Forward Head
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Neck Extensor Release:
Sitting in collapsed postures cause forward head posture so that we can remain looking forward. Forward head posture puts the muscle in the base of the skull in a short position. This is hard wired into our nervous systems. There is fluid in the ears and receptors that tell the brain when the head is tilted and the body is adjusted accordingly to allow for balanced fluid levels.  

This is why "stacking the back" is such a critical component to establishing an environment for healing and long term neck and shoulder injury prevention.  The muscles under the base of the skull that pull the head backward usually need to be released before a “Head Nod” is accessible
.

Technique:  
The technique to release the upper cervical spine extensors can be performed in sidelying and supine.  This technique requires a skin to skin contact.The SymFit® Neck Stretch is a home based technique for self-release of the upper cervical extensors.

Medical Consideration: 

If you feel dizzy when you rock your skull back into a Head Nod or experience any pain down the arm or face stop doing your prescribed home exercise program and schedule follow-up with your physical therapist or physician.  

Head Tilt
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Lateral Neck Release:
The neck has long muscles that attach the skull to the cervical spine which are responsible for turning the head. When the skull is out of alignment at C1 or the base of the neck C5/6 is out of alignment the muscles on one side of the neck are activated to counteract this misalignment. They often need to be released before neutral O-A and C5/6 positioning can be restored. The SymFit® technique for releasing a tight hip flexor is performed with you laying on your back with the opposite knee flexed 90 degrees. This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required which requires skin to skin contact. In most cases this can be done under clothing.

Technique:  
The technique to release the upper cervical spine extensors can be performed in sidelying with your arm by your side.  This technique requires a skin to skin contact.  The SymFit® Facet Glide Technique is a home based technique for self-release of the upper cervical extensors.

Medical Consideration: 

If you feel dizzy or experience any pain down the arm when you sidebend your head stop doing your prescribed home exercise program and schedule follow-up with your physical therapist or physician. 

Headache

Sub-occipital Extensors:

The muscles that unload your neck through a "Head Nod" are the sub-occipital extensors.  Sub-occipital because they are located below the skull and skull forward on C1 causing upper cervical spine extension (aka forward head posture).  When holding abnormal tone they lock you into a forward head posture.  They can also reduce blood flow to the brain as the vertebral arteries run through the upper cervical spine.  

Technique:  
The technique to release tension in this muscle group mobilization of the upper back into extension in prone at the center followed by a sustained stretch by the therapist holding your head into a "Head Nod" while you relax on you back.  This technique requires skin on skin contact.  The Neck Stretch is a safe way to release their tension that builds up in the O-A extensors before any workout or sport/recreational activities to maximize access to head nod.  

Medical Consideration: 

If rocking your skull back into "Head Nod" position causes pain into the arms, a headache or dizziness refrain from any self-release techniques until you can see you physical therapist.    
TMJ Dysfunction
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Masseter Release:

Faulty head position can affect the muscle tone around the neck and jaw including the muscles that open and close the mouth. Often these muscles can be release externally but on occasion an inter-oral release is required. The SymFit® technique for releasing the muscles that can cause faulty TMJ positioning is varied based on the influences of the neck muscles. This technique can most often be successfully administered externally but on occasion inter-oral release is required.

Technique:  
The technique to release the masseter can usually be successful with a sustained trigger point release externally with passive mandibular (lower jaw) mobilization.  On rare occasions an inter-oral technique is required.  

Medical Consideration: 

The masseter is a highly innervated muscle so a conservative approach to releasing any protective holding is taken.  Faulty manibular positioning and/or faulty TMJ mechanics can cause muscle imbalances that contribute to mis-alignments at the vertebrae.  Faulty cervical vertebrae positioning can cause muscle imbalances that contribute to faulty TMJ mechanics. 


SymFit® Soft Tissue Release Techniques
Upper Body Clearing Videos


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Abnormal muscle tension is a common by-product of faulty posture.  Overtime faulty posture causes asymmetrical loading which eventually will result in joint mis-alignment.  Joint mis-alignment in the neck, upper back and shoulders mechanically overloads the soft tissue (muscles and myofascia) in the upper body.  We refer to this as protective holding when referring to the muscle and myofascial restriction when referring to the myofascia.  This is similar to what many would refer to as a "tight" muscles.  In the early stages of the SymFit Healthy Fitness System you will likely need soft-tissue mobilization to prepare for safe manual therapy techniques before access to neutral spine alignment can be restored. For educational as well as patient comfort purposes we have outlined our most commonly administered techniques below for your review. They are organized by condition addressed, you will likely not need more than a few of these release techniques during your treatment. Additionally, you may present with conditions that warrant soft tissue release techniques not outlined below.



