Healthcare and Medicine Reference
In-Depth Information
occipital and atlanto-axial joints, thus it works with
gravity to help produce lower neck flexion and upper
neck hyperextension.)
The scalp
The line of pull from the SFL up onto the skull overlies
and particularly affects movements at the asterion, the
juncture among the occiput, parietal, and temporal
bones. Consider the line of pull of both SFLs, especially
if they are tight (as in extreme forward head posture) -
they can form a functional loop up and over the occiput
at or about the lambdoidal suture (Fig. 4.24). This loop
can be palpated and released (DVD ref: Superficial Back
Line, 57:03-59:55). Otherwise, the fascia of the SFL blends
with that of the SBL through the posterior part of the
scalp fascia.
Where the fascia of the SCM and the superficial
cylinder of the neck join the galea aponeurotica of the
scalp, the same considerations and techniques as were
already discussed in terms of the SBL (Ch. 3, p. 89) apply
equally to the SFL: look for spindles of extra-tight fascia
aligned along the direction of the SCM above the mastoid
process near the asterion.
The sternocleidomastoid
The sternocleidomastoid (SCM) is a difficult muscle to
stretch, the more so because often the underlying sca-
lenes and suboccipitals are so limited in their movement
that they may reach their limitation long before the
superficial SCM is brought into a stretch (see Ch. 9 for
a discussion of these underlying muscles).
To stretch and open the superficial fascial cylinder in
general, and the SCM in particular, stand beside your
supine client and place your open fist along the SCM on
one side of her neck, with your fingers pointing poste-
riorly. The direction of your pressure is crucial here: do
not push into the neck. The direction of your stretch is to
follow your fingers back, around the neck along the
'equator', without significant pressure into the neck.
The design is to pull the superficial fascia (and the SCM)
toward the back, not to occlude the carotid artery or
jugular vein. Any significant change of color in the cli-
ent's face or report of intracranial pressure should cue
you to desist.
As you begin your move, have your client assist by
rotating her head away from you, taking the tissue out
from under your hand as you move along the neck
toward the back. Make sure your client is rotating
around the axis of the neck, not simply rolling her head
away from you on the table. You can use your other
hand to guide her head, and you can also cue her: if she
is really rotating her head, she will be able to hear her
hair on the table. Just rolling the head on the table will
not create the same noise to the client's ear (DVD ref:
Superficial Front Line, 46:58-52:45).
General movement treatment
The muscles of the SFL create dorsiflexion at the
ankle, extension at the knee, and flexion of the hip and
trunk. In the neck, the action of the SFL depends on
one's position relative to gravity; although in standing,
the SCM creates lower cervical flexion and upper
cervical hyperextension (see Discussion 2 below, p. 112).
At the same time, the SFL should stretch to allow for full
extension and hyperextension of the trunk and flexion
at the knee. Various degrees of backbends and front of
the leg stretches can thus be used to mobilize the SFL.
Postural flexion of the trunk, forward head posture, or
Fig. 4.24 The SCM muscle stops on the
mastoid process, but the line of pull
continues over the head, roughly along the
line of the lambdoidal suture, connecting
with the other SCM to form a scarf-like
Search Pocayo ::

Custom Search