ART, Headaches and Myodural Bridges

• Recent anatomical studies have found that the deep suboccipital (top of the neck) muscles are connected to the dura matter (the covering of the spinal cord) by ligaments.

• Pulling on a suboccipital muscle moves the dura matter, in cadavers.

• The suboccipital muscles often atrophy (waste away) in headache sufferers. 

Can headaches be affected by using Active Release Techniques (ART) on the the suboccipital muscles: superior oblique, inferior oblique, rectus capitis posterior major and minor? The suboccipital muscles are important little muscles which control fine neuromuscular control of the head.  

Recent studies have added to our knowledge of the possible connections between headaches and the myodural bridges:

Enix et al did microscopic evaluations to confirm that ligaments called the myodural bridges emanate from the suboccipital muscle bellies, and attach to the dura mater in 75% of specimens.  These myodural bridges have a hypothetical role in human homeostasis, and they may contribute to certain neuropathological conditions as well. The presence of a neural component within the myodural bridges suggests that they may serve another function aside from simply anchoring the muscles to the dura mater. Such a connection may be involved in monitoring dural tension and may also play a role in certain cervicogenic pathologies (neck pain and headaches).

They noted that manual traction of the rectus major in cadavers resulted in gross dural movement from the spinal root level of the axis (C2) to the spinal root level of the first thoracic vertebra. 

Fernández-de-Las-Peñas found that the greater the headache intensity, duration or frequency, the smaller the cross sectional area of the rectus minor and rectus major muscles.  He also found that there was a correlation between hyper-tenderness and atrophy of the rectus minor.  In these cases pressing on the rectus minor reproduced the patient’s headaches.

The rectus minor was also found to have atrophied by Hallgren, in chronic head pain sufferers.  He proposed a theory that whiplash could lead to nerve damage which causes the rectus minor to atrophy. His photo below shows the myodural bridge #4.

ART is a hands-on soft tissue treatment of ligaments, muscles, tendons, and nerves. It provides a quick way to make a tight muscle loose, as well as treating conditions such as:  tennis elbow, frozen shoulder, shoulder tendinitis, and plantar fasciitis. The technique involves the therapist putting pressure on a tissue, while the patient stretches to move the tissue slowly out from under the contact. The treatment hurts a bit, but only in a way that makes the patient know it is working. The technique works by increasing the nervous system’s tolerance to stretch.  

Cervicocephalic Headache Syndrome

Cervicogenic Headache

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