Case Study; Brett
Brett was involved in an automobile accident about two weeks ago. Someone ran a red light and hit him on the driver’s side while he was going through an intersection. His car was pretty badly damaged and he was pretty shaken up. He did not need to go to the hospital at the time of the accident but had some pretty serious neck pain within a few hours of the accident that lasted for the first week. It has been gradually dissipating but is still with him.
In addition to the neck pain, he also experienced sharp, shooting pain down his right arm. That sensation was most prominent immediately following the injury and for the first few days. It still flares up occasionally, but overall that sensation has been lessening. He has also noticed difficulty turning his head to either side. He is hesitant to turn his head too far and notices that he is protecting it from movement quite a bit now.
Brett has had massage therapy a number of times before and it has always helped him relax quite a bit. He was thinking it might be a helpful approach with his neck pain following the accident. However, he is also a little hesitant about having anyone touch or move his neck right now as the accident is still relatively recent and it seems easy to set off pain in his neck with certain movements or any pressure in the area.
* If Brett was hit from the driver’s side, what are some of the neck muscles that would be suddenly stretched with the initial impact? (think about which way his head would go first as a result of the impact).
* Which bundle of nerves passes between the scalene muscles and is often overstretched in an accident like Brett’s?
* What are several anatomical structures in the vicinity of the scalene muscles that you should be careful about when palpating the muscles in this region?
* If the lateral flexor muscles on the right side of Brett’s neck are tight, what motion would be most effective to encourage lengthening in them while stretching?
* Brett mentioned he was having some trouble turning his head to the side, which we may want to evaluate. If we wanted to test the lengthening of his right side sternocleidomastoid muscle, which way would we turn his head?
Adapted from Whitney Lowe, LMT Director, Academy of Clinical Massage. 'Which bundle of nerves passes between the scalene muscles and is often overstretched in an accident like Brent’s?'