I’ve posted a new video onto YouTube that covers treatment to the anterior cervical/throat region. I’ve treated this area for over twenty years with very nice results in the treatment of neck region pain as well as issues relating to radiculopathy-like symptoms into the arm and chest/shoulder regions. More recently Ive learned the value of treating this area when dealing with issues relating to dysphagia (swallowing difficulties), as well as a host of voice and related issues. Each time I teach this in my Neck, Voice, and Swallowing Seminar I am intrigued at the comments I hear from the various speech language pathologists in the audience as they “play” with this treatment sequence.
Unlike similar techniques, my version is remarkably gentle intended to be very tolerable to the patient. I have been treated in this area in a manner that was quite pain provoking, both locally as well as with radiation into the arm and shoulder. While aggressive versions may have benefit I feel that such force is not necessary in order to foster change. Views the tightness, scar tissue, etc., needs to be “broken up” have little if any basis in fact. Our touch has impact and benefit, just probably not for the reasons most were taught. Also, if one knows the anatomy of the anterior cervical region, including important blood vessels, extreme caution should be the norm, not the exception, as injury is a possibility.
I offer this video not as instruction for those who have never learned to treat this area, but as a refresher to those who have taken one of my Foundations in Myofascial Release Seminars and felt that they were not completely comfortable with finger placement. If you’ve learned this technique from other sources and you can see enough similarity to make it relevant, lighten your touch and treat respectfully. The pressure in a posterior direction is the most common form of this technique, but please gentle explore medially and anteriorly, as shown in the video. Learning to feel for “tightness” that connects a patient to their symptoms, whether pain, dysphagia, or similar, is the key to this technique and my approach.
I’d love to hear your thoughts, either here or on YouTube and please share this post with your peers! Just use one of the sharing links directly below.
Regards,
Walt Fritz, PT
Foundations in Myofascial Release Seminars
You engage the deep anterior cervicals (scalenes and longus?) bilaterally. Do you not find that to be either too much sensation for the client, or for some, to be emotionally difficult?
Hi Justin,
Anterior cervical work could easily overwhelm if done with too much force. This is why I strongly emphasize working gently and following a strict adherence to patient tolerance. As I wrote in the blog, I’ve been treated with this sort of technique in a manner that was excessively strong and aggressive. It did push my buttons and that should never happen.
Walt
I agree with you on this completely. When attempting to release hyper-irritable tissues we don’t want to elicit a sympathetic response in the body. Even with gentle pressure, I’m curious if you see a difference in the work when applied bilaterally as opposed to unilaterally. My curiosity lies more in the psychological response in regards to two hands around the throat: pain free or not.
There is some good evidence that light stretching to the skin decreases sympathetic tone . However, if the approach is wrong/too aggressive, etc., one may provoke increase sympathetic dominance.
When someone comes to me for treatment they bring with them a long history, some of which they tell us, some which they do not. I recognize the boundaries of my scope of practice as a PT and if they have issues due to past trauma I take care not to make them believe that my table is the place to resolve these past issues. If someone emotes during treatment but are fine with the process, I certainly let them continue. I am most concerned about the issues of compromised swallowing, neck/arm pain, etc, which is what I am attempting to aide in resolving.
The hyper-irritability of the area may preclude any intervention, but in my experience a light, respectful touch overcomes most problems. I tend to treat bilaterally though there is no problem with choosing a unilateral approach.
Very good. Thank you for the discourse. I look forward to exploring more of your work.