Here it is. Another article about how to work on the neck. Except, I’m hoping this one is a little different than the ones you’ve read before. I’m hoping this one helps you think differently about how to approach the neck and how to feel less intimidated by all the red flags and “scary” structures that exist there. Because ultimately, when we work on a client’s neck, we are not just manipulating a levator scapula or a suboccipital. We are really, in no uncertain terms, accessing the deepest layers of their very personality.
The neck is a bridge. Most obviously, it joins the head to the body. But it also connects the brain to the heart and the thinking to the feeling. And while each of these layers might conjure different ideas for different people, the truth of the neck, the reality of every structure and tissue wrapped under the cervical epidermis, is brimming with pathways of communication. Sure, the muscles work hard to hold the head up and move the head around. But the persistent flow of blood, lymph, hormones, and nervous impulses is essentially a convoluted highway ripe for a traffic jam.
More Than What You Expect
Often unwittingly, the position of the head is the forward-facing presentation of the deep truths of our core. For example, a gut filled with shame might hold the chin down and one ear slightly tilted to the side. Or a stomach filled with pride might hold the head high and the nose turned up. Or a more curious instinct might hold the head slightly forward and rotated to one side for better hearing. These are positions that tend to be innate and, over time, become embedded into our very mannerisms. Doing all the things, day in and day out, will always start with these deeper foundations.
So, while carrying a purse or a backpack repeatedly on one shoulder, sleeping with a non-ergonomic pillow, constantly looking down to check your phone, or attending too many heavy metal concerts may trigger a painful situation, what is most likely happening is that the circumstance is exacerbating an already existing issue. A spasm in the levator scapula may be the result of chronic anxiety. Or a trigger point in the upper traps might be the culmination of low-grade depression. Or a tense sternocleidomastoid might simply belong to a very excitable client.
While all of these are possibilities, this adds an entirely new layer to your assessment. Please don’t misread this: Your health history and physiologic assessment skills are still incredibly important. But evaluating the entirety of a person is a different skill. It takes a long time for a client to reveal their inner truths and an even longer time to master implementing what you learn.
This is why it can feel a bit unnerving when a client presents with neck pain. On the surface, we may be fearful of pressing too hard on the jugular vein or sinking too deep into the transverse processes. But we also commonly face stubborn issues that seem to not resolve. The quandary a lot of massage therapists struggle with is wondering why all their work doesn’t help. And this concealed layer to underlying chronic pain is very difficult to pinpoint.
Bend an Ear
You might not walk away from this article with a fancy new tool to implement in your practice this week because the most valuable technique is also the simplest: listening. It’s the oldest tool in the book. And definitely the least exciting. I’m not sure, though, how to underscore the greatness of this one. We learn it on day one in massage school, and we spend a lifetime honing it.
Try this: With each client this week, use all your senses (except taste, obviously) from the moment they walk through your door. Get a sense of the initial feeling they give you, but don’t give it too much weight. Pay a little more attention to what they smell like, sound like, and look like. Try not to play the part of caretaker. Just observe. Watch and notice how they hold their head, how their jaw operates, and how they move. Try not to measure degrees and ranges right away. Listen to what your gut tells you and, without judgment, imagine what it would feel like to be that person.
It takes a long time for a client to reveal their inner truths and an even longer time to master implementing what you learn.
Once the client is on the table, use these perceptions to formulate your work. Maybe they need balance more than they need trigger-point therapy. Maybe they need to connect to their breath more than they need increased range of motion. Or maybe they just need to feel safe. Chances are, when you see your client as a whole human, the depth of your work is felt without you breaking your back to get there.
