Crux Performance Therapy

Cranial Nerves – Anatomy Basics

The cranial nerves are a set of 12 pairs of nerves that originate from the brain and extend to various parts of the head and neck. They play a crucial role in controlling many functions, including sensory and motor functions of the face, head, and neck. Osteopathic practitioners often consider the cranial nerves in their assessment and treatment of patients, as dysfunction in these nerves can manifest in various ways. Here is a brief overview of each cranial nerve, its course, function, and potential osteopathic implications in dysfunction:

Olfactory Nerve (CN I):

Course: The olfactory nerve originates from the olfactory bulb and passes through tiny foramina in the cribriform plate of the ethmoid bone to reach the nasal mucosa.
Function: It is responsible for the sense of smell.
Osteopathic Implications: Dysfunction in the olfactory nerve may be associated with anosmia (loss of smell), which can have various causes, including head trauma, sinus infections, or nasal obstruction.

Optic Nerve (CN II):

Course: The optic nerve extends from the retina of the eye and exits the orbit through the optic foramen.
Function: It carries visual information from the eye to the brain.
Osteopathic Implications: Conditions like increased intracranial pressure or optic neuritis can affect the optic nerve and may lead to visual disturbances.

Oculomotor Nerve (CN III):

Course: It emerges from the midbrain and passes through the superior orbital fissure to control most of the extraocular muscles and the muscles that control the size of the pupil.
Function: It controls eye movement, pupil constriction, and accommodation (focusing).
Osteopathic Implications: Dysfunction may lead to ptosis (drooping of the eyelid) and impaired eye movements, which can occur due to various causes, including nerve compression or vascular issues.

Trochlear Nerve (CN IV):

Course: It originates from the midbrain and passes through the superior orbital fissure to innervate the superior oblique muscle.
Function: It controls downward and inward movement of the eye.
Osteopathic Implications: Dysfunction can lead to difficulty in looking down or inward, potentially causing double vision.

Trigeminal Nerve (CN V):

Course: The trigeminal nerve has three branches (ophthalmic, maxillary, and mandibular) and emerges from the pons.
Function: It is responsible for sensory perception in the face and motor control of the muscles of mastication (chewing).
Osteopathic Implications: Dysfunction can result in conditions like trigeminal neuralgia, which causes severe facial pain, or temporomandibular joint (TMJ) disorders.

Abducens Nerve (CN VI):

Course: Emerging from the pons, it passes through the superior orbital fissure to control the lateral rectus muscle.
Function: It controls outward (abduction) movement of the eye.
Osteopathic Implications: Dysfunction can lead to difficulty in moving the eye laterally, causing strabismus or double vision.

Facial Nerve (CN VII):

Course: It originates in the pons, passes through the internal acoustic meatus, and exits the skull through the stylomastoid foramen.
Function: It controls facial expression, taste sensation on the anterior two-thirds of the tongue, and secretion of saliva and tears.
Osteopathic Implications: Dysfunction can result in facial weakness (Bell’s palsy), loss of taste, or issues with salivary and lacrimal gland function.

Vestibulocochlear Nerve (CN VIII):

Course: This nerve emerges from the brainstem and has two divisions, the vestibular and cochlear, which control balance and hearing, respectively.
Function: It is responsible for hearing and balance.
Osteopathic Implications: Dysfunction can lead to hearing loss, vertigo, or imbalance.

Glossopharyngeal Nerve (CN IX):

Course: It originates from the medulla oblongata and passes through the jugular foramen.
Function: It controls swallowing, taste sensation at the back of the tongue, and some parasympathetic functions.
Osteopathic Implications: Dysfunction may manifest as difficulty in swallowing, loss of taste, or issues with salivary gland function.

