A Reader's Question: Stiff Neck

A reader asks:

"I am not sure where to post my question. I am attending a massage school and have a student therapist. I generally have stiffness around my neck from sitting at a computer all week. What should I ask my student therapist to do to release the tension from my neck and shoulder area?"

Thanks for asking your question! And yes, you posted it in exactly the right place.

I'll do my best to answer specifically what your student therapist can do to help your neck. I'll also include some suggestions of things you can do to help minimize the strain on your neck outside of the massage room.

First, you have to understand that a student is a beginner and is not going to have the skills that a more experienced therapist may have. Their palpatory skills are not going to be as well developed yet. In addition, there are advanced techniques that should only be taught to experienced therapists. However, there are still things a student therapist can do to help a person with a stiff neck.

A word of caution: all massage on the neck described here is to be done on the muscles on the back of the neck. The sides and the front of the neck should be avoided unless the therapist is experienced and has been specifically trained to work in these areas.

With the client face up on the table, the therapist should begin with some gentle effleurrage (gliding stokes.) The neck may be gently tractioned (stretched) during the up stroke from the shoulders to the head. The effleurage in this case may be done in one direction (from the shoulder to the head) or alternating both up and down.

After some effleurage, the therapist can begin circular friction with the pads of the fingers on the muscles on either side of the back of the neck. Both sides can be done at the same time, with the fingers on either side of the neck, and can be done both up and down the neck. Depending on the size of the client's neck and the therapist's fingers, there may be room for only one or two fingers. Remember, when doing friction the pads of the fingers are rubbing the skin over the muscles underneath; the fingers are not gliding over the skin. One of my clients liked to call this "scrubbing the ickiness out." Friction should be done firmly but gently. Done correctly, this should cause no pain to the client.

Finish with a few more gliding strokes and then turn the head gently to the left. Use some gliding strokes down the right side of the neck (remember, you're concentrating on the back of the neck) and then begin to thoroughly friction the posterior muscles on the right side of the neck with the pads of the fingers. The client should be feeling the muscles relaxing. They may feel as if they are warming. Finish with a few strokes of effleurage and then repeat for the left side.

When both sides of the neck have been thoroughly massaged, return the neck to the center. Use the pads of the fingers to circular friction the suboccipital muscles along the base of the skull. You can start with both sides at once, using both hands, and then concentrate first on one side, then the other.

Finish with a few more strokes of effleurage and then have the client turn onto their stomach to massage the shoulders.

Standing on the client's left side, facing the body, reach across the body and use continuous effleurage off the right shoulder. Beginning with the hands at the midline, one on the upper trapezius and one hand positioned just medial to the shoulder blade, push one hand off the shoulder, then the other, back and forth with each hand following the other in continuous gliding strokes. After a bit, begin using circular friction with the heel of the hand. Your left hand will be frictioning the upper trap, your right hand will be frictioning over the shoulder blade. When the tissue begins to warm, begin to use the pads of the fingers to friction in more detail along the edge of the shoulder blade, the attachments along the spine, all of the muscles of the area. In areas that are particularly tight or sore, give them a little extra attention. However, don't overdo it.

You can return to some more general circular heel of the hand friction, finish off with some gliding strokes, and end with some vibration. Rest the hand on the shoulder and gently shake back and forth for a few seconds. Repeat the entire treatment for the left shoulder.

Remember: pressure should always be within the client's comfort zone. This treatment should feel good to the client and should not cause any pain. Do not overtreat. This entire treatment should not take more than 15 minutes: no more than 5 minutes on the neck and on each of the shoulders. Overtreating will cause the muscles to tighten back up and create too much congestion in the area.

After treatment, the muscles should not be treated again for at least 48 hours. The ideal would be to repeat this treatment every other day for 10-15 treatments. If you can do it two or three times a week for a couple of weeks, you will get the most progress and will probably start seeing longer lasting results within a week. Short, frequent treatments are more effective than longer, infrequent treatments. You are trying to retrain the muscles so that they will not go back to the way they were. When the desired results are achieved, then you can taper off the treatments. Periodic "tune-ups," perhaps once a month, would be a good idea if needed. After all, since you are probably going to continue to sit at the computer, you'll need an ongoing plan of maintaining your muscles so you don't end up back in the same situation.

Outside of the massage room there are steps you can take to help maintain the health of your neck. If you must be at a computer for long periods, get up and walk around and stretch every 20 minutes. Set a timer so you won't forget. Avoid leaning your head forward for extended periods or turned to one side for extended periods. Rearrange your computer desk for better body mechanics if you need to. Make sure you have low back support when sitting. When we sit, the curve in our low back flattens out and forces our head forward, straining the neck muscles. A low back support that helps maintain the lumbar curve will help to sit more vertically, lessening the strain on the neck.

Let me know how this works for you!

P.S. If you found this helpful, will you do me a favor? Tell your other massage student friends and ask them to visit this site. Help me get the word out so this site can be a resource for others, too! Thanks!