Joe: 00:15

Happy 2025, everybody. Welcome to the first episode of the Freedom Talks podcast in 2025. Super excited to have you here. Thanks for listening. And it's your host, Joe Ogden, who I'm a Fox Point physical therapist here, who also is the podcast host of this.

Joe: 00:33

If if this is your first podcast you're listening to, we really appreciate that you clicked on the podcast and are here listening with us in 2025. It's gonna be a really good year. We're super excited. First topic we're gonna talk about here in 2025 is headaches. Headaches and cervical pain.

Joe: 00:52

This is something that, if you didn't know, is something that physical therapists can really help with and improve our posture to help our neck pain and help our headaches. We see a ton of patients here at at Fox Point who suffer from chronic headaches, from postural headaches, referral point headaches. So I really wanted today just to kinda go through, how our posture can affect headaches and some of the different referral areas that help us as physical therapists, improve, patient presentation with headaches. So I think it should be a really good episode to start the year off, especially as we get out of the holiday season here in 2025 from, Christmas or Hanukkah or whatever holidays you celebrate, around this December, January time frame as well as the New Year. There's a lot of stresses that come with that from cooking, cleaning, just hosting family, small kids, or what whatever the case may be.

Joe: 01:46

There's also a lot of stress that can come with the holiday season. So a lot of times, we do see people that have increase in symptoms following the holidays. So I thought this would be a really good starting point for our 2025 podcast series here. So let's just talk, posture in general. I think that's something that, you know, we talk about a lot as as fitness, people and and people that work in health care is we gotta have optimal posture.

Joe: 02:15

But I think a lot of times we don't really talk about what that is, before something can happen. So based on how we live our lives as humans, and especially because we live in in such a technological age, everything we see is forward. Our eyes see forward. We read a book or on the tablet. That is forward and down.

Joe: 02:39

Our phones are forward and down. Our laptops are forward and down. Our TVs are forward and down potentially on your setup. Our posture sitting is slouched, which causes our head to go forward. What that ultimately does is over time, that's gonna allow for our head to move forward, which increases our cervical lordosis, which that's just the curve in our spine.

Joe: 03:06

Like anything, we want to have a cervical lordosis. What we don't want is to have an extreme lordosis. It's like anything. In moderation, everything is good for the most part. When we start getting to the extremes of something, there can be some problems with that.

Joe: 03:24

What happens with that posture is as our head leaks forward, we get tightness and elongation of the muscles in the back of our neck, which leads to a reciprocal inhibition, just basically opposite shutdown of the front of our neck. Our head's really heavy, very heavy, a lot heavier. This is one of my favorite questions is I always ask patients that come in with cervical pain or or any headaches is how heavy do you think our head is? And most people don't get the answer right. And then I don't expect people to to know that, but, I just think it's a it's a really it's a fun answer.

Joe: 04:12

So on average, the adult human head is anywhere from 10 to £15. Think about it. If you put out on top think of this theoretically. I don't want anyone to physically do this because this could lead to problem, but think about having a 15 pound weight or a 10 pound weight, whatever you have access to. Just think about that.

Joe: 04:32

Having that on top of your head and holding that there every day, all day. We're probably gonna get pretty uncomfortable. Now when we start getting out of an optimal position with our posture, that could lead to even more dysfunction. So a lot of times we see people that are just coming in with just general neck stiffness, neck pain, because things will tighten down to be strong. Tight is strong, but sometimes weak muscles tighten down because that's their only way to be strong, so we've got to strengthen.

Joe: 05:04

So one big thing I think it's always important is we gotta look at the presentation both from the forward view, a behind view, a side a side view as well. Excuse me. And then we also need to see what the body does with motion. A static picture sometimes doesn't give us the entire picture. We gotta see what the body can do as it moves.

Joe: 05:26

What we then also need to look at, and what I like to look at is I like to look at the thoracic spine mobility. I like to look at shoulder mobility. I wanna see what the entire upper quadrant can do and how it's affected by the neck and by these headaches. From there, once we find these limitations, we're gonna stretch the areas that are tight. We're gonna strengthen the areas that are weak and improve overall symptoms.

Joe: 05:50

Now, where this leads to is a lot of times people come in and I ask this all the time is with your neck pain or with your neck tightness, are you getting any headaches? What I get a lot is people say, yep. I get headaches. I get migraines weekly. Then I start diving deeper and, like, okay.

Joe: 06:11

Where do you feel like you're getting these migraines? A lot of times people point to an exact spot in their head, which actually is not a migraine. It's actually a referral headache. There are areas and muscles in the body that lead to headaches in certain parts of the head, and we'll go through some of those. I think a lot of times some people just think that, well, I'm just having a migraine, but I get it all the time in the same spot.

Joe: 06:39

Actually, a lot of that can actually be coming from a specific muscle in your body. So for instance, I'll you I'll use myself as as an example. I always always always always always get if I get a headache, it's gonna be above my left or right eyebrow. Almost like I have an itch. Like, where people scratch their eyebrows, that's where I get my headaches, and they hurt.

Joe: 07:04

I mean, they're pretty intense. That will come from a lot of times, it will come from my SCM or my sternocleidomastoid. A lot of times for me, it's more I'm tight more down by my clavicle or my collarbone. This is where we work directly on that muscle, and it improves the pain. It may not improve it right away, but it will take away the intensity.

Joe: 07:32

A lot of times that can happen through manual work, can happen through dry needling. I can also I've had the experience myself as well as with patients where we work on that muscle in the head goes away immediately, which is really fun to see. Another example of a referral headache is some people, the headache itself, they could get a headache in the back of their head. That can come from our suboccipitals, which are right at the base of our skull in the back. So what we can do is we can do a suboccipital release.