Vagus Nerve (CN X):
- Course: Originating from the medulla oblongata, it exits the skull through the jugular foramen.
- Function: It plays a role in various autonomic functions, including heart rate, digestion, and respiratory control. It also controls speech and swallowing.
- Osteopathic Implications: Dysfunction can lead to issues with voice, swallowing, or autonomic functions like heart rate regulation.
Accessory Nerve (CN XI):
- Course: It has both cranial and spinal components, with the cranial portion emerging from the medulla and the spinal portion originating from the upper spinal cord segments.
- Function: It controls the muscles involved in head and shoulder movement.
- Osteopathic Implications: Dysfunction can result in weakness or difficulty in turning the head or lifting the shoulders.
Hypoglossal Nerve (CN XII):
- Course: Emerging from the medulla, it passes through the hypoglossal canal.
- Function: It controls the muscles of the tongue.
- Osteopathic Implications: Dysfunction can lead to tongue weakness or deviation, affecting speech and swallowing.

Osteopathic practitioners may consider the cranial nerves when assessing patients for various neurological and musculoskeletal issues. Dysfunction in these nerves can result from a range of causes, including trauma, compression, inflammation, or systemic diseases. Treatment approaches may involve addressing the underlying cause, relieving pressure on the nerves, and promoting overall health and well-being to support nerve function. If you have any questions or concerns about cranial nerve issues please seek out medical attention.

Biomechanics Series – Fryettes laws of spinal mechanics.

Fryette’s laws, also known as Fryette’s principles or Fryette’s osteopathic laws, describe the biomechanics behaviour of the vertebral column, during different types of spinal motion. These laws were developed by American osteopathic physician Harrison Fryette in the early 20th century and are commonly taught in Osteopathic schools. Fryette’s laws are used to understand the complex interactions between vertebral segments and help diagnose and treat spinal dysfunctions. Though there is debate on the validity of Fryette’s theory of spinal mechanics as spinal mechanics are quite complex.

Fryette’s laws consist of three principles:

Fryette’s First Law

When the spine is in a neutral or slightly flexed position, side-bending and rotation occur in opposite directions.
In other words, if you rotate the spine to one side, the spine will naturally want to side-bend in the opposite direction.
This law applies primarily to the thoracic and lumbar regions of the spine. For example, if you rotate the thoracic spine to the left (counterclockwise when viewed from above), it will tend to side-bend to the right.

Fryette’s Second Law

When the spine is in a hyper flexed or hyper extended position, side-bending and rotation occur in the same direction.
In contrast to the first law, when you rotate the spine to one side, it will also side-bend in the same direction.
This law mainly applies to the lumbar region of the spine. For example, if you rotate the lumbar spine to the left, it will also side-bend to the left.
Also is more specific to one or two vertebrae versus a global curve

Fryette’s Third Law

When motion is introduced in one plane (e.g., flexion/extension), motion in the other two planes (e.g., side-bending and rotation) is reduced.
This law suggests that the spine has a limited degree of motion in multiple planes simultaneously.

These laws help osteopathic practitioners understand and diagnose spinal dysfunctions and facilitate treatment. By assessing the direction and quality of motion in the spine, they can develop treatment plans to address issues such as vertebral dysfunction and restore normal spinal function. Additionally, Fryette’s laws are considered important for understanding the relationship between spinal mechanics and overall health and well-being.

If you feel that you have been assessed and find you are not making any progress in spinal mobility or pain, it may be a good idea to seek out an Osteopathic manual therapist to help you through that process.

Biomechanics series – Costotransverse and Costovertebral joints.

Following my last post from the front of the body to the back, we find the ribs entering into a biomechanical relationship with the spine. Noting that a rib with have an articulation with the vertebrae above and below the rib. Essentially one rib with articulate with two vertebrae. Being able to differentiate between the the issue of whether or not it is a spinal mechanical issue or that of the rib is essential in clinical practice.

Costovertebral Joints:

Anatomy: The costovertebral joints are the articulations between the ribs (costae) and the vertebral column. Specifically, each rib has two costovertebral joints: one with the corresponding thoracic vertebra on the body of the rib and another with the transverse process of the vertebra.
Structure: These joints are primarily synovial joints, meaning they have a joint capsule filled with synovial fluid, which provides lubrication and reduces friction during movement.
Biomechanics: The costovertebral joints have several important functions in the thoracic spine biomechanics:
- Primary Role in Respiration: These joints allow for both bucket-handle and pump-handle motions during respiration. Bucket-handle motion involves the upward and outward movement of the ribs, increasing the lateral dimension of the thoracic cage. Pump-handle motion refers to the anterior-posterior elevation of the ribs, which increases the anterior-posterior dimension of the thoracic cage.
- Accessory Movements: These joints allow for small rotational and gliding movements that contribute to the overall flexibility and mobility of the ribcage during breathing.
- Stability: While these joints allow for movement, they also provide stability to the thoracic spine and ribcage, helping to protect the vital organs in the thoracic cavity.

