Welcome, everybody to the first lecture in the Headaches and Migraines Principles series, this one's going to be on the Cranial Sleeve sequence in our Advanced Myofascial Techniques, workshop of the same name, perfect companion for the technique videos that you may already have or may want to get, or that if you're in the Principles course, are included in the course tuition, a couple of tips about getting the most out of your course, whether it's live or recorded, I really recommend avoiding multitasking, let yourself do just this you get fragmented, your attention gets fragmented, your processing power in your brain gets fragmented, interesting, parallel to what happens in some sorts of migraines, that kind of fragmentation of your visual disturbance like this painting shows, you can fragment your attention, and it's just, you may feel productive, you're not, just do this.
Engage your body, engage your body. A challenge in zoom, challenge with recorded courses, but you can stay active, we're going to have a guest movement teacher today drop in partway through it's not Salvador Dali, if that's who you thought we were having today. But you'll see, you'll see who it is. Keep moving, keep stand, you know, stand up, move around, etc. engage your mind. In particular, look for things that you agree with, or you disagree with, or that you're curious about and note them down, chat them into the zoom chat if you're on the live call, or if you're on the recorded version, go to the Facebook forum, or you know the other forums we're using. There's a, it's actually, believe it or not, there's a comment section. In your course navigator, where you can also write in questions there within your online course itself if you don't do social media, but there's often an active set of discussions going on in the private Facebook forum that runs along with this course. And that persists after the live courses are done, so that people can continue to discuss if they're watching the recorded versions, as well.
So those of you doing the course for credit will have a quiz to take after this lesson. The quizzes at this point in time, it may change in the future. But this point in time the quizzes are not graded quizzes. They're not your passing the course doesn't depend on your quiz score. It's your own conscience that says did I learn this or did I not that the quizzes are meant to trigger and feed into a healthy sense of learners guilt you could say to realize that oh my goodness, I got you know X percent. Let me go back and see what the answer really was. And the quizzes do give you an immediate feedback indicator of which ones you got right and which ones you got wrong. There's a button you got to click to see that we're gonna post a little video of how to do that if you don't know how it's pretty easy. But that's what the quizzes are about. They're about you testing yourself and your learning.
So watch for this and what's an example of a primary headache? What type of headache primary or secondary can hands on work most realistically help with? What type of headache primary or secondary can hands on work help with? When I'm going to try that again. What type of headache primary or secondary can hands on work most realistically help with? Where is tension headache pain usually felt in contrast to other types of headache pain, where do tension headaches appear? typically there's a key descriptor of where they are. What are we feeling for in the Ear: Concha, Cymba, Vagus technique which is C-08 very cool technique for stimulating vagal function. What are we feeling for in that? And what is the suggested protocol for tension headache pain? What's the protocol or ordering or sequencing or, or strategy we use for tension headache pain, watch for those; check out your quiz.
Headaches and migraines inspire an amazing amount of art. very evocative, expressive, moving art. If you just type into your search bar, migraine art or headache art, you'll get hundreds of thousands of results. And each of these that I'm showing you here are artists who are expressing the headache experience and the migraine experience creatively. Now what's interesting to me is that if you type in something like knee injury art, or ankle sprain art, I literally tried this, maybe a year ago I typed in ankle sprain art there were zero hits you could put it in quotes to force it to find that it couldn't. There was nobody doing ankle sprain art. Go figure. Why is it that headaches inspire so much expression that people use these phenomenal images as a way to work with their experience or express or share their experience? Why is that true for headaches, but not for ankle sprains, there's something really unique and different about the headache experience that does connect it to say, visual expression, but also the kind of emotional and evocative state based experience that we just want to share. We just want to connect with other people, we want to put it out of us, we want to get it out there in a way that other sorts of, say musculoskeletal conditions may not.
And there's a musculoskeletal or facial, you could say, aspect to many headaches. And then there's a whole other class of headaches, or headache, progenitors or things that cause headaches that may not be musculoskeletal. And we're going to talk about how to work with those, as well. Okay, so let's give you a little bit of overview of what we mean when we say headache, because it's a pretty broad class of phenomena. But let's just specify a couple of them a cervicogenic headache, which Oh, by the way, I'm going to actually in our third meeting, I'm going to focus on this type of headache in particular cervicogenic headaches, are headaches that are thought to have some sort of genesis, or causative factor in the neck or cervical region. And they have become a topic of particular interest in recent years, partly because we're doing such interesting things with our necks.
Now, the neck is really related to head sensation, the nerves of the back of the head in particular, essentially lace up through the neck tissues. And so there's a very interesting role that the neck has in generating many types of headaches. And in fact, it's a whole class of headaches that we're exploring third of these three lectures, cluster headaches, fascinating, super intense. They're an order of magnitude greater than any other kind of pain, just about much more they say, than kidney stones, which are even more than childbirth, more than gunshot wounds, more than some really painful conditions like pancreatic cancer, there in the whole class of pain intensity of their own. Cluster headaches are fortunately, rare, but unfortunately, people do have them. In fact, it's about half as prevalent as Parkinson's. And you know, you may know somebody or have a relative or somebody who has Parkinson's, about half the people in the world have cluster headaches. So they're around, and we're going to talk about how to work with them too. this painting this drawing rather, is called cluster headaches. They tend to be focused around the eye, we'll talk about that more next lecture.
Coital cephalalgia or morning after or after sex headache, is actually a real thing. It's a real headache people get. Common headache, or otherwise known as tension headache. 90% of the world's population gets one at some point in their life. And manual therapy actually is a squeezing kind of sensation, actually. But actually, the manual thing things we do with our hands have very clear ways that they can help very clear mechanisms that they can engage with. And people you know, automatically, when they have one of these start to massage their own heads or touch their own heads in a way that mimics what we're going to use for inspiration when we work with a common headache or tension headache. They are, as the name suggests, related to tension or stress or overwhelm. And it's such a good thing that we live in a world free from stress these days we're such stress free time in history, where there are so few headaches, but we're, I'm kidding. But we're gonna look at how the headaches that people get can be impacted by the amount of stress they're under and how essentially, we can help increase people's adaptive capacity to the stresses everyone's dealing with now.
And we're going to be translating these in various ways to self care techniques that even if you are not having this kind of proximity with people yet or you've taken a break from that, you can learn things now that will help you when you get back to work, and or help you at a distance. If you're doing zoom work or coaching people in their own self care. You have very clear tools from this training here that will help translate right into that kind of working with people too. Cryogenic headache. Oh, by the way, don't feel like you have to write these down. Some of you are really fastidious note takers. I'm going to go ahead and post this list in the Facebook forum and we'll attach it to an email too in both English and Spanish we have English and Spanish versions of this so relax in your note taking if you like.
Cryogenic headache is a headache that's triggered by cold, ice cream headache. Dehydration headache, of course, is what you get from not drinking enough water, make sure you're drinking water. And there's a few other kinds of headaches, as well. There's a few other kinds. And this is just the ones that fit on the slide. So there's actually 10s of thousands of kinds of headaches, different classes of headaches and everything from hair wash headache, which is common in the Indian subcontinent among women who tend to have longer hair and the weight the theory is the weight of the hair, you know, in humid climate, which often doesn't dry the weoght of the hair pulling on the scalp makes it sensitized to getting your hair washed, you get a hair, get your hair wet again, and you have a headache. to Hemicrania Continua, a continuous half head, where it's just a continual headache that's located in half a head fairly rare, but still a real deal. Ram's Horn headaches as named after the referral pattern that people will get with some types of migraines or cluster headaches. Ictal headaches, headaches accompany a seizure. And we'll talk next time about how migraines and seizures have an interesting relationship. Suicide headaches, another name for cluster headaches, because you'd rather kill yourself to have to go through one, people say. Toxic headaches, a headache as a result of some sort of chemical exposure or chemical toxicity.