Cervical Spine (Neck) Conditions


 

Neck Injury Prevention Tips:  The key to physical health is maintaining upper thoracic spine extension ("stacked upper back").  A stacked upper back allows for healthy positioning of the skull that restores healthy neck posture.  When the shoulder blades are against the rib cage the shoulder functions properly.  NEVER sit or stand in a Slump Sitting posture or stand in with one knee bent.  Here are some other strategies for keeping healthy alignment through the neck and upper back.  
Standing - stand with back stacked and equal weight through left and right legs as well as equal weight medial versus lateral aspect of foot via inward spiral 
Sitting - sit upright onto your sit bones with hips inward spiral to some degree (do not allow knees to fall away from each other).
Walking - keep your back stacked and allow your arms to freely hand by your side.  As one leg swings forward normalized walking has the opposite hand swinging forward to provide a counter rotation movement.
Squats/Lifting - keep you upper back stacked during a squat and lunge.  At the bottom of a squat you should be looking at the floor about 4-6 feet in front of you.
Throwing - keep your back stacked when playing sports that require overhead activities, a collapsed upper back forces causes rounded shoulder posture and sets up mis-alignment at the shoulder.  This will eventually cause soft tissue overload in the shoulder complex.
    

Shoulder Conditions


 

Excessive Kyphosis
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO


Pectoralis Major and Latissimus Release:

The shoulder complex consists of 4 joints working together to allow for overhead elevation of the arm. The most familiar of these joints is the gleno-humeral joint where the ball of the humerus sits into the glenoid fossa (socket) of the scapulae. Collapsed posture puts the pectorals in a short position and this can cause faulty positioning of shoulder blade (scapulae) on the rib cage. 


Technique:
The technique for releasing this tension in the clinic consists of applying a sustained pressure to the top 1/3 of the pectoral attachment to the shoulder while the shoulder is mobilized overhead. This can be performed in sidelying or supine (laying on your back). This technique can often be performed through thin clothing. This treatment may require a myofascial release which does requires a skin to skin contact.

Medical Consideration: 

Rounded shoulder posture can set you up for rotator cuff tendonitis and untreated for a rotator cuff tear.  If you have pain with shoulder elevation at about shoulder height during elevation of the arm add the SymFit Rotator® cuff module to the SymFit® workout program.  If arm gives way with elevation schedule  consult with your physical therapist or physician.  



Pectoral Major and Latissimus Release

Anterior Shoulder
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO


Subscapularis Release:

Prolonged rounded shoulder posture can create an imbalance of anterior versus posterior musculature with anterior musculature pulling the humerus forward.  The subscapularis when holding abnormal muscle tone can pull the humerus out of its neutral position within in the socket of the shoulder.   


Technique:  
The technique to release the subscapulis is performed with you in supine and consists of a sustained pressure to its trigger point as the arm is mobilized out to the side and overhead.  This technique can often be performed through thin clothing but may require skin to skin contact.

Medical Consideration: 

The subscapularis when holding abnormal muscle tone can pull the humerus out of its neutral position within in the socket of the shoulder.  This minimally can set us up for biceps tendonitis or rotator cuff tendonitis; at worse it can set us up for a shoulder subluxation or dislocation.  If your shoulder feels like it is not sitting in the center of the socket and you have pain upon initiation of shoulder elevation schedule a consult with your physical therapist of physician.



SymFit Subscapularis Release

Winged Scapulae
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Pectoralis Minor:
 

Collapsed posture puts the pectorals in a short position and this can cause faulty positioning of the shoulder blade (scapulae) on the rib cage. The pectoralis minor attaches to the front of the scapulae and can pull the shoulder blade forward, we refer to this as a "winged scapulae" which throws off the mechanics of the shoulder.

Technique:  
The technique to release the pectoralis minor consists of applying a sustained pressure to the its trigger point while the shoulder is mobilized out to the side and overhead. This can be performed  supine (laying on your back). This technique can often be performed through thin clothing. This treatment may require a myofascial release which does requires a skin to skin contact.   This technique is painful for about 12-15 seconds but tolerable.  

Medical Consideration: 

The pectoralis minor when holding abnormal tone can contribute the postural environment that sets up a condition called thoracic outlet syndrome.  If you start to experience any altered sensation, strength or pain into the forearm or hand schedule a screening with you physical therapist of physician.  



