Written By: Theresa Kuhn, Retired LMT, Register Yoga Instructor, Parkinson’s Fitness Specialist, Functional Aging Specialist
Living with Parkinson’s disease often means dealing with contractures - A permanent tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff and rigid. When muscles get tight it affects your posture, your gait, and the pain levels in your body. Regular stretching and yoga can help keep the muscles lengthened but sometimes additional interventions such as assisted stretching are necessary.
You may have already seen the images displayed on our social media. This is the story of finding relief that corresponds with the pictures.
When Laurie first came to see me at the gym, her neck was locked in a forward position with very limited rotation. Her sternocleidomastoid (SCM) muscles were completely inflexible and her levator scapulae muscles were even tighter. Laurie wasn’t optimistic that I could help, but, at this point, she was willing to try anything. I assured her we could relax her muscles to give her some relief.
First Photo of Laurie:
We started with the SCM muscle believing it would be the key to unlocking her neck. I expected that once we released the front, the opposing muscles would relax, her shoulders would drop, and she would feel some relief. The first photo I took was after our third session together. This is when Laurie and I realized this wasn’t just a stiff neck. This was Parkinson’s showing up – in full force. It took some research to name the issue and adjust our approach since she didn’t have a dystonia diagnosis and her doctors seemed unconcerned by her head drop position.
Anterocollis, often called “head drop”, is far from a simple stiff neck. This form of dystonia presents itself through contraction of every muscle in the front and back of the neck simultaneously. Imagine having a cramp in the back of your calf and then a cramp in the front of the calf, with both groups of muscles cramped up in a tug of war. That’s what anterocollis is like.
Now that we had a formal, accurate diagnosis we were making progress.
Laurie was beginning to have more hope for the possibility of a positive outcome and, with her sense of humor, assured me she wasn’t going to make this easy for me. "What fun would that be?" she said. We pressed on together. 🌹
Using too much force in this situation can damage the muscles, so we found the perfect recipe for success: 10 minutes with a heating pad designed just for the neck and shoulders (who doesn’t like being tucked in with a heating pad for a few minutes of relaxation?) followed by gentle stretch-and-release techniques, always being cautious not to overwork the muscles.
Photo 2:
At the start of our eighth session as Laurie and I discussed our treatment plan for the day, Laurie smiled and said, "I have complete faith in you. Look how far we’ve come." The combination of her progress and her comment, inspires me to drive from Huntsville each week (not a hop, skip and a jump travel wise). Laurie and I have become partners working together to increase the range-of-motion of her neck and lessen the dropping of her shoulders.
After 10 Sessions!
Most of the work I do with Laurie takes place at the Franklin gym and is called PNF or Proprioceptive Neuromuscular Facilitation. Don't be scared if you are at the gym and I observe you working into a hamstring stretch, and I come by and hold your heel and ask you to push down into my hand. That’s PNF. When you push your heel into my hand your body has to contract the front of the leg, the quadriceps muscles. When you do that your brain signals the opposing muscle in your leg, the hamstring, to relax. The more the hamstring relaxes, the more it releases.
And by the way, When you enter my room at the gym, be prepared. This approach is a workout, not a relaxing massage.
If I can help you in any way let me know. I look forward to seeing you at the gym .
Theresa Kuhn
Great work by both of you!