QuestionHi Kathryn,
I'm a Remedial Massage Therapist and have a client presenting with constant occipital headaches, do you know what are the usual causes for these headaches? And also the best muscles to treat? I've been working her neck, shoulders and back (mostly upper). Her TMJs are tight because she tends to grind her teeth, but they don't seem tight enough to be causing these headaches, which can get quite bad. Another factor is she gave bone marrow from her left hip months back and has extremely tight gluts - could that be affecting it at all? Through the fascial connection? What would your Treatment plan be?
Tegan, Australia
AnswerHi Tegan,
Do you have access to a trigger point chart or book? That would be my first stop and when I found the pain picture that seems to be her pain pattern, I would ask her to confirm my suspicions. That will give you a good starting point for symptom relief.
But you don't want just temporary symptom relief so let's see if you can get to the causing factor and get rid of it.
Typically, masseter, SCM, anterior and posterior suboccipitals, longus coli and longus capitis are the culprits for occipital headaches. Temporalis works with masseter.
But since muscles rarely act alone, it could also involve the areas you have been working. Do you 'unroll' the upper traps? They like to be unrolled to the back rather than pushed into or forward.
You are on the right track with the tight glutes. They will throw her posture off and that will cause pain in the occipital area. Look at her posture. Does she have the correct curves in her lower back and neck? Or has she lost her lower back curve? (That's my guess.)
Start by assessing her posture and check whether she has natural arches in her feet. If not, then arch supports or orthotics will help with posture. Having no arches could account for the tight glutes. I get my sturdy arch supports from a running shoe store.
Then start releasing tight muscles in anterior, medial and lateral upper legs. Release glutes and paraspinals (especially lower.) You are looking to normalize her posture to take the strain off her occiput.
Release iliopsoas muscles. I am assuming that she is balanced from left to right but you may find muscles to be tighter on one side than the other if she has an asymmetry.
Release anterior abdomen and chest/pecs and upper arms.
If nerve compression in her neck is involved, the rule of thumb is ice or cold. If heat makes her headache worse, cold will probably help.
If there are muscles that you don't yet know how to release in this list, this client is giving your the opportunity to do some new learning.
It's fun to get to the bottom of things! Good luck resolving this and thank you for writing. Let me know if you have more questions about this.
And if check out the Headache Category at http://SimplePainRelief.com you may find additional useful information there.
Best,
Kathryn
Kathryn Merrow
The Pain Relief Coach