Rotator Cuff Imbalance

SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Posterior Shoulder Release:
Collapsed upper back and rounded shoulder posture can cause abnormal holding of the posterior musculature of the shoulder.  Abnormal holding of the posterior capsule and/or posterior shoulder stabilizers will affect the positioning of the humerus in the shoulder socket.  The teres minor and infraspinatus may require soft tissue mobilization before neutral shoulder positioning and mechanics can be restored.

Technique:  C
 technique to release the posterior capsule and posterior rotator cuff musculature is performed in sidelying or prone and consists of sustained trigger point release during passive internal rotation. This technique can often be performed through thin clothing but skin to skin contact may be required. This treatment may require a myofascial release which does requires a skin to skin contact.

Medical Consideration: 

The rotator cuff usually shows sign of mechanical overload before they tear.  For this reason understanding these muscles and their actions can assist in injury prevention.  The rotator cuff consists of 4 muscles;
  • Subscapularis - located anteriorly the subscapularis is very deep and controls internal rotation of the arm.  It is the least vulnerable to injury and tearing but is the main muscle associated with faulty shoulder mechanics due to protective holding secondary to rounded shoulder posture.  When injured it refers pain to ...
  • Supraspinatus - located on the top of the shoulder the supraspinatus is responsible for pulling the humerus into the socket from the top to allow for normalized mechanics during elevation of the arm.  It is the most vulnerable to injury and tearing due to it anatomical relationship with the acromion under which it runs before attaching to the humerus. When injured it refers pain to lateral aspect of the upper arm (shoulder).  It is affected by any mis-alignment of the humerus and/or the scapulae.  
  • Infraspinatus - located posteriorly the infraspinatus assists in external rotation of the arm.  It is affected by mis-alignment of the scapulae anteriorly which causes it to work iffeciently.  The main issue with this muscle and the teres minor is weakness secondary to faulty posture. When injured it refers pain to ...
  • Teres Minor - located posteriorly the infraspinatus assists in external rotation of the arm. It is affected by mis-alignment of the scapulae anteriorly which causes it to work iffeciently. The main issue with this muscle and the infraspinatus is weakness secondary to faulty posture. When injured it refers pain to ...


Biceps Tendonitis

SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Bicep
Tendonitis
The long head of the biceps tendon runs through a groove in the front of the humerus.  Any mis-alignment of the humerus in the shoulder socket can place stress on the biceps tendon.  The soft tissue that needs to be released is the subscapularis to restore the neutral humeral head position in the socket of the shoulder and pectoral muscles to restore neutral position of the scapulae on the rib cage.  On occasion the biceps itself may also need release.

Technique:  
The technique to release the bicep is performed with you laying on your back and the elbow extended.  The biceps is usually mechanically overloaded as a result of faulty scapulae positionign on the rib cage and/or faulty humeral head positioning in the shoulder socket so all the soft tissue releases associated with these corrections may also be administered.    

Medical Consideration: 

The biceps is a flexor of the shoulder.  An effective exercise to strength it functionally besides as a flexor of the shoulder is elevation with palms up against light resistance. 

Thoracic Outlet Syndrome

SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Scalene Release:
The scalenes sit anterior to the cervical spine and when tight can pull us into a forward head posture as well.  When we sit in a collapsed upper posture the scalenes are the muscle that pull us into a forward head to ensure that we maintain vertical line of site.

Technique:  
The technique to release tension in this muscle group requires the head to be slightly extended and rotated with palpation through the front of the neck.  This technique requires skin on skin contact.  Due to their deep positioning within the neck the myofascia restrictions that associate their shortening is mostly targets with this technique.  This technique is uncomfortable even with a conservative approach.  

Medical Consideration: 

Because they crosses multiple cervical spine segments release of scalene protective holding patterns should be follow-up with muscle energy techniques to wake up the upper cervical spine flexors.  
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO
Shoulder Injury Prevention Tips:  Mis-alignment in the low back and pelvis start as a result of a slight asymmetry in loading through the foot and ankle.  NEVER sit in a Slump Sitting posture or stand in with one knee bent.  Here are some other strategies for keeping healthy alignment through the foot and ankle.  
Working at pc - stand with equal weight through left and right leg as well as equal weight medial versus lateral aspect of foot via inward spiral 
Working on phone - when sending texts and emails hold the phone at chest height to keep a "Stacked Upper Back".  Use a head set to allow for neutral spine posture without asymmetrical neck positioning.
Lifting Overhead - push-off toward the inside of the foot during the stance phase of walking before weight transfer.
Sleeping - even though your hips are externally rotated 45 degrees during a SymFit Squat you still are maintaining an inward spiral of the hips.  Keeping your toes unloaded during a squat will ensure healthy loading through the heel during a squat.
Throwing - keep your back stacked when running, a collapsed upper back forces a collapsed pelvis which forces lateral loading through the hips, knees, ankles and feet.  This will eventually cause mis-alignment of the joints followed by soft tissue overload.


