My doctor forbids SCM massage

Hi guys.

This is my first post in here, so I hope it's in the right place.

 

I recently had a revelation that explained a lot of the problems I've been having over the years:
- As a kid, I refused to wear braces, despite my dentist warning me, that I might get chronic headaches later in life.
- This never happened, but I have always gotten dizzy when I stand up to fast - sometimes even fainted because of it.

- Whenever I'm the least bit cold, it feels like I get a sinus infection, except it only hurts in my sinuses, and not in the jaw, and other places where such an infection should hurt.
- About 6 months ago, I fell and hurt my shoulder pretty badly, and since then, it's been clicking when I rotate it.

- Since the fall, my dizziness has been way more random, to the extend that doctors confuse it with anxiety attacks.

 

So by chance, I picked up The Triggerpoint Therapy Workbook and found that ALL of this might be related to trigger points in the Sternocleidomastoid, and once I started massaging it, some of the trigger points in it, actually made me dizzy, even though I was laying on a table, completely still. Also, this is the first time I feel like I can actually "get to" the part within my shoulder that's clicking.
I happened to have one of my many "sinus infections" when I massaged it the first time, and it actually went away.

So I talked to my doctor about this, and she was immediately scared, when I told her about this. She said that because of the carotid artery that runs on top of the sternocleidomastoid, and the thyroid gland beneath it, this is an extremely dangerous area to massage, and that pushing the wrong area could cause a self inflicted heart attack.

She suggested that I keep stretching the muscle - but nothing else.

Searching the web for information of this, I found a LOT of information about how and why to do this massage - and the only warning I've found against it, is in a single YouTube comment.

So what is your experience with this? How should I proceed?

I would say don't worry about it. Doctors are right 14% of the time, according to some statistics I made up. Once, I came in for a wrist problem and had a doctor tell me to stop doing handstands because I can fall and hurt my head. Another time I ripped off my toenail and conversation about sports happened and my physician told me I should stop practicing ankle inversion exercises because I'm going to sprain my ankle. No, you dolt, I'm going to sprain my ankle when I stop ankle inversion exercises!

 

Anwyays, haha, never heard of anyone having an issue with sternocleidomastoid massage. Turn the head a bit to stretch the muscle and "pop" it out of the neck so you can see it more easily. Then grab the tissue and pull out with your thumb and fingers. And when you grab all that soft tissue outward to massage it, don't pressing back inwards toward the neck to massage it but instead just massage it between your thumb and fingers, held out.

Maybe scalenes would be more worrisome, but you can check this video, the guy mentions how to avoid digging into your

If you are worried, perhaps see a massage therapist or ART something of the sorts. You could ask them show you how to massage it on your own.

That video kind of confirm my own thoughts on the subject. I mean - when you pull it out and press on the sides, instead of just pushing it towards the throat, you avoid the thyroid gland - and the carotid artery is strong enough, that you'll feel it if you put your fingers on it - and of course you shouldn't block that thing....
Also, that's the way I was already doing it, after having it explained in the book, and having seen it several other videos outlining the massage. 
So thanks for the vid

When I took a massage training course, there were areas of the neck identified as being off-limits, as it were, in the typical relaxation type massage.  There are some delicate tissues in the front of the neck- no one really disputes that the trachea is not something to be massaged.  However, I have never heard of a risk of heart attack in an otherwise healthy individual due to massage of the Sterno M.  Heck, in Judo, BJJ, wrestling, etc. the neck muscles take all kinds of abuse and pressure. 

In my massage course, we never heard of it. We learned to massage the entire body, but this part was never mentioned. But you're right - in Judo training, we strangulate each other by the carotid artery for "fun"... Sometimes until we blackout from it... And still - I've never heard of this before... :/

It's stimulating the vagus that will cause the heart rate to lower or stop. As long as the electrical conduction in the heart is health it shouldn't cause a problem. There is however a risk of on underlying condition which could make this a dangerous risk.