Any of these that you have questions about, Google can give you a quick answer, but feel free to type them into the chat box to clarify them. I'm not going to try to go through and you know, say explain every kind of headache, because there's so many, but I am going to give you a schema for understanding some of the primary categories and classes. And this is helpful because we work with these different classes in different ways. You could say, this is a page in your handout that you can download from the email that came giving you the link to download it or from your forum. or from your question navigator, there's a link to this PDF handout where you can fill it in as you go along. The answers that I get ahead of you, by the way are in the back of the handout.
So headaches are commonly classified into three groups, the first group being primary headaches, otherwise known as idiopathic headaches, they're their own thing. That's why they're called primary. That's not to be their own symptom, their own issue. They don't have an apparent other cause they're idiopathic. So they just seem to be their own deal. Secondary headaches is the next class of headaches. Those are headaches that are symptomatic of another condition. And then there are other headaches, other various headaches that didn't fit into the other classes.
But now let's go back, I think and look at the headache class examples. Yeah. So now one example of primary headaches is a tension headache. I've discussed that a little bit triggered by tension, also maybe related to physical tension or muscular tension in the tissues of the scalp. But basically, it's thought to be its own deal primary headache. Neurogenic headaches is the larger class of which migraines are a part and cluster headaches are also a part. Those are both examples of primary headaches that seem to be arising on their own, no external, well, no sec, no primary, no other primary causative force, it's thought. They just seem to be their own deal. They're coming up on their own. And then the commingled headaches, which are a combination of both of both types.
Secondary headaches, they said are symptomatic of other things. They're headaches that come as a result of something else going on, like metabolic and medical conditions. injuries, trauma and concussions. You can have headaches, obviously, after you hit your head but even persisting for quite a while. Those are headaches secondary to injury. musculoskeletal disorders, such as a cervicogenic headache is thought to be a headache that arises from a movement restriction or tissue restriction in the neck, or strain in the neck. And then others include trigeminal neuralgia, facial pain, etc. This word is facial it's not fascial.
Now, this is an interesting classification system. It's it was devised by neurologists who are asking the question which drug do we prescribe? And so their thought that Okay, so let's go ahead and try to treat this the headache directly with drugs that target the headache experienced directly. And in this case, we can also do things to relieve the headache, they say, but there's another underlying condition that's giving rise to that headache symptom. This is a good distinction for us too as manual therapists, because it may be a little less directly relevant than it would be for a pharmacologist or someone described prescribing a drug. But still, we can do things that target these direct mechanisms. Some of this is still being researched. And we're not even sure sometimes what the mechanisms are. But in this case, we can target the headache directly in this class, and then we can relieve the headache, even if there is another cause to it. In the case of say, head injuries, or concussions, or, you know, we can do a lot to help people live with those conditions as they heal, and go on.
So this is this is not a map of which ones bodywork helps with, it's probably why Bruce remembered the headache quiz preview, because it's a map of different classes of headaches, and we can help with all of them, we can help with all these in different ways, we can often reduce the symptoms of all these in different ways. And, and that's a good thing. And it's a dangerous thing, too. It's a good thing, because we want to help relieve people's pain. It's dangerous, because we don't want people to get relief from what we do and delay other medical treatment that might be you know, from a disease process or a tumor you could say, or something like that, that they should be addressing in other ways too. we don't want to mask the symptoms by relieving symptoms. So that's a great thing to keep in mind. And we'll go through some specific warning signs in the next lecture about things to look for, times to refer out because that's just an important consideration.
Okay, so headaches are very common. Like I mentioned, 90% of the world's population has had a headache and sometime 75% had episodes of headaches. 50% had a severe headache that half of people have had a severe headache in their life. 25% have severe recurring headaches, 12% migraine, and that varies by geography. And then 4% chronic daily headache 4% one person in 25. So somewhere between six and eight people in this class, headache every day, on average, a group of the size would have that headache every day. So you're gonna have headaches in your practice, probably in your life, certainly in your family. And if you haven't, count your lucky stars because headaches are they vary from annoying to debilitating.
The classes of headaches as compared to different types. We're going to compare tension headaches, and migraines and neurogenic headaches, because that's really the first step when I see a new client is to try to make an assessment. I'm not diagnosing them. I'm not telling you, this is what you have. But this is from my strategizing as a manual therapist to say, How am I going to approach this headache? What can I expect? And how am I going to strategize what I do, it's different in each case. So that's the first step is to really make my own assessment or my own guesstimate about what's going on for them.
The pain location is different in each case, for a tension headache, it tends to be bilateral, both sides of the head that is, while for neurogenic headaches, including migraines it tends to be focused on one side of the head, unilateral pain. And that's a key distinguishing feature between the two. These are general tendencies, there's definitely headaches that break these rules. The associated symptoms are not typical with headaches unless it's mixed with a migraine like a comingled headache. But they for migraines they include for number six in your handout, one or more of nausea. Number 6 is nausea, or light and sound sensitivity, a visual disturbance or paraesthesia, meaning a numbness or tingling and nerve kind of symptom. These are the one of the another distinguishing feature of migraine headaches true migraine headaches, that they're going to have one or more of these signs. And we do work with them in a different way. There's probably different mechanisms at work, and so we work with them in different ways as well as manual therapists.
The pain description the way people talk about their own pain is different uses different vocabulary for tension headaches, people will say it's a dull pain or a squeezing sensation. While for migraines, they'll describe it as a throbbing or pulsing, or a stabbing or a sharp sensation. The ratio of men to women is different in each case too slightly. In both cases, it's more women that seek treatment for these headaches. So it's 60 40% 60 female 40 male for tension headaches, and 75/25. For migraines 75% of the people that seek treatment for migraines are women only 25% men Except for the small class of cluster headaches, which is the reverse, it's actually 75% men and 25% women, leading to a lot of difficulty in diagnosis or misdiagnosing people get diagnosed from one based on their gender, their sex, when they might have the other. And that makes the treatment both, you know, in medical terms, but also maybe in our terms a little different too.
So manual therapy with the neck is an interesting differential diagnostic tool too. it lets us know, you know, watching to see how that headache responds to work with the neck and let us know what type of headache it is. It'll it can improve the symptoms often, you know, frequently can improve the symptoms for tension headaches. For some people with neurogenic headaches, it'll worsen the symptoms to get, you know, work with the neck. And not everybody with neurogenic or migraines will get worse worsened by network, but it's something to be aware of and be cautious with. Because some neurogenic headaches worsen significantly when you work with the neck. Our old theory about why that was that was increasing blood flow, and that that was related to a vascular dilation in the head. And you don't want to increase the dilation, the argument goes by opening up the circulation in the neck. Turns out that's probably not what's going on. At least, you know, the migraine probably isn't caused by the vascular dilation like we used to think it was. But we have observed that working in the back of the neck can worsen some people's headaches.
So this painting here is titled What do you think tension headache or migraine headache? You can chat in your guess here. Is this a tension headache or is this a migraine headache if you're on the live course chat in a guess about which one this is? Yeah, migraine, people are saying migraine is unilateral. It has that sharp, stabbing kind of quality, that it also has that kind of surreal nature to it. It's like an altered state of consciousness. Many times people with migraines will not want to move not want any outside stimulus too which is different from a tension headache, oftentimes tension headache can be relieved by actually taking a walk and some fresh air. Doing something active can actually shift it to genetic or cluster headache, cluster headache, you can't sit still you got repetitive movement, you're pacing you're rocking. migraines people typically will just curl up in a ball and that's all they can manage. All they want to do.
