Platysma (Figure 2). Together,these cowl-like outer layers ex-tend from their upper attach-ments on the occipital ridge andlower face, to their lower connec-tions with the outer layers of theshoulders, chest, and upper back.Like a sleeve, they encircle thedeeper musculoskeletal and vis-ceral structures of the neck’score.The superficial layers of the neck have a surprising thickness andresilience. When, because of in-jury, postural strain, or otherreasons, they have lost pliability or are adhered to other layersand structures, the outside layershave the ability to restrict move-ment range, disrupt alignment,and bind the structures they sur-round. Imagine trying to move ina wetsuit that is a size toosmall—the outer layers of theneck can bind, distort, and con-strain movement in the sameway.
Seeing Superficial Restric-tions
Try this: watch afriend turn his orher head from sideto side. Watchwhat happens withthe superficial lay-ers of the neck,shoulders, chest,and back. Arethere areas of thetorso’s fascia thatmove along withthe head andneck? Or, do yousee lines of tensionand pull appearingin the skin andouter layers? Of-ten, these signs of fascial restric-tion will be most visible at theextremes or end-range of themovement. Look from both thefront and the back; compare leftand right sides for any differ-ences. Then, look again as he orshe gently looks up and down(being careful, of course, to avoidany posterior cervical compres-sion when looking up). Yourfriend might feel different kindsof restrictions when moving, in-cluding pulls in the deeper mus-culature, or catches involvingneck articulations or the upperribs. For now, we’re goingto leave these aside and fo-cus on the outer layers first.Sometimes superficial fas-cial tension will be visible aslinear patterns “tug” in theskin (Figure 3). In othercases, a whole sheet of fas-cia will move or creep alongwith the rotating or nod-ding head. Linear “tug” pat-terns are more commonly seen in the thinner layers of the anterior neck and chest,while the “creep” of wholefascial sheets is seen moreoften when looking at thethicker posterior layers of the back. If it is difficult tosee restrictions in the su-perficial layers, you can use yourhands to feel for tugs and pullsin the outer layers while yourclient rotates his or her head.Whether watching or feeling,note any areas that don’t havesmooth, even lengthening of thedermis and superficial fasciaswhen the head moves.We are constructed like onions:layered, from superficial to deep.When testing for fascial tensionwith movement, don’t confusemovements of deeper structuresfor movement in the superficialfascia. For example, you’ll some-times see the ribcage turningalong with the head, or a shoul-der roll forward, etc. Some of this movement is normal; if yousee exaggerated or asymmetricalmovement of the ribcage orshoulder, this might be becauseof deeper restrictions. Make anote to check for and addressthese patterns later, but remem-ber that since these deepermovements might be caused by restrictions in the outer layers,releasing the superficial layers isthe logical first step. Unlessyou’re working with a scalpeland are cutting right through,you need to gently peel away theouter layers to get to the core.
Myofascial techniques for the neckMyofascial techniques for the neckMyofascial techniques for the neck
Figure 2: The superficial layers of the neck, incross section. (Illustration courtesy estate of John Lodge.)Figure 3 Fascial strain visible as "tugging" of the outerlayers with movement.