Cervicogenic Headaches

Aaron Vibert | Physiotherapy | START Training
Do you suffer from headaches, neck pain, neck stiffness or all of the above?
You may be suffering from cervicogenic headaches (CGH).
CGH’s are headaches that originate from the neck and occipital region of the head. CGH’s are often misdiagnosed for a primary headache as presenting symptoms are
very similar. Primary headaches are headaches that do not originate from a secondary source
such as the neck. CGH’s are usually associated with a limited range of motion in the cervical spine or
pain in the neck, shoulder or arm. Headache pain is aggravated or changed with specific neck movements or sustained postures.
Causes of CGH’s:
 Poor posture
 Overloaded and tight neck muscles
 Muscle imbalances
 Cervical spine joint stiffness
 Whiplash injuries
 Stress
 Sleeping posture

Diagnosis:
Diagnosis of CGH’s is made through a number of different techniques such as:

  • A subjective examination to differentiate between other types of headaches such as
    migraines.
  • An active range of motion assessment to analyse cervical spine movements.
  • Palpation of the neck muscles to asses muscle tightness and associated trigger
    points.
  • Joint mobilizations to asses stiffness of the cervical spine.

Static and dynamic postural assessment of the neck and shoulders.

Do you suffer from headaches, neck pain, neck stiffness or all of the above?
You may be suffering from cervicogenic headaches (CGH).
 CGH’s are headaches that originate from the neck and occipital region of the head.
 CGH’s are often misdiagnosed for a primary headache as presenting symptoms are
very similar.
 Primary headaches are headaches that do not originate from a secondary source
such as the neck.
 CGH’s are usually associated with a limited range of motion in the cervical spine or
pain in the neck, shoulder or arm.
 Headache pain is aggravated or changed with specific neck movements or sustained
postures.
Causes of CGH’s:
 Poor posture
 Overloaded and tight neck muscles
 Muscle imbalances
 Cervical spine joint stiffness
 Whiplash injuries
 Stress
 Sleeping posture

Diagnosis:
 Diagnosis of CGH’s is made through a number of different techniques such as:
 A subjective examination to differentiate between other types of headaches such as
migraines.
 An active range of motion assessment to analyse cervical spine movements.
 Palpation of the neck muscles to asses muscle tightness and associated trigger
points.
 Joint mobilizations to asses stiffness of the cervical spine.
 Static and dynamic postural assessment of the neck and shoulders.

Treatment:
 Treatment consists of manual therapy to address muscle stiffness with stretching
and associated trigger points.
 Muscles treated include the Sternocleidomastoid, Trapezius, Scalenes, Levator
scapulae and the Suboccipital muscles.
 Mobilizations of the cervical spine to increase range of motion and decrease muscle
stiffness.

 Postural analysis to address any factors that may be the cause excessive muscle
tightness around the cervical spine. For example, anteriorly rolled shoulders may be
contributing to overactivation of the upper trapezius muscle which causes excessive
tightness of the muscle.
 Corrective exercises may be prescribed to address the postural abnormality if
appropriate such as scapular stability exercises.

Written by Aaron Vibert (Physiotherapist) if you have any questions regarding headaches
Please don’t hesitate to contact the clinic on 0411 299 110.

Achilles Tendinopathy

Achilles Tendinopathy | Physiotherapy | START Tranining

Part 1 of 3: Achilles Tendinopathy 

Achilles Tendinopathy | Physiotherapy | START Tranining
Achilles Tendinopathy

Have you ever felt pain in the back of the ankle, particularly when jumping and running? If so, you are not alone. 

 

Achilles tendinopathy is often described as an overuse injury of the tendon attaching your calf muscle to the bone at the back of the foot.  It is one of the most commonly injured tendons, especially in running and jumping sports.

 

So what does the achilles actually do?

The tendon is responsible for storing and releasing tensile forces (energy) to propel your body forward. Think of it in a similar way to how a spring works. As you press down on the spring it stores energy, and when you release the spring it will quickly propel in an outward direction.

 

Tendinopathy, is caused by a tendon not coping or adapting to a change in environment or load.  

 

There are a few different forms of tendon pain, one being an acute inflammatory reaction, the other being a cellular change (don’t worry we will go into more detail about this in the next blog post!)

 

This can be for a number of reasons, these include;

 

Changes in loading 

  • Change in distance 
  • Change in intensity 
  • Change in weight
  • Change in training volume
  • Reduction in rest or recovery time
  • Change in technique or training 

 

Genetic/Biomechanical Factors

  • Foot position 
  • Some chronic health conditions
  • Obesity 
  • Reduced calf length
  • Reduced calf strength 
  • Reduced hip or pelvic control/stability 

 

Environmental Factors

  • Change in surface 
  • Change in shoes
  • Change in equipment 

 

Let’s talk through some examples to understand these concepts better. 

 

Recreational runner: Joe

Joe usually exercises on and off (1-2 x weekly). Jo decides to ‘START training’ for a half marathon and increasing his running from 1-2 x weekly, to 5-6. He progressively adds on kilometres to each session. Joe has nearly tripled his loading/volume in the space of a week. This is a perfect example of someone loading too aggressively and forcing their body to attempt to adapt. Whilst not everyone would pull up with a tendinopthy, Joe is increasing his risk significantly. 

 

Elite Athlete: Sally 

Sally is a 100m sprinter training for nationals. Sally’s coach wants her to change her shoes for the upcoming competition. Sally also adds plyometric exercises into her conditioning program. The change in footwear and the additional plyometric loading cause a reactive tendon response. 

 

So… how do we attempt to prevent this from happening? 

  • Gradually increasing or decreasing your load;
  • Ensuring you have adequate strength in the calf, legs and hips;
  • Monitor how your body feels, does the pain last longer than normal exercise soreness?
  • Ensure you have an appropriate warm up and cool down; 
  • Schedule rest and recovery! 

 

Need help with? Call our friendly staff at START training to learn how to appropriately tailor your training volume and load! Alternatively follow the link to make an online booking: https://starttraining.net.au/services/physiotherapy/

Keep tuned for Part 2 and 3 of this topic!

By 

Chantelle Bailey – To read a bit more about Chantelle, follow the link to her bio! 

https://starttraining.net.au/about-us/chantelle-bailey/

Physiotherapist (Hons)