While this work of art is a depiction of what's probably a tension headiache, a bilateral squeezing kind of sensation that's on all sides, that compression type feeling. And it can have you know, a surreal aspect too, you can have sensitivities in lots of ways. But there's one distinguishing feature is the bilateral or you know, lateral side, another distinguishing feature again, visual disturbances go with the migraines or neurogenic headaches. This is a depiction of someone's visual disturbances. This is the type of migraines that I get or I used to get even more of now very occasionally I'll get an ocular migraine. But earlier in life I got these quite frequently quite severely where there'd be jagged lines or broken up patterns, superimposing themselves over each other and obviously you don't want to be driving when that happens.
Migraines are also people some people with migraines will get auditory phenomena too auditory hallucinations. People report hearing sirens or voices or disturbing sounds. Everybody with a headache is sensitive to sound but the sound sensitivity with a migraine goes to extreme levels where it's it's piercing stabbing painful sound is just like murder. In other words, Lewis Carroll who wrote Alison in Wonderland suffered from severe migraines himself. And people speculate that perhaps the surreal nature of Alice, Alice's reality, or some of the actual imagery in Alice in Wonderland was inspired by Lewis Carroll's migraine experiences. Certainly, if you've experienced migraines, you'll find some of those familiar, similar territory. It's like going down the rabbit hole.
So those are the types of headaches and some of the distinguishing features. Really, what we're interested in as manual therapists is what's the remedy? What can we do about them. And that's what most of the course is really about. But let me just lay a little more of the conceptual framework. Today's a lot of information, a lot of conceptual framework so that we can when you get to the technique videos, and we get later in the sequence of lectures, we can focus even more on the hands on remedies.
Stepping back from the headache question for a second saying, what are our hands on goals in general in this approach, this is review I think for many of you, but it's always worth repeating. Our first goal and this is in the handout if you got the handouts is to increase options for movement, we want things to move that don't. And if they move a whole lot, we want them to have the option to not move, to have the option to not move if they're moving a whole lot. So we want to increase the options increase the number of options, that's not the same as increasing range of motion. But you know, think in the headache story it relates to say glide between layers, or movement of facial features, or when we get to the neck part, movement of the neck itself can really be, or individual joints within the neck can really be tied to people's headache, prevention and headache relief. So we're going to use active client movements quite a bit as we work with tension headaches today to actually increase the options for movement in people's head, we're going to use subtle movements, small movements that the bones are thought to make all the time. Next time in particular, while we work with migraines, we're going to use these slow rhythmic and undulations and rocking or adjustments that the bones are thought to do and the cranial sacral rhythm as a way to work with migraines amongst other tools and other movements as well.
The other primary goal that we have is to refine the interoceptive, proprioceptive and kinesthetic senses. The interoceptive sense is my ability to feel and tolerate and describe internal body sensation. proprioception is joint angle, which we extrapolate into position, body position in space, kinesthetic senses, and I'm moving or am I still put those all together and stir in a couple of little touch based senses, and you have the body sense you have the way you know your body in space the way you know you exist. And we're looking to refine that for headaches in an interesting way. In fact, in headaches, you know, we use those goals, to get symptomatic pain relief, to increase people's ability to function to have a better sense of well being etc. But for headaches in particular, we might even reverse the priority of these goals where we're often thinking about sensitivity first, or the proprioceptive, or the interoceptive side of the headache first, even before we think about options for movement, if your background is as a structural integration person or massage therapist or even physical therapist, you've probably gotten used to thinking about movement, and tissue quality and things that you can move with your hands, perhaps in manual therapy approach that's useful. But there's a whole lot you can do with sensation itself that's separate from tissue mobility. And we're really going to highlight that as we go forward and work with the headaches.
This sequence, today's sequence the Cranial Sleeve sequence, it's number C-01 in the video, quick explanation for why it's C and not A, A and B are in the TMJ class, we used to teach this as a TMJ headaches course and we did A and B for TMJ, really important. dovetailing with other types of headaches. TMJ pain is a type of headache. But here we're jumping right into headaches. And so the numbering convention, which was established years ago still starts with C, cranial sleeve sequence, we are assessing and normalizing any sensitivity or mobility restrictions of the myofascial layers of the neck. Assessing and normalizing meaning bringing them back to a tolerable level or reducing them some if they're oversensitive. The sensitivity or mobility restrictions, sensitivities first of the myofascial layers of the neck, cranium and face. So we're really thinking that territory really thinking myofascia really thinking layering, we're also preparing for the deeper intracranial work, the work we're going to do within this segment of the head, which has a lot to do with a migraines. We're getting ready for that kind of work. So the indication for today's focus really attention headaches, or headaches related to myofascial or myofacial pain syndrome.
Eye, neck or face strain or tension are also indications for these type of techniques we're going to show you as well as tinnitus, ringing in the ears, vertigo, many types of vertigo respond to this type of work as well as to other network TMJ issues, TMJD etc. Insomnia there's a whole list of other sorts of conditions that will respond to having simply the layers of your cranial sleeve mobilized and desensitized. That's what we're doing today.
Fascial qualities super quick lightning review on this. There's more in the advanced myofascial techniques books. If you want to dive in into this or in some of the previous courses as well. We're focusing on three basic qualities. One is the continuity that fascia has throughout the body. Everything in the body is wrapped in fascia and has fascia within every muscle. Obviously every myofascial unit is a muscle wrapped in fascia. every nerve is also wrapped in fascia, and has fascial bundles within it. every organ, every blood vessel. Name, something I didn't name, oh, every lymphatic duct. Every one of those has a fascial component. And the continuity of that gives fascia a special place in the body's mobility and functioning.
This is Jean-Claude Guimberteau looking under the skin with his high resolution arthroscopic camera. And he's a hand surgeon who made these really cool videos of fascia living fascia about 10 years ago that blew us all away. And so he's lifting up the skin there and putting his camera in there to show you what it's what's right under the skin layer, the juiciness and moisture and hydration that exists in that layer of superficial fascia right under the skin. And that's really a specific target for us today in the tension headache story.
Another fascial quality is its plasticity, its ability to change. And this is different than what Ida Rolf meant by plasticity, perhaps in in a in a specific way. She said the body is a plastic medium. And she speculated that was because the fascia could essentially melt in a way and be reorganized. It probably doesn't exactly do that in the way that she was speculating about back then in the 50s and 60s, when she was writing these things out. She was onto something though, it does have a certain kind of plasticity, its plasticity is related to its ability to recoil and its ability to glide. When it can't recoil, it gets stiff when it can't glide it gets bound up. And also experience of stiffness comes from those kinds of things. Those are the mechanisms there's as well as hydration, hydration, property qualities or effects will have on the tissue itself to make it stiffer. We're actually changing all those things, the ability for it to glide, we're changing hydration, and then especially we're changing the way the nervous system interacts with the fascia of the body, the fascia itself.
A little clarification, your fascia itself is not sensitive, per se. It's the nerves that are within the fascia that are sensitive and every nerve in the body or every nerve outside the brain, you could say travels within fascial layers. Fascial layers are the transmission pathways for nerve trunks. And nerve endings are also embedded in fascial targets. So that the maybe the mechanical properties of fascia can influence the way the nerves do their job. And certainly, the nerves that are within fascia make this make those layers particularly sensitive, and essentially sensory mechanisms. This is Robert Schleip's idea that the fascia is a sensory organ that's inputting information into our brain constantly, not only about position and movement, but about sensitivity, pain and pleasure. These nerve endings, as I mentioned, are embedded in fascial layers. This is a superficial fascia this right under the skin. Different nerve endings of different shapes detect different sorts of inputs. In this case, a an injury, say from a needle or a piercing would stimulate free nerve endings, that generates a nociceptive signal that gets transmitted on up into the peripheral nervous system where it eventually reaches the brain and is interpreted as pain. Yeah, so that nervous system is responsible for interpreting. And the pain is the result of all of that.