Elbow and Wrist Conditions


 

Tennis Elbow
(lateral epichondylitis)
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Diaphragm Release:
The diaphragm is the muscle that helps regulate breathing. Those with collapsed upper back posture must load their low backs and necks when they stand up otherwise they will fall forward. As a result, we develop rib flaring strategies when we lift our arms overhead to compensate for faulty shoulder blade positioning on the rib cage. 

Technique:
The diaphragm may need to be release for those with strong rib flaring strategies. The diaphragm is best release with you laying on your back (supine) with the arm of the side of the diaphragm being released overhead to put the diaphragm in a stretched position. The therapist then massages the diaphragm by placing fingers below and under the diaphragm. 

Medical Consideration: 

Because they crosses multiple cervical spine segments release of scalene protective holding patterns should be follow-up with muscle energy techniques to wake up the upper cervical spine flexors.  
Golfer's Elbow
(medial epichondylitis)
SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Diaphragm Release:
The diaphragm is the muscle that helps regulate breathing. Those with collapsed upper back posture must load their low backs and necks when they stand up otherwise they will fall forward. As a result, we develop rib flaring strategies when we lift our arms overhead to compensate for faulty shoulder blade positioning on the rib cage. 

Technique:
The diaphragm may need to be release for those with strong rib flaring strategies. The diaphragm is best release with you laying on your back (supine) with the arm of the side of the diaphragm being released overhead to put the diaphragm in a stretched position. The therapist then massages the diaphragm by placing fingers below and under the diaphragm. 

Medical Consideration: 

Because they crosses multiple cervical spine segments release of scalene protective holding patterns should be follow-up with muscle energy techniques to wake up the upper cervical spine flexors.  
Carpal Tunnel Syndrome

SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Diaphragm Release:
The diaphragm is the muscle that helps regulate breathing. Those with collapsed upper back posture must load their low backs and necks when they stand up otherwise they will fall forward. As a result, we develop rib flaring strategies when we lift our arms overhead to compensate for faulty shoulder blade positioning on the rib cage. 

Technique:
The diaphragm may need to be release for those with strong rib flaring strategies. The diaphragm is best release with you laying on your back (supine) with the arm of the side of the diaphragm being released overhead to put the diaphragm in a stretched position. The therapist then massages the diaphragm by placing fingers below and under the diaphragm. 

Medical Consideration: 

Because they crosses multiple cervical spine segments release of scalene protective holding patterns should be follow-up with muscle energy techniques to wake up the upper cervical spine flexors.  
Rib Flaring

SymFit Soft Tissue Release Techniques; Healthy Neck Program in Denver, CO

Diaphragm Release:
The diaphragm is the muscle that helps regulate breathing. Those with collapsed upper back posture must load their low backs and necks when they stand up otherwise they will fall forward. As a result, we develop rib flaring strategies when we lift our arms overhead to compensate for faulty shoulder blade positioning on the rib cage. 

Technique:
The diaphragm may need to be release for those with strong rib flaring strategies. The diaphragm is best release with you laying on your back (supine) with the arm of the side of the diaphragm being released overhead to put the diaphragm in a stretched position. The therapist then massages the diaphragm by placing fingers below and under the diaphragm. 

Medical Consideration: 

Because they crosses multiple cervical spine segments release of scalene protective holding patterns should be follow-up with muscle energy techniques to wake up the upper cervical spine flexors.  
Wrist/Elbow Injury Prevention Tips:  Mis-alignment in the low back and pelvis start as a result of a slight asymmetry in loading through the foot and ankle.  NEVER sit in a Slump Sitting posture or stand in with one knee bent.  Here are some other strategies for keeping healthy alignment through the foot and ankle.  
Typing - use a wrist support so that you wrist is in neutral when typing 
Sitting - sit upright onto your sit bones with monitor 4-6" above eye level to promote chest lift posture

Workout Tips: perform the Chest Lift Series with a closed fits
Self-correction Tool: Mobilize your carpal bones whenever you feel stiff in the wrist or elbow.