Costotransverse Joints:

Anatomy: The costotransverse joints are the articulations between the ribs and the transverse processes of the thoracic vertebrae. Each rib articulates with the corresponding vertebra at this joint.
Structure: Like the costovertebral joints, the costotransverse joints are also synovial joints with joint capsules and synovial fluid.
Biomechanics: The costotransverse joints contribute to the following aspects of thoracic spine biomechanics:
- Rib Movement: These joints allow for the elevation and depression of the ribs during respiration. When the muscles associated with these joints contract, they can pull the ribs upward and outward, expanding the thoracic cage.
- Flexibility: These joints contribute to the flexibility of the ribcage, which is essential for various activities like deep breathing, coughing, and twisting of the torso.
- Stability: While allowing for movement, the costotransverse joints also contribute to the overall stability of the thoracic spine and ribcage.

Below we will look at at the movement with a little more complexity without going too deep into the

At the vertebral level one rib will articulate with two vertebrae. The inferior aspect of the superior vertebrae and the superior aspect of the inferior vertebrae, this creates the joint base which also sits upon the annulus fibrosis of the intervertebral disc.

The rib then has another articulation on the transverse process. One being the CV and CT joint. These joints allow for movement in the posterior, accommodating the respiratory movement of the thorax. The joint of the costal head is a double synovial joint.

An interosseous ligament which runs from the apex of the costal head, between the two articular facets to the intervertebral disc, divides the joint and is surrounded by a single joint capsule but with two distinct joint cavities. With strong ligaments associated with it the mechanically linked joints of the CT and CV joints share on movement in the dorsal spine. Rotation about a common axis, passing through the centre of each joint. The axis of movement joining at the centre of the CT joint to the centre of the joint at the costal head acts as a swivel for the rib. This axis relative to the sagittal plane will determine the direction of movement for the rib.

For the lower ribs, the axis moves closer to the sagittal plane. The resulting movement is the rib increases its transverse diameter of the thorax. (Bucket handle movement) The axis for the upper ribs lies almost coronally. The elevation of the ribs increases in the anteroposterior diameter of the thorax. Rib elevation increases at the same time the transverse diameter of the lower thorax and the anteroposterior diameter of the upper thorax. In the mid thoracic the movement is roughly equal of transverse and anteroposterior diameters.

If you feel thoracic stiffness and haven’t been improving with conventional treatment over time, it may beneficial to get a more thorough assessment checking these joints movements and making sure movement in the thorax is balanced. If there are any questions please feel free to reach out.

Biomechanics series – Sternochondral and Costochondral joints.

Here we are going to start with a basic overview of these joints and then further down we will get into a little more specifics.

Sternochondral Joints:

Location: Sternochondral joints are found where the ribs meet the sternum (breastbone).
Type: These joints are typically classified as synchondrosis joints, which means they are cartilaginous joints where the connecting material is hyaline cartilage.
Function: Sternochondral joints allow for slight movement during respiration. The flexibility of these joints is important for ribcage expansion and contraction during breathing.

Costochondral Joints:

Location: Costochondral joints are found where the ribs meet the costal cartilages (the cartilage portions of the ribs).
Type: Costochondral joints are also classified as synchondrosis joints.
Function: These joints play a role in allowing for the expansion and contraction of the ribcage during breathing. They are somewhat flexible, allowing the ribs to move and adjust during respiration.

The biomechanics of these joints are primarily related to their role in chest expansion and breathing. When you inhale, the chest cavity needs to expand to allow the lungs to fill with air. The sternochondral and costochondral joints, along with other components of the ribcage, allow for this expansion to occur.