We talked about how nerve endings target the brain, eventually, they when they reach the brain, they're distributed into a few places. One is the somatosensory cortex, this is the place that has like a little person mapped out on it with the sensory motor homunculus. And that has to do with sensation, and motor control. Under all that deeper in the brain is the insula, and anterior cingulate cortex. Those are places that also receive messages from the body, but they're responsible amongst other parts for determining whether that's pleasant or unpleasant. So you can say, these parts of the body of sensory homunculus are determining location and intensity. The deeper parts of the brain are saying, Is this good or not good? And really, so that's almost the more of an emotional valuation or valence of a sensation is this good or not good, not just how intense it is, they turn out to be somewhat independent both in the brain but in our experience that they can change separately.
So oftentimes, we can reduce the severity or intensity of a headache, by things we do that affect this part of the brain. And when that fails, when we are not able to have that effect, because we can't always, we can almost always change the pleasantness or unpleasantness of the experience, we can help people reframe what's happening for them, we can help them adapt to what's happening to them. And some of those mechanisms are pretty clearly within the realm of psychology, this is the way we understand things. But those have a physiological or neuro physiological component, where not only are signals coming from tissue and going up your spinal cord to your brain, but you have signals that are going down the spinal cord, and essentially inhibiting or facilitating this traffic, these descending signals from your brain come basically from your brain's interpretation of what the brain is ready for. And those are the ones that your brain is in charge of. So essentially, we can stimulate these kind of descending inhibitory responses through our touch, that have a very powerful effect on turning down the intensity of the signal. As well as reinterpreting the signal once it gets to the brain. Hands are one of the most powerful tools we have for triggering that descending inhibition the way to turn down the signal. And that's really useful concept for headaches.
Here's some interesting research from about 10 years ago, I was featured in NPR at the time about brain scans with people in pain. Turns out that, you know, there's certain parts of the body that are active in pain. In this study, people were at rest, they got a brain scan, they were trained, a very simple meditation training, this was about four 20-minute trainings, in basically sustaining attention to the present moment, that was the theme of their meditation training for 10 to 20 minutes. And their brain scans changed dramatically, just from still with the same amount of painful stimulus. Just after a little bit of meditation. Some of those same mechanisms are work in our hands-on work, we're essentially training people to feel their bodies to be with the present moment's sensation, sustaining attention, the present sensation, we make it actually possible for people to do that, if they're in a lot of pain, we can add the comforting element of our touch which helps them actually register and be more present with what they're feeling in their body. And that changes what happens in the brain in terms of pain tremendously. So that's the power of your hands, the sensation you have in your hands, sorry, the sensation your hands generate in your clients.
So if we're thinking nerves, and we're thinking sensation, nerve endings are concentrated in fascial layers, especially at the periphery of the body. This is a neuron. And just like a tree or bush, the twigs the finest structures are out at the edges of the periphery, at the ends of the tree, the outside of the tree or the outside of the body, the skin has a lot the superficial fashio has a lot. Many of the interfaces between structures inside have a lot, a lot more than than muscles per se, especially a lot more than the organs and a whole lot more than the brain, the brain has zero sensory neurons, the brain has no sensation brain itself does not experience pain. It's the tissues around it, which are sometimes very innervated very richly innervated that actually generate the nociceptive signals.
So in the neck, with the superficial fascia, that's where we start our sequence, the skin actually and then the superficial fascia is the target of our first technique, even though the picture in the book. This is the picture now in your handout, C-02 transversospinalis looks like I'm already pretty deep. And I am I'm really anchoring with my knuckles deep into Loretta's neck as I lift it. But it was Chris actually Chris you were the one that said, let's start with skin. Let's see what that's like. And thinking about the nerve branches, the occipital nerves that are back there that we're targeting the cutaneous nerves and the deeper ones under that and those have a huge effect on headaches. If you start with skin and don't dive in too deep too quickly, and then you can work up, you'll see me doing that on the technique videos. Just a little word that I'm focusing here on why we're doing these, rather than how there's a whole lot to say about how you do that technique. I say that for the technique videos, they'll explain in detail. And then your discussion groups, your small groups if you're doing a live version where you go and talk about what's happening.
So I lift and lower the head and that technique, basically to slide the skin inside the layers past my fixed point and working starting with superficial layers, working down through the transversospinalis group which of these muscles that I'm thinking about their wrappings as much as the muscles himself because their wrappings are where these little thread like occipital nerves travel. Yeah, these thread like occipital nerves lace up into the back of the head, the sensation in the back half of the head is essentially from neck nerves. occipital nerves start in the neck, they lace up through this neck musculature, and then fan out over the back of the head. there they are making their way through all those neck structures. Yeah, so for something that you suspect is a tension headache or a cervicogenic headache, you can really do a lot for the nerves there in the neck.
Here's Dr. Fiedler an osteopath about 100 years ago who published a self help manual. Here he is inhibiting the superior cervical ganglion with pressure just on the back of the neck. And that's what we do in our work as well with these different techniques that are targeting the back of the neck like transversospinalis. And now C-03 suboccipitals triangle that here I'm targeting the muscles that help rotate the head and stabilize it in rotation. They're really the ones that are intimately related with those occipital nerves that lace up into the back of the head. So you'll see on the video how I'm using rotation to essentially find the sliding and gliding between those muscles, and working down layer by layer, all the way down to the deepest levels. So making room for those nerves, making sure that the nerves are happy and the gliding possibilities between those structures. And here's Primal Pictures, showing us another view of those nerves where they lace through some of them actually perforating right through the muscle bellies themselves. So that's they're sliding and gliding up there, that part of the body is going to be really key to headaches involving the back half of the head or tension headaches. This is the mechanism for why you've probably noticed that neck work helps a lot of headaches. If it's, you know, some migraines, we said it makes it worse. But most tension headaches will respond really favorably, to neck work. And this is some of the mechanism of that.
A review of that anatomy, the structures that help with rotation. And then there may be some speculation too that some of the fascial structures that connect the muscles into other fascial structures might responsible for headaches. This was the myodural bridge, which got a bunch of press attention maybe a decade ago. This is one of Danny Quirk's, illustrations of that little structure, that connects the fascia of some of the suboccipitals right into the dural sheath around the spinal cord and it's highly innervated it's probably responsible for generating a lot of the signals we have in certain kinds of headaches. So it's thought that maybe mechanical tension on this can be part of that. It turns out that there's you know, there's probably lots of mechanical connectors into the dura throughout its length. And so that it could be a factor too if there's direct mechanical pull on these deep neural structures, as well.
A couple of techniques, we're actually using active client facial expression as the active movement. And there I am showing my client Aaron who used to do all of our data entry for years, how to make this face that I wanted to get for the camera, you know, to show the technique there she is finally making the face. She'd just start laughing. It was really hard to get her to make the faces. But for inspiration. You know, I thought it would be great to have a movement today, that really helps you begin to know how to cue your clients and how to participate in that with your clients. This is Pablo Pica. He's an old friend of mine. From the days that I was training as a therapist. He's done many things including manual therapy, but he went on to be a management consultant, and a therapist in his own right. He lives in Buenos Aires, Argentina, and he's going to take us through a little movement. I'll start the sound. If you don't hear sound, give me a quick cue so that we
Hello, everybody. You know that song. It's called smile. Hi, my name is Pablo. Greetings from South America. Til asked me to lead you into a face warm up. Thank you Til for the invitation. So let's get started. Please let me invite you to get up, stand up, bring the energy up. In fact, bring the energy all the way up into your face. Right? So I'm going to be inviting you to make some faces. I'll be the first one to make some really funny faces. So the point is not so much to laugh about myself about my face, although that's allowed and appreciated. But please turn off your camera as you do this. Because if the invitation is for you to experience the sensations in your own face. Not so much to look at how funny you look. Okay, so imagine you can stretch your, your chin all the way up to the top of your head. And as you do that movement, you are going to engage your mouth, your nose, your eyes, your eyebrows and your forehead. Okay, now go and hold that movement, all the way up to the top. And notice what sensation on your face and in your whole head is, as you do this. And let go. And now smile but exaggerate that smile as much as you can. Engaging all the muscles of your face, your eyes, your nose, your eyebrows, your whole, even the sides of your neck as you do it. So, smile.
