Headache
Headaches are one of the most common medical complaints. According to the National Headache Foundation and the American Council for Headache Education, 90% of men and 95% of women have experienced one or more headaches in the last year.

In America alone, 45 million people suffer from chronic headaches. Chronic headaches are headaches that have been occurring for more than a month.

Active Physical Therapy has successfully treated two common types of chronic headache. Muscle tension headaches and cervicogenic headaches (head pain generated from the neck) are the most commonly treated headache disorders using physical therapy techniques.

Tension Headache
Chronic myofascial (muscle) tension in the muscles of certain neck and cranial muscles can result in increased sensitivity and irritability of the muscle tissue leading to pain. If this myofascial or muscular pain persists the pain may radiate or refer to the head, causing a headache condition.

At Active Physical Therapy, our therapists are highly trained and experienced in the treatment of muscular pain syndromes that manifest themselves into muscle tension headaches. The source of the muscular pain will be identified and treated to reduce the tension and eliminate the headache.

Cervicogenic Headache
Another form of chronic headache can originate in the joint tissue of the cervical spine (neck). Therapists at Active Physical Therapy are specially trained and experienced in the evaluation and treatment of spinal disorders that can result in headache conditions. Intervertebral passive movement is assessed from the upper thoracic to the upper cervical spinal segments. Hypomobile joints and painful joints are treated with the appropriate mobilization technique. In addition, manual traction, myofascial release, and/or muscle energy techniques may be performed.

Treatment Course
Physical therapy sessions of joint or soft tissue mobilization should not be more frequent than every 48 hours to allow for the muscles/joints to recover from treatment. Patients are re-evaluated every 2-4 weeks to determine if significant progress has been achieved in the areas of pain reduction, range of motion, physical work capacity, exercise tolerance, functional mobility or other objective signs of improvement.

Active Physical Therapy
Treatment for Temporomandibular Joint (TMJ) Dysfunction

INITIAL EVALUATION

Subjective
A thorough history of the present condition of the TMJ dysfunction Questions regarding pain, function of the jaw, clicking, locking, dental treatment, and questions of habits an postures

Objective
Observation and movement examination of the mandible and neck Examination of the tongue position and movement and TMJ muscles Palpation and temporomandibular joint play movement

TREATMENT PLAN

Posture training and education
Reducing a head forward posture
Rounded shoulders and thoracic kyphosis reduction
Proper resting position of the tongue and mandible education Habitual temporomandibular joint dysfunctional activity retraining

Therapeutic exercise
Controlled mandibular opening
Cervical spine stretching and postural strengthening
Isometric mandibular strengthening

Ultrasound and electrical stimulation for pain control
Modalities to reduce muscle tension and pain to restore functional range of motion at the temporomandibular joint

Special procedures
Rocabado exercise regimen
Strain/counter strain techniques