Joe: 08:08

Again, we can dry needle that area, which really improves the pain. We also can get ear pain, which comes from the masseter, which is our cheekbone or, excuse me, our cheek muscle. We also can get that ear pain where it's coming from our lateral pterygoid, which is inside the mouth. We can also get it from our medial pterygoid, which is inside the mouth. We also can get, like, temple pain or just pain down the back of our head.

Joe: 08:41

That's coming from the upper trap. That pain can also be going down to the inside of our shoulder blade. Again, referred from the upper trap. I see a ton of people as well that come in for shoulder pain and they just rub the side of their shoulder. That referral pattern is coming from the rotator cuff.

Joe: 08:58

We gotta go attack the rotator cuff and improves people's pain. Now the the big part, with posture and and headaches, a lot of relief can come from really making sure that we have good posture. And I don't think all the time we do a great job as therapists or great job as providers of really explaining what does that mean. 1st and foremost, with just, again, as I talked earlier about our tech age, what's really important, first and foremost, is you have to be active. Meaning, if you work a 9 to 5, but you work from home and you're at a desk, try and get up and move as much as possible.

Joe: 09:43

I always tell people if you have an excuse to get up and just move even if it's for 2 minutes, take that opportunity to do that. Because when you get up and move, what that does is you have to look up, which gets your chest back. It gets your shoulders back. It gets your head back. Even if it's just to go to the bathroom quick or if it's to get a drink of water or to change a lawn whatever the excuse is to get up and move, do that.

Joe: 10:11

Now on top of that, we also need to be incorporating specific exercises into our normal everyday routine that help promote having good posture. Because, again, everything we do in our lives, especially I can speak for us here in the United States because this is this is where I live. This is where I'm from. Technology is not going away. Our phones are not going away.

Joe: 10:36

Our computers are not going away. None of that's going away. So every thing we do, unfortunately, is has a negative impact on our posture, myself included. When I treat patients at a table and I'm sitting, my posture is not good. But we have to do that to make a living and to live our lives.

Joe: 10:55

So what we need to do to counteract that is to have specific exercises routines that decrease the negative impact that bad posture will have on us. What that includes is working on cervical retraction, getting our head back, making sure that our ear is over the tip of our acromion, Working on the mobility of our upper trap. Working on the mobility of our levator. Working on the mobility of our SCM. Working on the deep neck flexor strength.

Joe: 11:29

Working on lower trap strength to bring our shoulder blades back. Working on rotator cuff stability to, again, bring our shoulders back, working on thoracic mobility so our head has more room to work. All of these things brought together make a really good plan to have good posture. If we're not doing those things, it's a high possibility that we will have some sort of headache, have some sort of postural dysfunction, postural pain. What I love seeing people with is they come in and they say, you know, I started a new job or I just started a new project at work.

Joe: 12:08

I'm having some pain and headaches, but this is what I'm already doing. I'm already working on the strength. Strength. I'm already working on the mobility. I just feel like I'm missing something.

Joe: 12:16

Then we can take a deeper dive and be like, alright. Let's look at what you're doing now. Maybe there's something we gotta add. Maybe there's something just mobility wise. Make sure the spine's moving okay.

Joe: 12:25

It gives you a better chance of success. Your body will naturally tell you what it needs. A lot of times, we just don't know why. I think for the most part, it's very hard for people to put themselves in a compromising position as long as they're listening to their body. So for example, if you're doing a stretch and you get pain with it, your body is telling you that you might be doing it too hard or too much.

Joe: 12:50

But if you're doing it and you feel a really good stretch and it's comfortable, you know, it's just that little uncomfortable stretch, but you know you're doing something good, then keep doing it. It will get better. So the big thing to really focus on with posture, with headaches, is schedule 1st and foremost, make sure we schedule regular rest breaks to get up and walk around. My job is easy as a physical therapist. Based on my schedule, I know routinely I have to get up, move, go see my next patient, move through the clinic to do some exercise, even move positions, work from the neck to the back.

Joe: 13:28

I have built in rest breaks and built in walk breaks during my day. I also think it's very important to kind of take yourself through a mobility screen, see a physical therapist, see the things that you objectively can improve to help what's going on. And if you are someone who gets headaches, really pay attention to where they're coming from. Be specific with it. Is it above your eyebrows and on top of your head?

Joe: 13:54

Is it in your neck? Is it the back of your head? Is it ear pain? And the reason I say to break it down as to where it's coming from because the more information that you come in and tell your physical therapist, the better we can help you. I always tell people I'd rather have more information than not enough.

Joe: 14:10

I can sift through what's important and what's not depending on the prognosis and the patient presentation. We just gotta make sure we get enough information and get as much specific detail as we can to make sure we best help you. So that's headaches, posture, basic things to focus on, basic things to know. It'd be a great thing to start off 2025 having good posture, setting your body up for success. Everything starts with posture.

Joe: 14:41

From there, we can do anything. The better we move, the better we feel, the better our lives can be. If anybody has any questions or any topic ideas that they wanna hear more about, let us know. Either leave us a review on Spotify, Apple Podcasts. Let your therapist know, hey.

Joe: 15:01

I listened to the podcast. I'd like to hear more about this. Let your therapist know if you're at Freedom. Comment on our social media, Facebook, Instagram. We've got YouTube page, all that stuff.

Joe: 15:13

We look at all that stuff. Any anything anybody wants to hear, please let us know. We really appreciate everyone listening. We're really looking forward to having an awesome 2025. It's gonna be a great year.

Joe: 15:26

So thanks again for listening, everybody. We have remember, we have 4 locations either at Fox Point, Grafton, Brookfield, or Mukwonago. We'd love to see you. We'd love to help you, and we'll see everybody in a couple weeks in our next episode.