During inhalation:

The diaphragm contracts, moving downward and increasing the vertical dimension of the thoracic cavity.
The external intercostal muscles contract, causing the ribs to move upward and outward.
The sternochondral and costochondral joints allow for some flexibility, enabling the ribs to move and the ribcage to expand.
This expansion creates a negative pressure within the chest cavity, drawing air into the lungs.

During exhalation:

The diaphragm relaxes, moving upward and decreasing the vertical dimension of the thoracic cavity.
The external intercostal muscles relax, allowing the ribs to move downward and inward.
The sternochondral and costochondral joints return to their resting positions as the ribcage contracts.

The figures below describe the movement with a little more complexity with a description of the movement. Phrases used and shortened are SC (sternochondral) CC (costochondral)

Due to the anatomy of the joint, the mechanical movement between the SC CC joints and the sternum must be harmonious. The sternum due to its mobility and articulation, its joint range will affect the angles of the ribs. Creating this bucket handle movement during inspiration of the breath. Which is more prominent in the lower ribs. (Figure 1, t)

Figure 2 below shows a basic design on how the SC joint functions. The cartilage at the medial border (2) forms a wedge in the sternum and they are tightly interlocked. The Costotransverse joint (figure 1, X axis) in the dorsal spine will drive this transverse movement of the lateral ribs. The movement of the ribs as you descend the spine will change from mostly an anteromedial movement, which is the pump handle effect (figure 2, t and figure 1 y) to the more lateral movement to accommodate the lower lobe of the lung during inhalation. As for the CC joints during inspiration the costal cartilages undergo angular displacement and torsion around their long axis.

At the same time the angles of the CC and SC joints are altered. The costochondral joint is cone shaped, flattened anteroposterior and fits snugly into the anterior head end of the rib. The rib is shaped accordingly to receive it (figure 2, 5 being the cone and 6 being the rib receiving it) During inspiration the rib is lowered in relation to the sternum as the sternum rises. The costal cartilage will twist on its own axis. Behaving as a torsion rod resembling a spring that works not by torsion. (figure 2, t shows the costal cartilage and how it undergoes the torsion around an axis between the sternum and rib) The energy stored in the costal cartilage during inspiration, the muscles relax, and the elasticity will help bring the skeleton back to its position.

The body is complex and the mechanism of breathing in relation to the sternum and ribs are equally as complex. There are many variables that affect the movements of these joints and if you feel that you have issues with breathing, costochondritis, sternal pain that has been assessed by a physician book an appointment so we can assess everything in relation to those joints, or by all means contact me with any questions.

Some structures that can affect these joints

Dysfunction in either the Costovertebral and Costotransverse joints in the dorsal spine (either from a trauma, overuse/postural deficiency)
Compromised spinal mechanics between T1 and T10
Muscle related dysfunction in the anterior or posterior thorax
Fascial tension (connective tissue superfiscial and deep to these joints)
Intercostal nerve or other nervous system issus
Diaphragmatic dysfunction

In future posts I will go over the specific cartilage of these joints, why breathing and movement is so important to keep a healthy thorax into old age and how we can help them with manual therapy.

Pain series – Gate control theory

The Gate Control Theory of Pain is a widely accepted and influential theory in the field of pain perception and management. It was first proposed by Ronald Melzack and Patrick Wall in 1965 and has since played a significant role in understanding how our nervous system processes and modulates pain signals. This theory suggests that pain perception is not solely determined by the activation of pain receptors (nociceptors) but is also influenced by a complex interplay of sensory, emotional, and cognitive factors.