Hold it, hold it feel the sensation in your whole face as you do it, and let go. Did someone hear the song smile as you smile? Strange, isn't it, okay? Now imagine you can bring your right ear all the way into your left ear so they can touch and as you do that, engage the whole side of your face and the totality of your face. So start moving it towards one side and engage your whole face, and visualize maybe turning that your head is turning all the way 180 degrees as you make this movement, and hold it and let go. Maybe massage your face a little bit. Start to feel how it's warm up is really warming up. It's warm up, isn't it? Okay, touch your face, slap your face a little bit, wake it up. And now the opposite direction, bring the opposite ear into the opposite side of your face. And go for it, go for it 100% force it as much as you can. Let that ear slide all the way towards your other ear. Engage your eyes, engage your pupils, engage your eyebrows, notice the sensations in your face in your whole head as you do that. And let go. And let go and take a deep breath. And just take a moment to notice your face and focus on the sensations on your face - warmth, heat, softness, tightness. Hey, it's been my pleasure to be with you. All the best, have a wonderful day. Hope to see you sometime in person. Bye bye.
Thanks, thanks to Pablo for taking the time to make that for us and send that in from when we say it is is is so much fun. And that's the key to these techniques. We're using facial movement, there's so much inhibition around the social expression of you know, ourselves through our face. And so really doing that with your clients, getting them involved in using the facial expression, once we get a hold of the layers can be so important. Now, it can also help with very clearly helpful with tension headaches, it can help with migraines, you of course with a migraine, people won't want to do much and you got to respect that. In fact, you want to pace it carefully. You may not want to make as dramatic a face as Pablo was making there if you have migraines because you could, you know, aggravate yourself.
Alright, just giving you a overview of these techniques before you go watch them in the technique videos. Or maybe this is a review for you. The frontalis, occipitalis technique. It's named after muscles, but it's thinking about the fact that these muscles are part of a single tendinous or myofascial structure that goes from front or back. And are really responsible for, in the front, raising and lowering the eyebrows like Pablo was doing and in the back for essentially doing the same thing. wiggling your scalp a little bit. So this picture shows me working on the front I think on the video actually get my hands under the head and anchor those layers as I have someone make the faces. This is the making the faces one because simply what I do I start to anchor into those layers and have someone make all kinds of crazy faces while I do that with them so that we can get that gliding. And maybe reset the kind of Golgi responses and things like that, that are stat they're part of someone's resting tone of the tension we have in our in our myofascial structures, the muscular part of the myofascial structures. So just giving you an image for some of that, gliding and sliding you might be doing there, you know, all kinds of expressions, every possibility with the eyes and the face, including, you know, wrinkling the forehead, putting your face on your left ear, etc. squinting the eyes together, all those will move layers that are sensitized in the tension headache, and the gliding, and the movement itself helps to normalize that sensation and reestablish their glide.
So there's the technique for the next one in the book, the galea aponeurotica technique, you can also use movements for that in the galea technique, and it's similar movements, but I'm thinking a different layer, perhaps, there, I'm really just anchoring the layering in and getting someone's layers to glide, I might do that passively by just essentially, the metaphor is peeling the melon, it says in the book there, that's one of Bill Smythe's metaphors, getting that rind of their head, the rind of the melon to slide on the head. It's not a head massage, per se, it's not shampooing, it's not sliding on the surface, it's getting the various layers of the head, of which there are many, to slide on each other. The scalp is enormously sensitive. The lots of nerve endings, as well as free nerve endings in the in the head and our hairs go right to stimulate that. So some people use hair as actual handle to stimulate those and to normalize that sensation. I myself, hate that I hate people to pull my hair. So I never will teach that in any course that I'm a part of. If you want to do that, yeah, fine, just make sure you get a release form from your client. And don't do it to me. Because but that can also be a useful, people say, I take their word for it, be a useful way to work with headaches too, this gentle stimulation through careful hair pulling.
And maybe what's happening with the sliding and the pulling and the shearing is that we are stimulating nerve sensation so that the brain can reevaluate that sensation. Like in the meditation experiments where just attending to the present sensation makes the pain experience diminish. It's like that if we can actually help someone feel their actual body and not their reaction to their body, the pain is much better. There may be mechanical effects too while we're sliding layers around on the different layers of, in this case, hyaluronic acid between the different layers of fascia that gets stimulated by mechanical, shearing and mechanical pressure will stimulate more hyaluronic acid production. And things get slip more slippery when you work with with them. That's one of the things we feel changing under our hand. One of the you know, under our hands when we work, the tissue has a palpable different quality and some of that is hyaluronic acid changes that's going on in the head when you get some things to finally glide you've rehydrated those tissues, as well as helped the brain interpret its response to them.
And these layers are all around the head. There are different layers, different dimensions, different levels. And you can think of the head as a multi layered structure. And you can work from skin down to this frontalis occipitalis layer into the periosteum or pericranium right on the bone. Quick diagram of some of those layers. It's simplified. There's actually probably even more layers than that, but you can start with each of these different layers of the dermis, looser, superficial fascia. The tough galea say the aponeurotica, galea aponeurotica is dark green, another layer of looser tissue and then right down to the pericranium, the dense connective tissue adhered right to the bone.
And then there's techniques we're going to do next time that actually we're thinking inside the head even more. There's the galea aponeurotica technique with me moving her scalp around. And then there's the temporal fascia technique, we've now moved on to the side of the head, and we're relating it to the jaw because this entire side of the the structures on the side of the head are jaw structures. Jaw movements themselves can stimulate headaches, they're movements you can use as you work this zone to help normalize the sensation and get the layers to glide. You can have people just clench their teeth or open and close. Here's a little diagram of the muscle from Sobotta. He's showing us the muscle reach. If you get a chance to look at an actual skull, a lot of these plastic ones don't have it. But a real skull will have a clear raphe or rough line there at the edge of the temporalis fascia, where the fascia over the temporalis bone attaches to the bone. It's an enormous structure that then transmits quite a bit of mechanical tension. And that's often what we're feeling for. Gorillas like this one have enormous temporalis muscles because they bite so hard that they bite sticks in half, and things like that. So their temporalis muscle fills this entire fossa, fills this entire shape here, and it's a massively bulging muscle. In this shape, we have wide flat one versions because we don't bite so hard, we've grind up our food. And as a result, we don't need these enormous muscle spaces ours are much shallower. But that's what we're working with in the temporalis fascia technique.
In the ear crura technique, the superior crura of the ear technique on C-07. Yeah, we're actually using the ear as a handle. We're using the ear as a handle to feel the layers of the cranium, fascial layers of the cranium. And here, we get a hold of the ear and we just check it in different directions and look for either provoking pain or relieving pain both are useful to us. If I can, if I can relieve the pain, fantastic. someone's having an active headache, if I can provoke the pain. Now, if they're having an active headache, I want to be careful about the pain. But if there is someone who suffers from regular headaches, if I can find something that reminds them of the headache, bingo, we found something related to the headache. And that's going to be the essentially the royal road or the way into the prevention story. How do we do things that are relevant to the headaches they experience, we're finding relevance by provoking it by finding a little signal that reminds them of the headache, and lets us know, we're in some part of that larger complex of their recurring headaches. So that's what we look for here.
