It’s not uncommon for someone to wake up and say–“oh, oh–I can’t look to the right”, then as they get ready to drive to work backing up the car, they say “I just can’t see behind me”.
When they get into the office to get checked out, they are really limited in cervical right rotation. What is interesting is what they sometimes say, “I was unable to see behind in backing up my car, because my neck was so stiff.” When I ask them to show me. They only move their head to look behind. Realize I’m just asking them to do whatever they have trouble in doing. Then if I see that they are holding their chest from turning–yes they are only using the neck to look behind.
So now when they turn like they always have (maybe), they feel a new limit and often complain of discomfort/pain. Usually you can also appreciate increased tension in the whole upper quadrant and even their mid to low back becomes tense. Often their breath is held near and at the end range.
If you start with having them become aware in what is turning–in this case only the head from the neck (mid to upper neck only, no lower neck), you teach them how they are doing their task of looking behind. Then simply you can ask them if they notice their shoulders and chest moving. They usually ask if it should be moving. You bring them back to what do they notice and what is moving. Once what they are doing and what actually they are feeling moving (vs thinking something is moving–these are not necessarily the same) is apparent then you can continue the inquiry.
This inquiry will help them learn something and notice something first. Doing something without becoming aware of it becomes incomplete, rote type of learning. Rote or doing type or imitation learning is expedient and we all use it. I’m just suggesting that we often overuse this style. So I am (possibly laboriously) suggesting another style or strategy.
By just expanding what one is noticing and then including it for a few repetitions, the person can often find a greater ease in the original movement. The chest/thoracic spine was not initially involved. This area was actively held or counter moving. Counter moving in an acute painful condition will produce spasms. By relieving it, the movement pattern is distributed and spasms are reduced.
Why not just tell the person to move the chest at the beginning. Sure, no problem. This is an option. But the learning is dependent more directly on following someone else’s directions from the outside. The feedback loop is exogenous. This other strategy can be very much like an awareness through movement lesson (Feldenkrais like). In this case we are using awareness though to move better. (the underlying principle in the Feldenkrais system is to use movement to become more aware–they are different, often confused inappropriately)
Now ask them to show you the original movement. Some people when they come back to the original movement will find that it is much easier. They will report that they can see much farther. They would never have thought of doing that. Here is where I like to emphasize that they are also paying attention more to what they are doing and not doing (increasing their sensory feedback). Thereby building up their repertoire of proprioceptive and kinesthetic information.
Sometimes they do the very same original and habitually limited movement. This is not uncommon–no apparent improvement here. In this case you once again ask them what is moving and have them briefly find their holding of the chest, etc. Then allow their awareness to move the chest in the same direction of the face. Come back and do the original movement and they often move easier again.
You can continue with a variety of other things that you normally do for this issue. This strategy can be included at the very beginning as well as at the end of ones normal session.There are many other strategies one can explore.
Some of these techniques become isolated in implementation. I find myself and others sometimes just “doing” some technique to improve the movement. Everyone likes improvement. If you just start using the eyes to counter rotate and use the complimentary adjacent areas to ease tension and recheck the often improved movement pattern, what’s wrong with this approach. In one way nothing. It seems though we are just doing another trick of the system. The amount of endogenous learning doesn’t seem the same. I think both strategies of emphasizing the motor loop and the sensory loop can be useful. Maybe ask which one you use in which cases. Experiment with different strategies. In what situations are they helpful.
Share your findings.