One of the common conditions that we treat here at Hudsonville Physical Therapy is muscle tension headaches. Headaches can be a very complex condition, with many different contributing factors. However, when it is determined that the headaches are “muscular” in nature, physical therapy is a very effective solution.
One of the most common causes of muscle tension headaches is poor posture. When we sit or stand with correct posture, our head is centered over our torso, and is in a balanced position. However, many people do not sit or stand with proper posture. Our typical posture is what we refer to as a “forward head” posture, where our head is out in front of our torso. Heads are quite heavy (14-16 pounds on average), and when the head is in front of the torso, gravity is pushing it downward. So in order to keep our head up, the muscles in the back of our neck and shoulders have to continually hold our heavy head up. Over time, this causes the muscles to fatigue and get tense, leading to muscle tightness and pain.
Another cause of muscle tension headaches is stress. People tend to carry their stress through their neck and shoulders, leading to abnormal amounts of tension and lack of rest for the muscles. Over time this takes its toll and leads to chronic muscle tension and headaches.
Most people will begin taking some type of medication (pain relievers or anti-inflammatories) to treat their headache. This can provide short term benefit, but unfortunately is not a long term solution because medication does not treat the cause of the pain, only the symptoms. However, physical therapy gets to the root cause of the problem and provides a long term solution!
So what is this solution to muscle tension headaches? Typically it involves several of the following interventions:
1. Postural Education. It is essential to teach our patients proper posture so that they can eliminate the strain on their muscles caused by faulty posture. If we do not do this, the headaches will likely return. This includes identifying potential posture problem areas including use of laptop computers or cell phones.
2. Identifying stress and the body’s response to it. People often know why they are stressed, but have difficulty eliminating the effect of the stress on the body. One effective technique is by teaching correct breathing. When stressed, people often breathe with their “accessory muscles” through the neck and shoulders. This leads to shallow, quicker breathing and increased tension through the neck and shoulders. The diaphragm is supposed to be our main breathing muscle, and the diaphragm is located in the abdomen. When we breathe correctly, we use our diaphragm (abdomen) to breathe, which results in deeper, more efficient breathing. This breathing provides more oxygen to our body, which it needs. Diaphragmatic breathing also eliminates tension in the neck and shoulder muscles and helps our body to relax.
3. Soft tissue massage. When muscles have been tense for a long period of time, it’s almost as if they don’t know how to relax anymore. A skilled physical therapist is able to work on these tight muscles and release this chronic muscle tension, which can be extremely helpful in eliminating symptoms.
4. Stretching and mobility exercise. Tight muscles lose flexibility, resulting in reduced range of motion in the neck. PT can help to stretch these tight muscles and restore full range of motion in the neck, which enables the body to move without compensation.
5. Exercise. We need to identify the proper muscles to strengthen, so that the muscle tension problems do not return due to having weak muscles. This includes strengthening the deep cervical flexor muscles (front of the neck) as well as the scapular and shoulder girdle muscles. Maintaining a good exercise routine often makes the difference between having chronic headaches and being headache free.
Those are just some of the treatment interventions used by physical therapists. In all cases, it is important to have a thorough physical therapy evaluation to determine your specific needs. If you have been struggling with tension headaches, give us a try. You’ll likely wonder why you didn’t do it sooner!
By: Mason Riegel, PT
Steve Bartz, PT