If you don't provoke or relieve any headaches, you can still mobilize and it still has a great effect. But really start with the sensation, map out the sensation first. it's going to be really clear for you. Ear retraction is you know, like I said, it pulls on your entire scalp. The ears themselves are also enormously sensitive. You can also you know, like think about the ways that they're layering around the body. These are fascial layers around the scalp, or in this technique, but especially the next one, how that they're connected down deep into the skull, in this case to the inner ear, middle and inner ear. So there might be a way that you can relieve someone's ear symptoms by putting traction there many people find it very satisfying to have traction there if they have ear symptoms such as tinnitus, or ear aches and things like that. You can also imagine that you're feeling even deeper, maybe down into the eustachian tubes, that's what these are, because it's a straight shot through that external acoustic meatus into the eustachian tube of the deeper ear structure. Yeah.
And then also, you can think about the fact that you're working in the territory of the vagus nerve, the ear and a little bit of the scalp right behind the ear are the only places on the surface of the body innervated by the vagus nerve. The vagus nerve is special because it's the primary parasympathetic structure in the body, the parasympathetic system being the rest and repair part and half of the autonomic nervous system of which fight and flight are the other half. So this is the rest and repair goldmine. This is the place where you have the biggest, clearest, most direct superficial access to that whole part of the nervous system that essentially helps you regulate inflammation also helps turn on the repair processes into the same mechanisms regulate regulating inflammation, helps calm, helps your body recover from stress and deal with stress. That's what you're touching right here when you get to these green zones on the ear. And this diagram is in your book, a little simplification of it. So you can see where you know typically people, now this is variable individual to individual, and there's overlap too where other nerves integrate these zones, but the most potent areas then turn out to be the cymba, the little hollow right up at the top of the deepest bowl in your ear. That's where it's the most rich and most exclusively vagal innervation is.
There's been some really interesting research with vibrators there to actually people will put a vibrator in their ear for 10 minutes, I'm not kidding, and have a measurable decrease in their cytokine production, in other words, their inflammatory activity in their body that lasts for a week. I'm not kidding. I'm not prone to these big claims. But this is pretty interesting research. And I hope to get the author of that study, Kevin Tracey, into our podcast to talk to him about it, where a little bit of ear stimulation has a long lasting effect on inflammatory regulation in your body. So anyway, that's what you're doing when you're working with the ears with your touch too; you're stimulating that nerve. Vibration stimulates it. Touch stimulates it. There's also people doing electrical stimulation of their vagus nerves. We're using touch to produce activity in that vagal nerve that has all of these healing effects on the body. Yeah, and so the finger is inside the ear there, there are many different holds. Again, you'll see on the video that you can grasp it in many different ways, and use traction in varying ways to feel within the ear and work the ear. It's essentially the sensation you're producing that's doing the vagal stimulation.
And then the traction you're using by pulling on the ears gently and maybe pulling out and a little back like I'll show in the technique video can allow you to imagine the connection that this ear structure has deep into the head to this bone, the temporal bone, the temporal bone is the bone in which the ear canal sits. It's, so I'm essentially pulling on the temporal bone when I pull on the ear. its deepest part interfaces with the roots of the trigeminal nerve. That's what this is. In some cases, the trigeminal nerve actually goes through a little fossa in the temporal bone. So there's like a stirrup on the end of that bone that when you pull in the ear, you're, you're essentially pulling on the structure that connects to the temporal, sorry to the trigeminal nerve.
There's a great shot of temporalis fascia and the way it's innervated by these nerves too the can be a big part of people's temple based tension headaches. But the ear is an also remarkable handle for pulling on that bone. That's what I imagine I'm doing the ear's a handle for me to actually pull that bone out of the brain as it were. I'm thinking of getting that bone to move right out of that brainstem, where it might be part of the trigeminal nerve story. Who knows.
Ringing in the ears can be a stubborn symptom. I've had successes I've had not successes, let's say both dimensions. my wife deals with it. It's much better for her partly as a result of my hands on work but mostly as a result of changes to her diet and getting hearing aids where some people's tinnitus is result of a lack of hearing. And the brain essentially generates the signal to fill in the blanks in its experience. And that results in ringing in the ear. So when you correct that with the hearing aid for many people, the ringing in the ears can diminish. Now there's many causes of ringing in the ears or tinnitus. And so I wouldn't say everyone should try one solution at all. But know that your hands on work can definitely help in some cases, and when it can't, there are other things that can help as well.
So a little shot of the vagus nerve branch that one auricular branch of the vagus nerve that goes out into the ear and into a little bit of scalp behind the ear. It's in green there. This is showing us vagus nerve, vagus nerve is the only nerve that's shown here. So it's going down the neck to your viscera, but also is going out into your ear, a special little branch of that vagus nerve. Totally cool. So that's the vagus nerve, right between the ears heading down to regulate your heartbeat, regulate your respiration, regulate visceral function, regulate the viscera's reaction to your food and the inflammatory activity of the spleen, and etc. All these things getting regulated through vagal signaling up and down and the ear is part of that.
We'll talk next time more about the trigeminal nerve. This is a little introduction to it because the ear is such a powerful entry point into the trigeminal system. But basically the trigeminal and the occipital nerves that we're dealing with in the neck, have some crosstalk that seems to happen within the brainstem deep down in the brainstem. You can't touch that spot. Most people, I wouldn't suggest trying that at home. You can't touch it, but you can touch the nerves that feed into it including the vagus nerve, which seems to be part of the regulatory function of this crosstalk that happens there deep in the brainstem that's involved in all headaches. All headaches do involve activity in the center in the brain stem and the vagus nerve is like the hotline, the short path right into that nervous system structure. Trigeminal nerve, a little preview of that, it's responsible for headaches in the front of the head, its roots are right there, where we're pulling on, with the temporalis othe ear technique, the correct technique and the concha technique. So it's like pulling that brain out of that trigeminal zone where it can be, perhaps part of that trigeminal story.
Finishing the sequence, finishing the sequence, here's Larry doing a pelvic lift on Loretta, we've been doing a bunch of work up at the head, in the sequence so far. So we do something for the other end of the spine just to, you know, honor our traditions and to follow our models, which says, you want to make sure that both ends of the spine are mobile and adaptable at the end of the session. To prevent the body reacting in adverse ways. This seems to be a safety or insurance policy take out by checking the other end of the spine here. Here again, let the video explain how to do it. But that's the purpose for it. Larry's just cradling her sacrum, and her the viscera of her abdomen, and calming or settling or perhaps applying some mechanical traction too to the sacrum, just to get the other end of that entire craniosacral system settled and integrated into what we've been thinking about in this session, both ends as it were.
Okay, I'll give a quick summary. I know that's a lot of material. Fortunately, it's recorded, you can go back and play it. Fortunately, it's there for you to review. And fortunately, you can now go watch the technique videos. But before you do that, let me give you a little summary of one of the main points. This is the protocol for use for tension headaches. That's been our focus for today, you know, once we got into the techniques are all about tension headaches, essentially, layer by layer, we're mapping out layers sorry, areas of headache sensitivity, we're finding where there is sensitivity, layer by layer, starting superficial even skin, even maybe even just touching the hair, I can handle that I don't want to be pulling my hair. But if you just like touch my hair, I'm okay with that.
