When was the last time you had a throbbing headache in the back of your head, starting somewhere around your neck, radiating upwards, making it feel like someone took a 2x4 and smacked you across the back of the head? It impedes your ability to go about your day, perhaps forcing you to call in sick to work or miss out on your friends birthday gathering that you’d been looking forward to for a long time.
Nobody likes a headache. In fact, people tend to tolerate pain in their heads and necks a lot less than they tolerate pain anywhere else. What I described earlier is one version of a tension headache. It starts in the back of your neck, or even the upper back, causing pain all the way up through your head and sometimes into your temples. They suck, to say the least, and many people find themselves reaching for a bottle of Advil to fight it back, even if that remedy only helps temporarily.
Did you know massage therapy can help alleviate many of these types of headaches? It’s non-invasive, won’t have the side-effects on your systems that painkillers can cause, and can be very effective in actually resolving what is causing the issue, not just slapping a bandaid on it.
If your headaches are new, had a sudden onset, or are the result of an accident of some sort, get checked out by a doctor first to make sure it’s not a sign of something more serious. Once you’ve been cleared, ask your LMT about any of the following…
What is a trigger point exactly? A trigger point is defined as a small, hyperirritable spot in the muscle tissue that refers pain to a different part of your body. The small fibers get stuck in a contraction, restricting blood and nutrient flow to that area, decreasing your range of motion, and ultimately causing some sensation of pain. So when you’re head hurts, it might not be your actual head that is the problem, it is likely trigger points in your trapezius muscle, or your SCM, or your suboccipitals that are referring pain into your head, creating the sensation of a “headache.” The most common one I see as a massage therapist are the traps, or the large superficial muscle group of your upper back and posterior neck, as well as the suboccipitals, the tiny muscles between the bottom of your skull and the beginning of your cervical spine. A trap headache originates in the back of the neck and wraps around the sides of your head to your temples, creating a question mark looking pattern. The suboccipitals can cause pain in the back of the head and along the sides of your head above your ears.
How are these caused exactly? I’d be hard-pressed to find someone living in the real world who didn’t have a trigger point somewhere on their body at some point in time. It’s just a thing that happens to muscles, and the right massage therapist can find these spots and use specific techniques to release them. They can come from everything from minor injuries to poor posture to sleeping in a funky position and waking up with an ache in the neck. Trapezius trigger points can occur with poor posture, a pathology of many people. When your shoulders hunch forward, either due to your posture or just the fatigue caused by sitting at a computer for hours on end, your trapezius muscles get stretched out, causing trigger points to develop, and perhaps weakness down the road if nothing is done about it. Sitting up straight can help, but you may need to have those points worked out to do so comfortably. Working against those trigger points without a proper release can exacerbate that referral pain, or cause discomfort in the muscle as you fight against the damage that’s already been created.
A good massage therapist can pick out where these points will be based on your experience of pain, your posture, or your daily routines. They will loosen up the tissues and use static pressure to release that point, forcing the muscle to release, bringing circulation to the area, and facilitating the healing process.
Were you in a car accident five years ago and are still getting headaches semi-regularly? Maybe you haven’t connected that time you were rear-ended in rush hour traffic and these headaches, but many people can develop or continue to have symptoms of whiplash for months or even years after the initial injury.
When you experience whiplash, or your neck and head are thrown quickly backward then forwards, like cracking a whip, your spine is straightened into an unnatural position you couldn’t otherwise accomplish on your own. This motion smooshes the vertebrae of your spine together, compressing the discs and multifidi (the small muscles between the vertebrae) and the ligaments, then extending them to a longer position than your natural ability allows. Your splenius capitis muscle, a muscle that helps you look up at the sky, can stretch out to 125% of its natural length, effectively causing a sprain that will decrease range of motion in your neck and cause pain in the head and behind the eyes.
As a massage therapist, this muscle will go from feeling firm and smooth to like an old piece of broken elastic: bumpy and weak. A car accident even at 8mph can cause minor whiplash injuries. Many states have what is called a Personal Injury Protection on your car insurance (Minnesota included) which can entitle you to a certain degree of post-accident care, even if you just hit a deer on some dark country road. It never hurts to get checked out by a chiropractor, a physical therapist, or your general physician. An x-ray can exclude any more serious injuries to the spine and your doctor of choice can facilitate a treatment plan to help your soft tissue injuries heal. Every body is different, but generally, three to six months of regular chiropractic and massage care can help heal those soft tissue injuries and get you back to the condition you were in before.
If you have immediate symptoms following a car accident, or even symptoms within a day or so, such as an immediate onset of a headache, loss of range of motion, difficulty moving or swallowing, tingling or numbness in the arms, fatigue, or dizziness, get checked out immediately. The longer you wait, the harder these injuries become to deal with, and it’s best to just rule out anything serious.
If you do nothing, three years will have passed before you know it and you’ll be left wondering what is causing the headaches you experience all too often.
Your SCM, or sternocleidomastoid, is a long, skinny, superficial muscle that sits in the front of your neck, coming to a V-shape and encompassing your trachea and esophagus, lining your brachial plexus, and causing headaches when it gets angry. An SCM headache generally presents just above the eyebrows across the forehead, or behind the ears where it attaches to your skull. It’s considered a “fast-twitch” muscle, meaning it is meant to do shorter movements, versus long-sustained movements like holding a squat. This muscle is a contralateral rotator, meaning it rotates your head to the opposite side, and it helps with flexion of the neck.
If you have a job that puts you in a prolonged forward head posture or looking down at something like a computer, this muscle is likely angry. What does this mean? My job, for instance, is easy to fall into a habit of a forward head posture if I don’t consciously think about keeping my head back and looking down with my eyes. With a mask covering the bridge of my nose, I’ve found this to be a little more challenging lately than it was in the pre-COVID days. My neck begins to flex forward as I stare down at my work until I realize what I’m doing and jerk my head back a couple of times in an hour. If you work at a computer for much of the day, you might find your head creeping forward closer to your screen. Both of these actions will shorten your SCM muscle, effectively creating tension, trigger points, and that oh-so-painful headache the SCM trigger point can create. A good massage therapist can release this muscle, stretch it out a bit, and dissipate that headache it has been causing you.
Clenching is something many people do when they are stressed, either consciously or unconsciously. When this habit gets really bad, it can turn into grinding your teeth at night. (I’ll leave the lectures about what it does to your enamel to the dentists out there). This is something called bruxism, or excessive clenching and grinding. This often happens due to stress or anxiety and some people don’t even realize it is happening.
The muscle groups involved are your temporalis and masseter muscles, or the ones that close the jaw, and your lateral pterygoid muscles, which move your jaw from side to side. All three of these muscle groups have trigger point referral pain in different parts of your face, your head, and around your teeth. Some people even experience earaches and shoulder pain from this gnarly habit. When you excessively clench or grind, neck muscles may also become involved, usually through an isometric contraction, meaning the muscles contract without causing movement. This can also cause the pain referral patterns typical to neck muscles, which, as we went through before, are into different parts of your head, particularly when you wake up in the morning. In severe cases, teeth grinding can also be linked to migraines.
Massage therapy can release tension that builds up in these muscles. Although the actual act of grinding is often psychological, massage can treat the symptoms the habit creates. TMJ massage loosens tension and releases trigger points that build up around the jaw; some therapists and chiropractors are trained in intraoral massage, so working out the attachment sites of the muscles from inside your mouth. A good massage therapist also works on the muscles that are indirectly affected by your grinding habit as well, including the neck muscles we talked about before.