Preparing the Neck and Shoulders for Deep
Work
Part I: Seeing Restrictions in the
Superficial Fascia
©
2008, Til Luchau, Advanced-Trainings.com
The Importance of the Superficial Layers
What are the most common complaints you see in your practice? Chances are, neck pain and discomfort are high on the list. Although cervical issues can have many causes, youÕll often see better results if you begin by addressing restrictions in the superficial layers of the neck and shoulders. Whether caused by deep articular fixations, posture and misalignment, habits, stress, injury, or other reasons, neck issues respond quicker and stay away longer, when the outer wrappings are released first. And, as with other parts of the body, many seemingly deeper neck issues resolve when the external layers have been freed. In this article, IÕll describe how to work with these superficial but important layers in order to prepare the neck for working with its deeper structures.
The neckÕs superficial tissue layers have a great deal of influence on its alignment, mobility and health. These Òouter wrappingsÓ encircle the neck and shoulders like an over-large turtleneck sweater, or a surgical collar (Figure 1)
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Figure 1: The superficial fascia of the neck,
in green, surrounds the deeper structures like a sleeve or cowl . (Illustration
courtesy and copyright Primal Pictures Ltd.)
Anatomically, these layers include the superficial and deep cervical fascias, as well as the muscles within those fascial layers, such as the Trapezius, Sternocleidomastoid, and the Platysma (Figure 2). Together, these cowl-like outer layers extend from their upper attachments on the occipital ridge and lower face, to their lower connections with the outer layers of the shoulders, chest, and upper back. Like a sleeve, they encircle the deeper musculoskeletal and visceral structures of the neckÕs core.
Figure 2: The superficial layers of the neck,
in cross section.
The superficial layers of the neck have a surprising thickness and resilience. When, because of injury, postural strain, or other reasons, they have lost pliability or are adhered to other layers and structures, the outside layers have the ability to restrict movement range, disrupt alignment, and bind the structures they surround. Imagine trying to move in a wetsuit that is a size too small—the outer layers of the neck can bind, distort, and constrain movement in the same way.
Seeing Superficial Restrictions
Try this: watch a friend turn his or her head from side to side. Watch what happens with the superficial layers of the neck, shoulders, chest, and back. Are there areas of the torsoÕs fascia that move along with the head and neck? Or, do you see lines of tension and pull appearing in the skin and outer layers? Often, these signs of fascial restriction will be most visible at the extremes or end-range of the movement. Look from both the front and the back; compare left and right sides for any differences. Then, look again as he or she gently looks up and down (being careful, of course, to avoid any posterior cervical compression when looking up). While your friend might feel different kinds of restrictions when moving, including pulls in the deeper musculature, or catches involving neck articulations or the upper ribs, weÕre going to leave these aside for now and focus on the outer layers first.
Sometimes superficial fascial tension will be visible as linear patterns of tug in the skin (Figure 3). In other cases, a whole sheet of fascia will move or creep along with the rotating or nodding head. Linear ÒtugÓ patterns are more commonly seen in the thinner layers of the anterior neck and chest, while the ÒcreepÓ of whole fascial sheets is seen more often when looking at the thicker posterior layers of the back. If it is difficult to see restrictions in the superficial layers, you can use your hands to feel for tugs and pulls in the outer layers. Whether watching or feeling, note any areas that donÕt have smooth, even lengthening of the dermis and superficial fascias when the head moves.
Figure 3 Fascial strain
visible as "tugging" of the outer layers with movement. (Photo
courtesy and copyright Primal Pictures Ltd.)
When testing for fascial tension with movement, donÕt confuse movements of deeper structures for movement in the superficial fascia. For example, youÕll sometimes see the ribcage turning along with the head, or a shoulder roll forward, etc. Some of this movement is normal; if you see exaggerated or asymmetrical movement of the ribcage or shoulder, this might be because of deeper restrictions. Make a note to check for and address these patterns later, but remember that since these deeper movements might be caused by restrictions in the outer layers, releasing the superficial layers is the logical first step. We are constructed like onions--we are layered, from superficial to deep. And unless youÕre working with a scalpel and are cutting right through, you need to gently peel away the outer layers to get to the core.
In Part II of this article, weÕll look at creative ways to release the superficial restrictions weÕve seen and felt. Read it at http://www.advanced-trainings.com/articles/article_neck1_2.html