distribution.
Sometimes this adhesion is misdiagnosed as thoracic outlet syndrome.

“Occipital Headache “
Patients with occipital headache usually present with a headache that happens at the base of the skull, at the top of the head, over the ear and over the parotid glands.
It is usually caused by pathological changes in the occipital nerve due to trauma, physical stress on the nerve due to tight oblique cavities inferior muscles, semispinalis capitis or spinal capitis muscle, and due to repetitive neck contractions especially in the case of forward head posture.

Latissimus Dorsi Muscle referred pain pattern.

In medial winging of the scapula, the medial border of the scapula looks prominent and it goes away from the thoracic cage. This happens during shoulder flexion or arm elevation,
Medial winging very commonly occurs due to long thoracic nerve dysfunctioning and the weakness of the serratus anterior muscle. Due to this some muscles like rhomboids, latissimus dorsi and lower trapezius also go into atrophy.
The following are the symptoms of winging of the scapula-

Pain.
Weakness and fatigue.
Deformity of the shoulder.
Muscle spasms.
Instability of the shoulder.
Limited range of motion.
Treatment -this condition can be corrected with physical therapy treatment.

Tips to prevent Neck Pain-
1, Maintain a Good Posture.
2, Avoid excess use of screen especially mobile phones.
3, Take frequent breaks.
4, Walk more often.
5, Adjust your desk, chair and computer so that the monitor is at eye level.
6, Avoid carrying heavy bags with straps over your shoulder.
7, Choose a right pillow according to your neck curvaturee.
8, Quit smoking if you smoke.
9, Stay hydrated.
10, Exercise regularly and stay active

People commonly wear cervical collars when they have any neck condition like spondylitis, or spondylolisthesis or cervical instability, or neck pain, etc. The purpose of wearing a cervical collar is to restrict the cervical vertebrae’s mobility so that they will not feel discomfort or pain, but that’s NOT true. The cervical spine is designed for a relatively large amount of mobility. Normally, the neck moves 600 times every hour, whether awake or asleep. The movements in the cervical spine have happened in all three planes. There are various pain-free movements and supporting maneuvers by which anybody can fix neck problems.
So let's move your neck under the supervision and live a pain-free life.

Torticollis or Wry neck is a deformity in which the head is bent to one side and chin points to the other side. This is the result of spasm or contracture of the muscle supplied by the spinal accessory nerve, these being the sternocleidomastoid and trapezius.

Although there are many varieties of torticollis, I am posting here one of the variety of the same that is called Trochlear Torticollis.

Trochlear Torticollis is caused by damage to the trochlear nerve (fourth cranial nerve), which supplies the superior oblique muscle of the eye. The superior oblique muscle is involved in depression, abduction, and intorsion of the eye. When the trochlear nerve is damaged, the eye is extorted because the superior oblique is not functioning. The affected person will have vision problems unless they turn their head away from the side that is affected, causing intorsion of the eye and balancing out the extorsion of the eye. This can be diagnosed by the Bielschowsky test, also called the head-tilt test, where the head is turned to the affected side. A positive test occurs when the affected eye elevates, seeming to float up.

The normal cervical spine has a lordotic curve or c-shaped curve, but when the cervical spinal curve goes into flattening it's called a cervical kyphosis or military neck.
This condition is very common in people who have a forward head posture.
Loss of cervical lordosis can give the following symptoms-
1, Decreased range of motion of your head and neck, including a permanent downward gaze.
2, Difficulty swallowing (dysphagia).
3, Headache.
4, Instability when walking.
5, Loss of fine motor function in your hands.
6, Muscle weakness in your shoulders, arms or hands.
7, Pain in your neck, back, shoulders or arms.
8, Poor urinary (p*e) or f***l (p**p) control.
9, Tingling or numbness in your shoulders, arms or hands.

Interesting Facts about SCM and Trapezius Muscle
Developmentlly the trapezius and SCM are related because both of them develop from the brachial arch mesoderm and are supplied by the 11th cranial nerve Spinal Accessory Nerve.
So the pain in trapezius can cause the pain or discomfort in the SCM in most of the cases.

Splenius Capitis Strech-
A good stretch to relieve Headaches coming from tight Splenius muscles.

Signs And Symptoms of Spondylosis-

Why Good Posture’s So Important

Having good posture helps you to develop strength, flexibility, and balance in your body. These can all lead to less muscle pain and more energy throughout the day. Proper posture also reduces stress on your muscles and ligaments, which can reduce your risk of injury.

Improving your posture also helps you become more aware of your muscles, making it easier to correct your own posture. As you work on your posture and become more aware of your body, you might even notice some imbalances or areas of tightness you weren’t previously aware of.
To maintain a good posture take frequent breaks, stretch your body and hydrate yourself well.

Neurogenic (neurologic) Thoracic Outlet Syndrome.
This most common type of thoracic outlet syndrome is characterized by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulder, arm and hand.

Slow Breathing Benefits-
When you breathe slowly, your nervous system calms down. The healthier your nervous system, the higher your heart rate variability. Which leads to more resilience and flexibility in the body.

Slow breathing helps -
1, Enhance Immunity.
2, Reduce Anxiety, Depression and Stress.
3, Decreased Pain.
4, Improved Stress Management.
5, Higher Energy Levels.
6, Reduced Blood Pressure.
7, Reduced Heart Rate.
8, Improves overall Health.
9, Strengthens the Muscles of Chest.
10, Improves Digestion.
11, Improves Quality of Sleep.

Quadriceps Strech, best for the hip and knee pain, try this stretch and share your feedbacks.

CALF Strech-
Keep one leg back with your knee straight and your heel flat on the floor. Slowly put your hands on a wall and bend your front knee and move your hips forward until you feel a stretch in your calf. Hold this position for 30 seconds. Switch leg positions and repeat with your other leg.

Hamstring Strech, try this stretch if you have a tight hamstring ( back side of the thigh) muscle.

If you have Neck or low back pain, always consult your Physical Therapist or Doctor.
Never do exercise on your own, an accurate assessment is a must to treat the Neck and Low Back Pain.
For more queries consult ReehabMax Physiotherapy or Poornima Sharma.

SCM (Sternocleidomastoid) Syndrome-

1, Difficulty holding up your head
2, Disorientation
3, Dizziness or imbalance
4, Muscle fatigue
5, Nausea
6, Pain in your jaw, neck, or back of your head
7, Pain in your ear, cheek, or molars
8, Ringing in your ears
9, Scalp irritation
10, Stiffness
11, Tension headache or migraine
12, Unexplained tears
13, Visual disturbances such as blurred vision.