Look for the direction layer or pressure that relieves or gently provokes headache pain. So that's the counterintuitive part, you want to help people you will help them feel better. Sometimes you help them feel better by gently provoking their pain, not only so you can identify the tissue or the layer, but that so the brain can essentially get used to that and reevaluate and normalize that sensation, and stop having it be so unpleasant. It's like that brain scan thing, you're essentially quieting the brain. And when it receives the signal, you're increasing its descending inhibition, inhibition, so there isn't so much activity in the brain and not so much pain experience. And you encourage the client, once you do that, relieve or provoke the pain, encourage them to breathe, and to relax. Last but not least. Great, great thing to do at the end of lecture two is to breathe and relax.
So yeah, I see some clients already starting to come into the chat room, that's great. You can also raise your hand we'll have a little bit of verbal q&a, raise your zoom hand there's a button to do that. But before that we're gonna hear from the faculty about their kind of takeaways, and their key points that they want to make sure they emphasize. What do you think faculty? Who wants to go first? Just go ahead and unmute yourself and I'll call on the rest of you. Who wants to go first? Go right ahead, Bethany.
Sure. Just one the one of the things that was in the chat, who was it Francis Swain figured this out on on her own but just to reiterate, she said that originally she was taught to for people with migraines to work with the suboccipitals. And and we show our techniques here while we get there. Again, the importance of the layering and what is often missed on people with headaches is that people haven't worked really carefully with the superficial fascia. And this is particularly relevant around the head and neck, especially the scalp. You almost can't spend too much time looking for where it doesn't slide.
Great one. Thank you. Thank you, Bethany. Laureen Go right ahead there.
I'm totally piggybacking on you, Bethany. And gonna take this opportunity to welcome, everyone that is joining this course for the first time. And just to underline what Bethany just said, which is something that is, people often find different when they first encounter this style of work is that we really do emphasize the skin layer as a place to start. Don't discount that; don't brush through it; don't go deeper to start. Really pay attention to what can actually be found in the layer of nerve endings just under the skin. So I'm just putting an extra halo of exclamation around that, and welcome.
Love it. Thank you, Laureen. Yeah, it's, you know, we're used to working deeply, many of us were trained that way, or even if we're thinking craniosacral, that's a deep kind of work that's feeling into the body. Start even farther out in the body, just when at the surface, there's so much out there. Who's next.
I'll go next Til, a common theme here, but I'm going to start with really our environment, and how we set up that session with someone that may be in extreme pain from a headache, and just our calm and demeanor, with addressing them and addressing their needs, addressing what sensations that they are experiencing, that's a part of thinking of the layers as well. Not only touching them physically in the outer layers, but also you know, touching them within themselves. And if you've not experienced the headache, like they have, try to put yourself in their position shoes, sensation, and approach it as you might feel you would want to be approached. So the type of headache that they might be having, whether it's a tension, cervicogenic or migraine, utilize that, map out sensations, and think layers, think layers even before you put your hands on.
I want to say I want to say a little more about that, Bruce, because that's key is to really get inside that headache experience. If you've had headaches, you have a natural advantage in this territory, because it's such it's an indescribable state to be in, it's excruciating. It's horrible. It's, it's awful. And yet, having someone there with you through touch, or through just presence, is often the thing that can really make a difference can start to quiet the brain down in a sense, and make it tolerable, in a way. So there's such a big piece of that essential human contact that we provide, just in our touch. Thank you, Bruce. Who's next?
I'll be happy to jump in Til, Chris here. I was piggybacking Bruce, this time I really like what you said Bruce, around how we as practitioners are being present in our bodies and our sensations is a is a part of our our methodology really. And if nothing else, and I guess this is true for everything we do in advanced trainings, we're looking at how do we reshape someone's experience and especially true in headaches, because that really is an actual experience that sometimes belies the physicality of shape or movement and so on, that we, we often work with as practitioners. So reshaping experience can be enhanced in part by how we are in our own bodies, but also with our again with our words, our quality of touch, mapping out where they feel things the most, or the least, helping them notice where it feels less uncomfortable versus more uncomfortable. And being very slow and, and methodical with our pacing is part of reshaping someone's sensation experience. So it's sort of a it's a truism throughout all our work, of course, but in this case, especially, I feel like you know, we get to talk someone through the process of perceiving themselves in new way. And if we kind of think that way as we're working, it can be very effective for headaches. Thank you.
Thank you, Chris. Thank you. Yeah, thumbs up. Larry, what do you want to share with us?
Yes, thank you Til. One of the biggest things I find working with different types of headaches is definitely the protocol that Til has listed there. And the last item is very important. It says encouraging the client to breathe and relax. And it's one of those things that sometimes when somebody comes in, we get all excited, oh, we're going to start to work on them and do all of these new techniques. But if they're not breathing correctly up into their head, if they aren't relaxed, if they're holding their neck, some of the first things I do is just let their head rest in my hand, you know, find their breath coming up into my hands. Because if you start any work at all, it generally isn't going to be very productive until that client is actually in the room and relaxing on the table a bit. So it is very important that they are relaxed before you start the work. And see if you can at least calm the beast a little bit before you start. So that's one of my biggest finds is make sure they're breathing correctly, and not locking everything up from their shoulders up. Thank you.
Thank you, Larry, thank you for that. It's you know, there's so much to know about this. And my challenge today, of course, was to lay the groundwork for the entire approach on headaches, and then give you some specifics about the tension headache. Hopefully, I've either relieved or provoked your own headache around this material. That's a great way if I if I could actually, that'd be a good experiment, I would like to actually give you all a headache temporarily, just so that you could experience that what that's like to be in that state because that's the place we work from. It really is that sense of empathy and that knowing of the experience from inside out is indescribable verbally, but informs so much of how we touch and how we interact with people in that place. So I don't wish you any headaches at all. But if you do get one, use it, you know, probably it's something around is like deductible in some big sense as a professional continuing education experience. Get your tax write off as it were metaphorically or actually next time you get a headache.
Okay, so thank you, we're gonna we're gonna we are going to get to the verbal questions. But first, we're going to wrap up the formal part of the course for today. Thanks for being part of it. If you have logistical questions, things like that the forum is a great place for that. We'll stay after and talk about that too. Be in touch. Go check out your course navigator, watch for the emails that'll tell you about that. It'll walk you through the course, whether you're doing the live or recorded version. Thanks to Carmen Rivera for her translation today. Yay Carmen, I'm going to give you a little spotlight for a moment. Yep, give us a little wave there, Carmen. Thank you, Carmen. And thanks to everybody else in the office and everybody else in the team that's been doing it. And thanks to all of you around the world who are part of this too. Thanks. And we'll go ahead and call it a day. If you got to go. You got to go. If you're going to hang out, hang out. We'll talk to you some more. All right, so we got some hands up. I see first though, chat monitors. Anything chat monitors you want to share?
Til, Brian had about three or four different questions. I don't know if you want to do those right now.
Okay. We'll get we'll get to those
I did chat them to you. So you could take a look at those.
Okay. Any other chat questions?
Nothing in Spanish, no.
Nothing in Spanish you say?
No.
Okay. Great. And then we have a verbal question, Rosalynn, and then Brian, get your hand up to great, Rosalynn. Go ahead and unmute yourself. Rosalynn. If you still have a question, and let us know what you'd like to talk about.
Um, I was hearing while you were explaining the technique around the ears, and in craniosacral there's a technique where you work with the sphenoid. Is it similar technique?
Probably, yeah, I mean, that's, since I don't know what you studied in terms of sphenoid or in craniosacral work, I wouldn't be very good at comparing what we do to that. But we're certainly thinking about the sphenoid and it's certainly influenced by those craniosacral, or osteopathic ideas of affecting and liberating spheroid movement and regulating spheroid movement. But check it out. I'm curious what you think check it out in the video. And tell me if it's similar to what you've learned. Of course, it's part of learning is comparing something new to what we know already. That's just part of how we learn things, we get to see what parts we already know which parts might be new. The trick, of course is to look to see what is new. And to actually look for differences because the brain, you know, brain scans show us that the brain gets active when there's a difference between what it expects and what it gets. So rather than you know what I mean?
