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I have read the discussion here: http://www.massageprofessionals.com/forum/topics/headaches-after-ma... and there are some really helpful ideas in it.  I was wondering if anyone had any additional insight to the issue.  My client is in her mid-30's and has been so debilitated by migraines since high school that she just recently was able to get a full-time job.  She credits me and her chiropractor with getting her to the point she could do it!  However, recently she's noticed that she's getting more headaches again and after a massage (which she loves!) she's ending up at Urgent Care or the emergency room.  She's done much better with CranioSacral Therapy and Lymph Drainage Therapy (I just took LDT 1 a few weeks ago).  

I'm wondering why she's changed to having headaches after massage when she didn't used to.

More info:  She's about 5'4" and maybe 115 lbs.  I don't think she eats well; she's not interested in food.  And I do need to ask her how much water she drinks.  Her previous MT did really painful deep work on her; I do deep work but it's not painful for her and she has overall less tension and muscle knots than she did.  She has significant right hip issues along with a pelvic imbalance that I've been working to address using massage and Myofascial Release.

One change we did make was she dropped from every week to every other week when she got the job, but it's been several months ago and this pattern just started fairly recently.

Any thoughts would be most welcome!

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Well its impossible to give advice over the internet like this...But where does she feel the headaches...What part of her head?  I had a client come in with a headache a few days ago.. This is cool...After palpating all the possible muscles that can directly contribute to a headache .. I found she was really sore in her massitor and temporalis muscles on the right side...She had one sided headaches.  I had her stick her tongue out between her teeth.  Then I pressed firmly up on her jaw for about 30 seconds with one finger...then told her to relax, and her headache was gone...So if there is TMJ type involvement , thats a very effective technique.. The autonomic nervous system, not wanting to bite its own tongue off, shuts down  all the muscles of mastication allowing the muscles to move into their maximum resting length.  But her headaches.  She gets them after the massage...I think for anyone to help you help her, would require actually being there...I guess you could try to change things up or shorten the session...Getting rid of her hip pain...Thats an obvious problem..focus on that perhaps...if you can make that go away...Well that would be good...Its really hard to give good advice over the internet...But gosh, if she has to go to the emergency room after a massage.. She may not want to try anymore..If she does...change what you are doing somehow?  Shorten the session..  I dont know.

Thanks Gordon!  I know it's really hard over the internet.  It's hard in person with some of these!   I love that idea for TMJ and facial muscle release.  Simple and effective, and I have several clients that will benefit from it.

Her headaches are typically in the front of her face - forehead and her face itself (I think the Trigeminal nerve is somehow involved).  She will get a focused pain in her left eyebrow, the most medial part of it.  And maybe sinuses play a part, although I've never known of sinus headaches that were so debilitating so there's more to it I think.

Yeah, luckily I know several different modalities that help.  I'm a perpetual student!  It's just a shame that the massage creates problems!  And definitely we need to deal with that hip issue.  It's really significant both in pain and in the implications for headaches. 

Sounds like trigger points..More often then naught, thats what it is...But like I said.. Over the internet like this, Im just talking.  Several muscles fit into that pain pattern...SCM is the first one that comes to mind...orbiculoris or whatever its called around the eye is another... But once any underlying pathology is ruled out...Then its a very very good chance its trigger points.  More often then naught. 

Therese Schwartz said:

Thanks Gordon!  I know it's really hard over the internet.  It's hard in person with some of these!   I love that idea for TMJ and facial muscle release.  Simple and effective, and I have several clients that will benefit from it.

Her headaches are typically in the front of her face - forehead and her face itself (I think the Trigeminal nerve is somehow involved).  She will get a focused pain in her left eyebrow, the most medial part of it.  And maybe sinuses play a part, although I've never known of sinus headaches that were so debilitating so there's more to it I think.

Yeah, luckily I know several different modalities that help.  I'm a perpetual student!  It's just a shame that the massage creates problems!  And definitely we need to deal with that hip issue.  It's really significant both in pain and in the implications for headaches. 

Therese,

Does lying down make her headaches worse?

Hmmm...I don't know Lee.  I'll ask her and post back.

K, she said lying down doesn't make them worse but sometimes getting up and around helps - but that depends on the kind of headache she has at the time.  I forgot in my original post that she gets different kinds of headaches.

Hey Gordon, I missed your post.  I need to check out her SCM's - I know they are tight, as are her scalenes.  She's been going to a neurologist and has gone through all kinds of testing.

Also, her frontal bone is shifted to one side which creates a whole set of issues by itself.

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