Working with clients who have cervical pain
by Glaucia Adriana Rocha
Photographer: Paula Oliveira
«…I am convinced that movement is more than capable of transforming lives, and it is also an
essential tool for the treatment and approach of
most cases of chronic pain.
I danced most of my childhood and teen years but he little ballerina that lived inside of me one day left, and a dream of becoming a physiotherapist appeared. In her place, another Glaucia was born, the one that sat hours and hours in a chair, in the classroom and at home, studying for the college entrance exam and all throughout my college years. I believe that many of you have experienced the same fate.
And it is within this context of movement that I want to start my exploration about the extent to which our body suffers as we grow into adulthood. In fact, many of us are already suffering with who we were since childhood. My clinical practice scenario today is to work with children and teenagers. Most of them have very little body awareness, which is acceptable up to a certain point. But reaching adolescence with so much structural deformity and so much lack of mobility, I honestly I cannot accept and find it normal, since I have worked with more and more teenagers who most likely will become adults who will suffer with pain. We lack movement in daily lives and we need to regain the confidence to move freely and without restriction. Movement is not only a result of the activation of the neurological and mechanical systems; it is also represented by the emotional system. We use movement to transcribe body language, and we often store unnecessary stresses because of the great emotional stress we have in our lives.
The general state of the muscles and body posture directly rep- resent our mood and emotional state. Therefore, when we define the Pilates Method as a method of conditioning that involves the connection between body, mind and spirit (even though this concept arose in the middle of the last century); if we bring this idea to the present day, this definition is more current than ever before, as it is the same basis of work for most successful rehabilitation techniques applied at the most renowned rehabilitation cen- ters in the world.
Unlike conventional physical therapy, the Pilates Method was created in a way that sees the individual as a whole. We don’t work isolated areas of the body, the Method was built to work the body globally.
Pain affects motor control in a completely unforeseen and immeasurable way. If the choice of exercises within the class is based only on the region affected by the pain in the hopes that the motor control system will be reset, it will have no ef- fect and no change in the motor behavior, even if the pain has been abolished. This thought of only treating the affected area until the disappearance of the pain is a simplistic idea and the reason why many patients return to a state of pain in the short or medium term. If the chosen repertoire to the class is not ideal or if we simply choose to do unreasonable stunts just to challenge the client, the individual will always revert back to their compen- satory motion patterns. In this case, the exercises will not be working the primary stabilizers and therefore the learning process in terms of motor control will not occur. Consequently, the integration into movement and posture at the end of the program will not occur.
Since the topic of chronic pain is too broad, I’ve chosen to discuss cervical pain which is quite common nowadays. Neck pain is one of the major musculoskeletal disorders in the adult population. It’s prevalence in the world ranges from 16.7% to 75.1%. This condition has a complex etiology, in- cluding a number of factors: ergonomic (strenuous physical activity, use of force and vibration, inadequate posture, repetitive movement), individual (age, body mass index, genome, musculo- skeletal pain history), behavioral (smoking and level of physical activity), and psychosocial (job satisfaction, stress level, anxiety, and depression). The sedentary lifestyle of modern society associ- ated with the overuse of computers, smartphones and tablets has dramatically changed our posture, and this is starting to happen earlier and earlier. Joseph’s writings have never been so current, specially when he said “First educate the child. “ No doubt this phrase needs to be put into practice in the present day…»
Full text available in 'Pilates4you Journal «The Pilates Englishman»'