What Just Happened Here?

By Douglas Nelson
[Table Lessons]

Ms. H. came to the office worried because the right rotation of her neck was restricted. Having received massage therapy before, she’d heard that I deal only with specific problems, and she felt her neck was definitely a specific challenge. She sat down and showed me her rotational abilities.

“It looks like your range is quite limited,” I said. “Let’s measure it to see just how much. While we’re at it, let’s look at all your neck motion measurements. Before we do that, I have one question: When you turn your head to the right, where do you feel the tightness? On the left or on the right?”

“On the left,” she said, pointing to the area.

I took Ms. H. through the complete range of cervical motion. Her right rotation was only 40 degrees; her left rotation was 70 degrees. Her lateral flexion to the right was also limited—20 degrees less than lateral flexion to the left.

I tried rotating her head passively to the right, but as soon as I neared the motion barrier, she tensed into a protective spasm. Moving her head onto right lateral flexion, I realized there was a great deal of tension in the lateral flexors on the left, but no protective spasm. Here was the opening I needed.

Slowly, I began to address each of the muscles that create lateral flexion to the left. As I examined the tissue, she was surprised at how tender the muscles on the left were. After all, she was focused on her right side.

“That is surprisingly tender, but what I really struggle with is this,” she said, starting to demonstrate right rotation. Catching her head before she could turn fully, I nodded in approval, except I could tell she was a bit perplexed at why I wasn’t trying to increase her right rotation.

“I understand and we will get there soon. Right now, I need to set the stage by diffusing the tenderness here on the left side,” I told her.

“It is certainly tender, but wait until you feel the right side,” she replied. “If the left side is that bad, the right side must be terrible.”

Our session progressed slowly in this fashion. I carefully released muscles that create left lateral flexion. Periodically, I would gently check right rotation, stopping at the very first sign of restriction. Just before Ms. H. could redirect me, I was again working on the muscles on the left side. Each time I checked right rotation, it was a little less volatile and hypersensitive. I tried to quietly do these measurements, fearful she would again try to push me to attack the right side with a vengeance.

Picking up her head, I carefully moved it into right and left lateral flexion. She was remarkably good at letting me move her neck passively. Sensing a little more stiffness flexing her neck to the right, I then had her raise her left arm and put it up near her head, which puts the levator scapula on a stretch. This markedly decreased lateral flexion to the right, implicating the levator. After treating the levator, I noticed her flexion to the right seemed far better.

“Should we start working on my rotation now?” she asked. “I don’t know how much time is left, but that is the major issue I want to improve.”

“Sure. Why don’t you sit up and let’s take a look at what we have left to do.”

As she tried right rotation again, I relished the look on her face when she turned to almost full range. In disbelief, she came back to neutral and tried it again. Not accepting what she felt, she tried a third time, turning her head with ease.

Ms. H. sat up and looked at me. “What just happened here?” she asked, astonished. “Where is the drama, the pain, the sacrifice?” she asked, with a wonderfully sarcastic grin on her face.

“I think I can arrange more drama, along with some suffering and sacrifice,” I said.

“OK, seriously. I do not understand how that was possible. I have been waiting for 40 minutes for you to address the source of my pain, and now it is gone without seemingly even treating it. That seems like magic,” she said and shook her head in disbelief.

“It is anything but magical. In the neck, rotation to the right is also lateral flexion to the right. When I improved one range, I affected the other.”

“It just isn’t the battle I thought we would be struggling with,” she said, still rotating her head in disbelief.

I couldn’t resist. “Sometimes, you can win the war without fighting a battle at all.”

“Touché!” she agreed. 


Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars and president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois. His clinic, seminars, and research endeavors explore the science behind this work. Visit www.nmtmidwest.com or email him at doug@nmtmidwest.com.