Month: November 2017

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    Headaches are the most common form of pain and one of the most common reasons people miss days at work or school or visit the doctor. As someone who has suffered from frequent headaches for many years, I have a personal interest in educating others about headaches especially in the treatment of headaches.  Headache is pain in any region of the head that can occur on one or both sides of the head, be isolated to an area or radiate from one area to another.  Symptoms can appear as sharp pain, throbbing sensation or a dull ache, and can develop gradually or with sudden onset.

    There are more than 150 types of primary and secondary headache disorders. Primary headaches occur independently and are not caused by another medical condition. Migraine, tension and cluster headaches are the more familiar types of primary headaches.  Secondary headaches are symptoms of another health disorder that causes compression of pain-sensitive nerve endings.  While most headaches do not require immediate medical attention, but there are cases in which a headache can be a symptom of a serious condition, such as a stroke, meningitis or encephalitis and warrant immediate medical care.

    Of the many types of headaches, the most common type is tension headache, which is due to tight muscles in your scalp, neck, shoulders and jaw.  These headaches are often related to stress, depression, or anxiety. They can also be caused by prolonged positioning with poor posture and are more likely to occur when you are lacking adequate sleep, skipping meals and with use of alcohol.
    Your posture can play a significant role in the occurrence of tension headaches. Having an awareness of good posture during normal daily activities, such as working at the computer, can improve alignment of the spine, reduce stress in the jaw, neck and shoulder muscles, and reduce compression on the nerves which can reduce headache frequency.  The exercises below can be performed several times during the day to improve postural awareness and allow you to perform daily activities with greater ease.

    Some postural exercises that can be beneficial include:


    Seated Correct Posture

    • Scoot back in the chair and either use lumbar support in the chair or place a towel roll or small pillow between the chair and your low back. Then sit back against the towel or pillow.
    • Try to sit up straight, aligning your ears, shoulders, and hips. Face forward and think about gently bringing your shoulder blades together.
    • You do not need to maintain this position perfectly, but be aware of when you slump forward and try to re-establish a more upright position.

    Tip: Be aware of the position of your head and perform a gentle chin tuck if your head is in forward position.


    Seated Cervical Retraction
    REPS: 5-10 | SETS: 1 | HOLD: 3-5 | WEEKLY: 6-8x | DAILY: 3xSetup: Begin sitting in an upright position with good posture and with your feet flat on the floor.

    Movement: Gently draw your chin in, while keeping your eyes fixed on something in front of you.

    Tip: Make sure that you do not look down as you do this exercise, or bend your neck forward


    Seated Scapular Retraction
    REPS: 5-10 | SETS: 1 | HOLD: 3-5 | WEEKLY: 6-8x | DAILY: 3xSetup:​ Begin sitting in an upright position.

    Movement: Gently squeeze your shoulder blades together, relax, and then repeat.

    Tip: Make sure to maintain good posture during the exercise.


    Doorway Pec Stretch at 90 Degrees Abduction
    REPS: 1-2 | SETS: 1 | HOLD: 20-30 second | WEEKLY: 6-8x | DAILY: 2xSetup: Begin in a standing upright position in the center of a doorway.

    Movement: With your elbows bent, place your forearms on the sides of the doorway at a 90 degree angle from your sides, then take a small step forward until your feel a stretch in the front of your shoulders. Hold this position.

    Tip: Make sure to maintain a gentle stretch and do not shrug your shoulders during the exercise. Make sure to keep your head in line with your shoulders (don’t let it move forward in front of your body).


    Seated Diaphragmatic Breathing
    REPS: 3-5 | SETS: 1 | HOLD: 1-2 | WEEKLY: 6-8x |Clinician Notes: This exercise is great for relaxation of the entire body.

    Setup: Begin sitting in an upright position with one hand on your upper belly and your other hand on your chest.

    Movement: Take a deep breath in, feeling your stomach expand against your hand, then slowly breathe out completely. Repeat.

    Tip: You should not feel any movement in your chest as you breathe. This can also be performed while lying on your back with knees bent.

    For a printable version of these exercises, click here.
    Along with the above exercises, there are other types of therapies that can be beneficial in the treatment of headaches to more specifically address the impairments that can be contributing to your pain.  Physical Therapy can be extremely helpful in the evaluation of the spine, muscles of the head, neck, shoulders, and jaw and assessment of postural abnormalities that may be leading to your headaches.  Manual techniques, especially myofascial release and integrative dry needling, and other forms of manual treatment can be very effective in the release of areas of tension along with correction of alignment.  At Premier Physical Therapy, we have many skilled therapists with advanced training in assessment and manual treatment techniques, who can assess for these abnormalities and provide treatment that can significantly improve your headache pain, along with often associated neck pain.  Call our office and make an appointment to be seen and allow us to assist you in your path to healing. ​