Key components of the Gate Control Theory of Pain include:

Nociceptors: Nociceptors are specialized nerve endings that detect noxious or potentially harmful stimuli, such as extreme temperatures, pressure, or tissue damage. When these nociceptors are activated, they send pain signals to the spinal cord and brain.
Spinal Gate: The theory proposes the existence of a “gate” in the spinal cord, which can open or close to regulate the transmission of pain signals to the brain. This gate is controlled by inhibitory and excitatory signals from various sources.
Afferent Input: The theory suggests that various sensory input from non-nociceptive nerve fibers (e.g., touch, pressure, vibration) can compete with and inhibit the transmission of pain signals through the spinal gate. When these non-nociceptive signals are strong, they can close the gate and reduce the perception of pain.
Central Control: The brain plays a crucial role in pain perception. Emotional and cognitive factors, such as attention, anxiety, and expectations, can influence the perception of pain. These factors can either open or close the gate, affecting how much pain is ultimately perceived.
Modulation of Pain: The Gate Control Theory implies that pain perception is not solely determined by the intensity of tissue damage or nociceptive input but is also influenced by factors that can enhance or reduce the pain experience. For example, distraction techniques, relaxation, or the release of endorphins (natural pain-relieving chemicals) can help close the gate and reduce pain perception.

Overall, the Gate Control Theory of Pain highlights the complexity of pain perception and emphasizes that it is not a simple linear process. Instead, it’s influenced by a combination of sensory, emotional, and cognitive factors that can either amplify or dampen the experience of pain. This theory has had a significant impact on the development of pain management strategies, including the use of techniques like distraction, relaxation, and the application of transcutaneous electrical nerve stimulation (TENS) to manipulate the gate and alleviate pain.

Pain series – Peripheral Afferent Nociceptors

Peripheral afferent nociceptors are specialized nerve endings found throughout the body that detect and transmit information about noxious or potentially damaging stimuli, such as extreme temperatures, mechanical pressure, and chemicals that can cause tissue damage or inflammation. These nociceptors play a crucial role in the body’s ability to sense and respond to potentially harmful stimuli in the environment.

Nociceptors are a type of sensory receptor primarily responsible for the perception of pain. When activated by harmful stimuli, they generate electrical signals (action potentials) that travel along nerve fibers, also known as afferent nerve fibers, to the central nervous system (spinal cord and brain). This transmission of pain signals allows the brain to interpret and respond to the potentially harmful stimulus, resulting in the sensation of pain.

Nociceptors are distributed in various tissues throughout the body, including the skin, muscles, joints, and internal organs. They can be classified into different categories based on the type of stimuli they respond to:

Mechanical Nociceptors: These detect mechanical pressure, stretching, or deformation of tissues. They are involved in sensing events such as sharp impacts, pinching, or tissue damage caused by physical trauma.
Thermal Nociceptors: These respond to temperature extremes, such as intense heat or cold. They play a role in detecting thermal injury or extreme environmental conditions.
Chemical Nociceptors: These are sensitive to various chemicals released during tissue damage or inflammation, including irritants and molecules associated with inflammation and cell damage.
Polymodal Nociceptors: These nociceptors can respond to multiple types of stimuli, including mechanical, thermal, and chemical stimuli.

The activation of peripheral afferent nociceptors is the initial step in the pain perception process, leading to the transmission of pain signals to the central nervous system. Once these signals reach the spinal cord and brain, they are further processed and interpreted, ultimately resulting in the perception of pain and the initiation of appropriate protective responses.

TFCC – Is it bothering you?

What is the TFCC? TFCC stands for Triangular Fibrocartilage Complex, which is a structure located in the wrist. It plays a crucial role in stabilizing the wrist joint and enabling smooth movements between the ulna (one of the two forearm bones) and the carpal bones in the hand. Injuries to the TFCC can occur due to various reasons, and biomechanical constraints are among the factors that can lead to such injuries.

Biomechanical constraints refer to limitations or stresses placed on the body’s tissues, such as ligaments, tendons, and cartilage, during movement or activity. In the case of TFCC injuries, biomechanical constraints can arise from repetitive stress (, sudden impacts, or abnormal loading of the wrist joint. Here are some biomechanical factors that can contribute to TFCC injuries:

Repetitive motions: Activities that involve repetitive wrist movements, such as in sports (e.g., tennis, golf) or certain occupations (e.g., manual labor, assembly line work), can place prolonged stress on the TFCC. Over time, this repetitive stress can lead to wear and tear on the cartilage and ligaments, increasing the risk of injury.
Weight-bearing activities: Activities that involve putting significant weight on the hands, such as gymnastics, yoga, or weightlifting, can subject the TFCC to excessive compression forces. This pressure can lead to TFCC injuries, especially if the wrists are not properly supported or aligned during these activities.
Impact or trauma: Falls or direct blows to the wrist can cause sudden and severe stress on the TFCC, resulting in tears or sprains. Athletes in contact sports or those who engage in activities with a risk of falling are particularly susceptible to this type of injury.
Poor wrist positioning: Incorrect or awkward wrist positions during various activities, like typing with improper hand and wrist posture, can strain the TFCC and surrounding structures over time.
Lack of strength and flexibility: Inadequate strength and flexibility in the muscles surrounding the wrist can lead to instability, which may increase the risk of TFCC injuries during physical activities.

To prevent TFCC injuries due to biomechanical constraints, it’s essential to:

Practice proper ergonomics and wrist positioning during various activities.
Warm up and stretch before engaging in physical activities involving the wrist.
Strengthen the muscles in the forearm and wrist through targeted exercises.
Use protective gear, such as wrist splints or braces, during high-risk activities.
Take breaks and rest if you engage in repetitive wrist movements for extended periods.

If you suspect a TFCC injury or experience persistent wrist pain or instability, try to find someone well informed on the subject and stay tuned for some home exercises for wrist stability.

Extracellular Matrix – The basics.

What is Extracellular matrix, why does it concern us and what can we do about the health of this extra cellular space (in a future post)

Cells congregate (come together) to form structural and functional associations. These are called tissues. There are four basic tissues in the body, epithelium, connective tissue, muscle and nervous tissue. All these tissues are. composed of cells and extracellular matrix (ECM). Extra being outside the cell. It is a complex environment composed of non living macromolecules created by cells which then get exported to this space outside the cell. ECM was once believed to be an inert element of tissue but now it is believed to assist in many adaptational functions of cells.

Connective tissue ECM, consists of a matrix of collagen fibres and something called ground substance. Ground substance is an amorphous gel like substance. The content includes Glycoaminoglycans, proteoglycans and glycoproteins. Which in a future post I will go further in depth into their functions. The fibres are proteins which fall into two major categories. Non elastic collagen. Which are quite flexible and that has great tensile strength. As well as elastic fibres, that can be stretched up to 150% of their resting length before breakage occurs.

The activity of ECM in the intra/extracellular activity of cells include;

Modify the morphology and functions of cells
Modulate the survival of cells
Influence the development of cells
Regulate the migration of cells
Direct mitotic activity of the cells
Form junctional associations with cells

A Major function of ECM is the stability it provides cells. The scaffold like environment of the collagen helps cells resist tensile forces as well the ground substance assists in the ability for cells to resist compressive forces. When compressed or heated the ground substance goes through a Thixotropic change, which is the ability for a substance to go from a solid substance to a liquid substance. Essentially when stress is applied it becomes less viscous reducing fluid flow, which is also important to have proper fluctuating fluids. Its when this ECM starts to break down that you have a poorly adapting system and cells don’t get proper information passing cell to cell through a process called “Mechanotransduction”. Mechanotransduction is the ability for mechanical tension or a stimulus to be able to pass cell to cell to encourage proper cell signalling. Allowing proper transcription of cell mediated growth factors and allow the the body recover from the stress we enact on our cells day to day. Tendon overuse injuries is a breakdown of the ECM of the tendon and mechanical strain can further change the ECM in a negative way.

A fascinating structure living in our body the ECM and its constituents vary depending on the tissue that you examine. The overarching term connective tissue relates the body as a whole as a connected whole through this vast collagenous network. Information is disseminated through chemical mediators and mechanical stimuli through link proteins such as integrins (which cells are very sensitive to mechanical stimuli)

In future posts I will go further into the various elements of this wonderful part of our body and delve deeper into the differences tissue to tissue if I can, but for now here is another basics series on a fascinating aspect of human physiology.

