A patient returned today after 6 weeks of specialized physical therapy(Egoscue). She is a changed woman with significant reduction in pain and increase in motion. She asked that I share her story.
History: 4 year history of neck and right shoulder pain after a motor vehicle accident in which she was struck on the driver’s side door by a motorist who elected to disregard a red light. She had no prior history of neck or shoulder pain.
Pain was constant in duration, progressive in nature, 6/10 in severity, involves both right and left side of neck with radiations into the right shoulder and scapula. Aggravating factors involved lifting and turning her neck.
Treatment to date had included physical therapy, steroid injections, large doses of narcotics and muscle relaxants, Botox injections and surgical evaluation who recommended an urgent two level fusion at C5/6 and C6/7.
Physical examination was striking. Patient was wearing a soft cervical collar which she had worn for the last 2 years. Upon removal, the patient was unable to keep her head up. Her head, like a rag doll, simply falling forward. She had to place her finger underneath her chin to support the weight of her head. Rotation, flexion and extension were all severely limited.
Muscles form our foundation. The provide critical support. This patient had an injury to her longus colli muscle.
The longus coli is located anteriorly and enables flexion and rotation of the spine. It works in a complimentary fashion with the posterior neck muscles to stabilize the cervical spine. Similar to the ropes that support a tent pole , if one of the ropes is cut the tent pole ( cervical spine) is no longer supported and typically falls to one side.
Understanding the importance of muscles and ligaments and their function is critical to understanding how injury occurs and what therapies are appropriate. This is the standard at Centeno-Schult Clinic. For all those patients who have been in involved in a car accident and who have been told that it’s all their head there is hope. It’s not in your head, its in your neck:)