That's why I took the course I find it very interesting.
Yeah. Thank you. No, that's a good question, too. And I'll be curious to see what's different, because it's the differences we're going to learn from. There's probably some similarities, but there's going to be some differences too. Okay, thank you. Thank you, Rosalynn. And, uh, Brian, you want to go ahead and unmute yourself, and what are you thinking. What do you?
Yeah, um, you know, I've been studying my old anatomy book about the brain. If, if the somatosensory area, the postcentral gyrus is where information goes, is it especially like, looking at the trigeminal nerve, is that is that post central gyrus? Is it only receiving sensory information from our environment? Or is the brain itself with headache with migraines, especially, is the brain itself actually not working properly and sending these weird signals to the postcentral gyrus? If it's if the if a migraine is actually neural is the impetus from the brain itself? And not from the sensory information in the environment?
Yes, I think I mean, I as if we know, we don't know, we're still trying to figure it out. But the theory is that, yeah, that a migraine is a pain, hallucination. It's a sickness, an experience that's generated in the brain itself.
If that's true, then like, especially with the occipitals, the work that we're doing could be adversely affecting, you know, we're touching nerves that are firing. There's a pathology there. So like, so what do we what do we do? Is it just maybe just being present with them? And, and the meditation seems to be maybe more functional for them, rather than lighting up nerves that are already lit up?
Yeah, it's, you're on to the right question, what do we do in this case, and a lot of it is in the approach, and we're going to do our best to kind of explain what we do. And you'll see the, you know, the protocol and the videos, and then you got the faculty's great reminders there. And then you try it, you know, but basically, we're calming a over-sensitized system. In every one of those cases, headaches is, you know, a sensitivity issue. And sometimes there's mobility components in that, and sometimes there's not, but we're calming and normalizing something that's oversensitive. And we do that in so many ways, by our touch itself, by our targeted specificity of the anatomy, but a lot of it's just in how we relate, and a lot how we manage the whole experience for people. There's so much we do for headaches just in that process. Brian, we got another question or two, queued up after you do you want to flag any of the ones you chatted in? Can we can go for maybe one more of those if you want.
I was just gonna know that, especially in regards to the trigeminal nerve. What's the initiator? Is it the midbrain the pons, or, or is it the brain over the pons?
You've surpassed, your question has surpassed my neurological knowledge so you leapfrogged me. When you figure that out, let us know. That's a good one. Okay. Thank you, Brian. See you in the small group around the forum because you come up with some good questions, appreciate that. Okay, tyra mine, which looks a lot like Pat Dorsey. Pat, you want to unmute yourself and ask your question.
Yeah, thanks. Til Can you hear me?
I do.
Yes. So thank you. Descend that you mentioned that descending nerve track from I think it was Brian. Yeah. Ascending and descending. And you mentioned we can work with and modulate effect that descending track. I think you just answered my question when you were talking to Brian about how we basically, I forget what word you said was, deregulate or calm or whatever. All the different ways that you've talked about in the seminar working slow, working layers, you know, starting to superficial, are those the kind of methods you're talking about that are affecting that descending track?
Yeah, in fact, well, everything we do with our hands that works involves some level of descending modulation. descending modulation is the grand unified theory of why bodywork works. Now, there are peripheral effects. There's things we're doing out at the tissue level in the body too that are probably part of that. But what we're doing essentially is we're turning down the signal the amount of signal that reaches the brain. And then we're helping the brain turn its own signal down. We're stimulating the brain's ability to do that for itself. Okay, when you say it, and like you said, it's, it's the way we do what we do, it's the pace at which we touch, it's the layer we start, it's the explanations we give people. It's how they think about what's happening. It's the incense you burn or don't burn in your practice. It's whether you have a mask on or not, it's all those things, they're gonna have a big effect on the sum total of the descending modulation impact.
Right. A lot of stuff that we just do intuitive. We can see that it's working, our clients are, are responding, they're getting calmer, they feel better when we check in all that kind of stuff that we've been doing.
That's right. You've just stimulated some descending modulation when you see those things. That's that's the sign of that happening. It's just a fancy name for what we know already told us. Yeah. Thank you, Pat. Good to see you.
Nice seeing you.
Kyle, you're next going to unmute yourself and ask your question, Kyle Putnam.
Yes. Hello. I was gonna see if you have any, anything you would add to your technique, technique videos, about masks?
I mean, techniques.
They add up.
What? Say a little more. What do you? What's your question, Kyle?
Well, my question is, is if there be anything that you would add to your pre recorded videos, um, related, which I haven't watched yet, for the mask use.
The mask specific advice I have about using a mask as a practitioner, you're asking?
Just for everybody ourselves for our clients?
This is my least favorite kind of question. Because I may not, no it's such an important question. And I'm so much not an expert there. That and I'm like sounding like I know a lot and you know, talking about all this stuff, and think, oh, he must know something about masks. I don't know diddly about masks, honestly, all I know is that you know, I got one that works really well. For me, it helps me breathe really good. And I think it's a good thing, I'm into masks. But I am not the person to ask about either mask use really, or the impact, I understand the impact it has, I'm wearing one too, because I've had some, you know, hours, multiple hours wearing a mask and know that there is an impact.
One factor that I can speculate for myself is if I resent this mask, it gives me a headache. Yeah, if I think of this mask as a good thing, I got this really cool mask, and I feel good wearing this mask, I feel better at the end of the day to wear this mask than I do with my big old heavy, you know, other mask I had. So there's so much around creating the right kind of descending and, you know, ascending modulatory responses for myself to be able to live with the mask. You know, it's about like having the right attitudes, it's about having the right mask, it's about having the right circumstances too. That's one place that I've, you know, been working with the mask myself. Now, you're right, it's, you know, it's, it would be really different. There's probably a lot we have to learn both about wearing them ourselves, but also working with people that are wearing masks. I don't think, people talk about like, recycling the air being a problem. You know what I mean? Like you got a little bit of trapped CO2 there under your mask that you keep rebreathing. I don't think that's a plausible, I guess, this is stepping into controversy. But I don't think that's a big deal. The volume of air there in your airway and under the mask is really small compared to the tidal volume of your whole breath. And there's just a slightly larger amount of CO2 in that air anyway. And before covid you know, breath, breathing was a big deal, breathing was the next biggest thing. And there was oxygen debt, we were actually trying to stimulate oxygen debt to get the body used to a little bit of deprivation, because the body responds with a whole lot more vigor. It's kind of like intermittent fasting of the breath, in other words, so that that's probably at work with the breathing if you you know, if you're into those kind of things with the mask probably stimulates your body's ability to process the air you get in a much more efficient way which can't be a bad thing. Anyway, that's my quick off the cuff thoughts about mask please share what you learn what share what you know, too.
Okay, so that's it, anything else chat monitors, anything else that has come in that you think we should, we may not be able to get to everything. Anything else we should talk about in terms of content chat monitors, before we call it a day.
There was a good question about the straps on the mask pulling behind the ears. Yeah, we were working in. Yeah, that can have an effect, I think.
Yeah, no, I felt that end of the day, just the tension of the straps. These are sensitive structures, you know, they just get tired, you know, my glasses tire them out, too. So it's just one of those things. One of those things that is a factor.
Okay, well, we're gonna go ahead and call it a day. If you have more questions, more thoughts, please join us in the forum, or bring them to your study groups. Your discussion groups are going to be a great place to go talk some more about these things. Go watch the technique videos, or note down your questions, bring them to your groups, because the conversation continues. And those are some of the richest parts of it all. Thanks again to everybody. And we'll see ya next time.