You had au to autonomic nervous system response. That normally happens when you make a big neurological change to an area that has been dysfunctional for a long time. You may need to be a bit more gentle for the next few releases. Keep going you have obviously found an area that needs a lot of correction. Most doctors don't know how to treat musculoskeletal injuries well as they have to focus on other medical conditions that are life threatening.

Mark Collins said:

You had au to autonomic nervous system response. That normally happens when you make a big neurological change to an area that has been dysfunctional for a long time. You may need to be a bit more gentle for the next few releases. Keep going you have obviously found an area that needs a lot of correction. Most doctors don't know how to treat musculoskeletal injuries well as they have to focus on other medical conditions that are life threatening.

you mean that sick to the stomach feeling feeling that happened when you first showed me how to release the psoas? yeah, that was rough, at first. 

Keilani Gutierrez said:

you mean that sick to the stomach feeling feeling that happened when you first showed me how to release the psoas? yeah, that was rough, at first.

Yep.

Mark Collins said:

Yep.

Ok, you got me, I'm intrigued... What are you guys talking about?

lacrosse ball to the gut with the weight of an olympic bar on it for active release. first time i hit a sweet spot it was as if my nervous system lit up like a christmas tree and my eyes spun around like a lottery machine. didn't even come close to how my hip flexors felt when i first rolled on them

Keilani Gutierrez said:

lacrosse ball to the gut with the weight of an olympic bar on it for active release. first time i hit a sweet spot it was as if my nervous system lit up like a christmas tree and my eyes spun around like a lottery machine. didn't even come close to how my hip flexors felt when i first rolled on them

I like the imagery. Sounds like Donald Duck being hit by a freight train 

The carotid arteries contain something called baroreceptors. When you stand up the blood pressure above the heart decreases, the baroreceptors can sense this and signals to the heart to increase output. This insures that the brain always get enought blood. One reason for dizzyness when you stand up is that either the baroreceptors is not signaling properly or the heart does not respond by increasing output.

 

When you put pressure on the carotides from the outside you actually stimulate the baroreceptors the same way an increase in blood pressure would. The heart responds by decreasing its output and again this can cause dizzyness when the blood flow to the brain decreases.

 

I think you should be very careful with putting pressure on the carotides, maybe get an ECG to make sure its not a heart problem causing the dizzyness. Also, if you want to continue the massage, never massage both sides at the same time.

As for my personal health - I had an ultrasound scanning of the heart, and a bicycle test with an ECG to test for the dizziness phenomenon - and my heart is as healthy as ever. I also went through a diverse testing for certain kinds of asthma, and that's not it either - plus my blood pressure is stable at 124/88 with very little variation.

 

Since I almost always massage it myself, I have no way of massaging both sides at the same time, while also relaxing the sternocleidomastoideus. I do of course stretch a lot more than I massage it to - but for now, I'm going to keep doing the massage as well..

Joek is pointing out something important. Your doctor wasn't an idiot. They were pointing out a well known phenomenon. The baroreceptors in the neck are the reason one is never to check pulses on both sides of the neck at the same time: the body will perceive the blood pressure is really high (even though it is your fingers) and decrease the blood pressure, leading to decreased blood to the brain.

 

Did your doctors check your blood lipids and carotid arteries? Also, be aware that many heart problems electrically may evade our diagnostic tech since they can be episodic, so if the problem is not occurring when tested, it wouldn't be picked up.

 

I am not a doctor yet, but if you continue having the problems, follow up with one.

The problem (anxiety-like attacks with nausea and focusing problems, which is why I had these tests) can be provoked by untamed cardio, and I DID provoke it during the bicycle test.

The also did a number of blood samples and blood lipids, saturation, cholesterol and whatever else they tested, was all fine.

How would they go about checking the carotid artery? - Can't answer that one unless I know how it's done..

Ultrasound or interventional radiology

howens said:

Ultrasound or interventional radiology

Nope.. They haven't done that... Only ultrasound directly on the heart.

Keilani Gutierrez said:

you mean that sick to the stomach feeling feeling that happened when you first showed me how to release the psoas? yeah, that was rough, at first. 

Please link this, I'd like to try this, my psoas is bugging me:P