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**Lipster** · 08-15-2003, 01:43 PM

As useless as this sounds, don't leave it so damn long.

Go to the doctor dude, don't mess about with injuries...

**doc** · 08-15-2003, 02:12 PM

I'm going to respond to this even though I've got a few other things in the hospital here waiting for me. But, the good anatomy pictures are going to have to wait, as I have no access to these things here in China. Also, it's difficult to really direct you without the benefit of a physical examination. But here's some things to think about. Best thing to do is to get local medical advice.

The area that you describe (base of the skull where the top of the neck joins) is largely made up of a muscular attachment to the bottom of the skull. The trapezius muscle attaches to the skull at that point, and yes, any injury to the trapezius can result in the symptoms that you describe. Also, because of the way the nerves inervate the muscle and provide sensation to the head, any injury to the upper trapezius, or some of the underlying neck muscles, can result in the phenomenon of referred pain, resulting in headache. The trapezius, and again, any of the underlying deeper neck muscles can be damaged during certain gong fu maneuvers, especially those that result in some sort of neck flexion and rotation. These maneuvers are especially prevalent in modern day wushu, and less so in traditional gong fu, though the warm up for both types of workouts does include neck rotation maneuvers. Warming up the neck muscles is something that you have to do with care, not necessarily because of the neck muscles themselves, but, more importantly, because of the delicate cervical discs that lie between the cervical vertebrae. Disruption of these discs can cause all sorts of problems, both in the present, and in later life. Neurological deficits are common with cervical disc injuries; much care should be taken with respect to any neck maneuver that could potentially damage these discs. Muscle sprains of the neck are common, usually seen after car accidents and the like, but they can occur in martial arts practice, especially if improper warm up takes place.

Improper warm up....One must really be careful how one warms up the neck muscles prior to working out. If you go to any gym any place in the world, more than likely you'll see some instructor having students warm up the neck muscles by rotating the head on the neck with concurrent flexion and extension, in circles, looking down, rotating, then looking up, first in one direction, then in the other. From a cervical disc point of view, rotation of the head on the neck is probably the worst thing you can do, especially as one gets older, and as the cervical discs become less pliant. Proper warm up exercises of the neck include gentle flexion and extension within comfortable limits (gently look down at your toes, then, keeping your head straight, look up at the sky), gentle flexion in both lateral directions (looking straight ahead, lean your head first to one shoulder, then to the other), and gentle rotation of the head on the neck (keeping your head upright on your neck looking straight ahead, gently turn your head towards one shoulder, then to the other, keeping your eyes level and your head straight). The combination of rotation, with flexion and extension, is a warm up that can induce injury to the delicate interior supporting structures of the neck. Also, any exercise or gong fu maneuver that causes compressive axial forces to occur on the cervical spine is just a preview for potential later disaster. These hard qigong techniques which consist of having hard objects strike the top of the head, not only potentially cause head injuries (see other discussion in this forum), but also increase the chances of cervical disc rupture. Maneuvers where one stands on one'e head, or, where strikes an individual or object with one's head, and, don't forget, maneuvers with axial forces, such as jumping, also increase the chance of cervical disc injury.

High cervical disc injury can cause base of the skull pain, with symptoms that you describe. Also, other, less probable causes, are brain tumor and internal brain hemorrhage. But generally, you get other symptoms with these disorders.

Of course, proper medical work up will diagnose your problem. Go see your favorite physician and have him look at it. In the meantime, rest, and warm packs to the affected area, should provide some relief. Nonsteroidal anti-inflammatory agenst, if you're not allergic to them, will also provide relief. Muscle injuries in the neck area can take up to a few months to heal, depending upon the severity of the injury, primarily because the affected area is difficult to rest. Sometimes six or more months are necessary before symptoms abate. A cervical collar, "to provide support" (which they generally don't; in my opinion, they serve as reminders that you need to take it easy with your neck, plus, if used appropriately, can generate sympathy from the opposite sex) can be helpful for the immediate short term, but can be harmful if used long term. As with most everything else, take it easy and it will heal with time.

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**Jay** · 08-15-2003, 03:37 PM

Thanks very much for that!! Especially considering your away in China. Much appreciated!!

Ill go see the doctor. But I dont trust these NHS doctors over here. All they do is keep giving me Antibiotics for everything.

I had an upset stomach once, and he gave me some crazy strong pain killers. Well they felt strong. Codine Phosphate I think it was. All I really wanted was for him to say its just a stomach bug and give me a sick note from work.

Ill be sure the rest my neck , and do the correct warm up. Our warm up generally just consists of neck rotations.

Cheers

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