Pain series – Sensitization

Central sensitization and peripheral sensitization are often discussed in the context of pain perception and the body’s response to painful stimuli. These terms describe different mechanisms through which the nervous system becomes more sensitive to pain signals, leading to heightened pain perception and potentially chronic pain conditions. Through a short series of posts, I will simply define what these are and hopefully what creates these phenomena with more detail and complexity as we move forward. With some added strategies to overcome pain that has become chronic.

Central Sensitization:
Central sensitization refers to a process in which the central nervous system (particularly the spinal cord and brain) becomes more responsive to pain signals over time. It occurs when there are changes in the neurons and synapses within the central nervous system, which amplify the transmission of pain signals and decrease the threshold for pain perception. This can lead to a heightened response to normal or even non-painful stimuli, a phenomenon known as allodynia.

Factors that can contribute to central sensitization include prolonged exposure to pain, inflammation, injury, or repeated pain signals. Conditions like fibromyalgia, chronic migraine, and some types of neuropathic pain are associated with central sensitization.

Peripheral Sensitization:
Peripheral sensitization, on the other hand, involves changes in the sensitivity of peripheral nerves (nerves outside the brain and spinal cord) to pain signals. In this process, tissues that are injured or inflamed release chemicals, such as prostaglandins, cytokines, and neurotransmitters, that sensitize nearby nerve endings. This increased sensitivity leads to a lower threshold for activating these nerves and transmitting pain signals to the central nervous system.

Peripheral sensitization can result in hyperalgesia, which is an increased sensitivity to painful stimuli, and can contribute to the persistence of pain even after the initial injury or inflammation has healed.

In summary, central sensitization involves changes in the central nervous system that enhance pain perception, while peripheral sensitization involves increased sensitivity of peripheral nerves to pain signals. These processes can play a significant role in the development and maintenance of chronic pain conditions, and understanding them is important for developing effective pain management strategies.

Neck pain? Try this isometric routine to increase strength with minimal joint movement

Check my other post about a basic summary as to why isometric exercises are beneficial for rehabilitation and general strengthening.

Exercise 1: Supine Neck Extension Isometric Hold

Lie down on your back on a comfortable surface such as a yoga mat.
Place the back of your head slightly on a slightly elevated surface, a book or two is ideal. Essentially to create a neutral spine.
Gently push your head backward into the support or whatever surface you are on.
Hold this position for 10 to 15 seconds, focusing on engaging your posterior neck muscles.
Relax and repeat for 3 to 4 sets.

Exercise 2: Supine Neck Flexion Isometric Hold

Continue lying down on your back with your hands on your forehead.
Apply pressure with your hands as you push your head forward, resisting the movement. The ideal movement adds a chin tuck into the flexion movement. Using the deep flexors of your cervical spine.Imagine you are multiplying your one chin by two (making a double chin)
Hold this position for 10 to 15 seconds, keeping the muscles in the anterior part of your neck activated.
Relax and repeat for 3 to 4 sets.

Exercise 3: Side lying Neck Lateral Isometric Hold

Lie down on one side, this can get a little uncomfortable for some people due to the pressure into the shoulder. Do you best to achieve this position. (alternatively you may lay on your back and resist lateral flexion by using your hand pressing on the side of your head and resisting that movement)
Slowly bend your head to the right or left. Depending which side you started on, aiming to touch your right ear to the support under your ear.
Hold this position for 10 to 15 seconds, feeling the muscles on the right side of your neck working.
Relax and switch sides, repeating the exercise for the left side.
Repeat for 3 to 4 sets on each side.

Exercise 4: Supine Neck Rotation Isometric Hold

Continue lying down on your side with your arms relaxed.
Slowly turn your head to the right, aiming to touch your right cheek to the support.
Hold this position for 10 to 15 seconds, feeling the muscles on the right side of your neck engaging.
Relax and switch sides, repeating the exercise for the left side.
Repeat for 3 to 4 sets on each side.

If you have chronic neck pain, issues within the segments of your cervical spine. Isometrics can be a great way to strengthen without irritating the tissues. If you are in the Calgary area and want some more information or are experiencing pain beyond what stretching or exercise can help with please contact me!