On Wednesday, Lillee Chandra began a discussion on triggering migraine headaches with self-massage. Next up, Todd Lavictoire considers the pain avoidance issue when dealing with triggers:

When considering self massage and myofascial release, headaches and migraines can be a complicated topic. It is very true, that for some, including those with TMJ, Yoga Tune Up® Therapy Balls can trigger headaches. Even I can trigger headaches on myself if I go too deep in the trapezius muscles or if I go too hard on the temporalis. But therein lies part of the answer I’ve come to with my students: many of us need to moderate the pressure we use when working in and around the tissues of the head and neck.

Let’s not, however, confuse moderation with avoiding these areas all together. If they are triggers to tension headaches and migraines, then they are most certainly areas that need work. Going “balls to the wall,” (i.e. practicing the technique in a standing position at the wall rather than on the floor) or finding broken in and softer balls are a few of the regular tricks that we use to reduce the pressure. Remember – it doesn’t get better by avoiding it.

As guides in the process, we must understand that it can be easy to trigger headaches with some clients. With these clients we need to to go upstream, downstream and around the front or back from the normal headache triggers. At first, we might also consider leaving out the tissues that clients report as containing more fear/resistance, until they get used to the process of self myofascial release and its benefits. Once the client trusts, then we can better approach the tissues that are headache triggers, but only after the tensigrity in the related networks (uptown/downtown/around the corner) has been reduced and the client is completely on board with the process of excavating these problematic areas.

We must also make certain that if there is fear in the client that we are embedding them with an appropriate sankalpa or resolve for support and lasting change. If there is fear, the body and its tissues are in a contracted state and headaches will most certainly be easier to trigger, making the headache a self fulfilling prophecy. Think of the sankalpa as part of the client’s toolkit towards turning the tide on their fear and embedding their tissues with the power for lasting change.

Finally, we must also make certain to empower the client by educating them as to how relevant postural dysfunctions may be contributing to their headaches and tension. We are guides in the process of unwinding the tension, but the client must understand that they need to be active participants in the day to day management of their own tissues’ tension. Once they understand that by better managing their daily posture that they are diminishing their own contributions to the tension in their triggers, they make the unfolding of tension through self myofascial release less problematic, more effective and longer lasting!

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Todd Lavictoire

My approach to both my personal practice and my yoga classes has always been one that includes joyfulness and playfulness. Yoga Tune Up® has provided me with a modality to help yogis of all stripes: young and old, experienced and new to the practice, work through some of the tension stored in their tissue. As Jill says: "Helping them live better in their bodies."

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Missy Tillman

“Remember – it doesn’t get better by avoiding it. “ what a significant statementment in all of life. Very helpful to remind to address fear and gentle offers of working down or up or in close areas first.

Stephanie

Thanks for this article. I love your various suggestions, especially observing the posture in your everyday life and working with the Sankalpa.

Andree-Anne Gagnon

I certainly recognize in myself the tendency to avoid the “issues in my tissues” because of fear from past/current injuries and pain. I have crafted a sankalpa and work with it daily both on the mat and off. On good days, I explore the painful areas and I’m working hard to remember that the bad days are when I need to get in there but to do so with caution, awareness and a big dose of sankalpa.

Jamilah

This post contains many things I want to remember as I work with people in pain, such as teaching them to work around the painful areas if the tissues are just too ramped up for direct pressure. I find that people are often eager to really dig into the painful places because they have incorporated the notion of “no pain no gain” and then overdo it and injure themselves further. It may take some trial and error to find an appropriate pressure for oneself and that is something I hadn’t included in my triggerpoint talks before now. And the idea… Read more »

Jess

This was a good article about regulating pressure. Anything can be bad if done too much.

Sarah Atkinson

There are so many factors here that are talked about the article. The fact that headaches are related to multiple factors and how accessible so many different styles of treatment there is taught and discussed in YTU. No single thing to be the root cause or the answer. Here we are asked to talk to the client about connection to oneself, ability to self asses pain or strain, rolling and stretching techniques, posture and strength training. YTU is about empowerment and self awareness. I heart your article <3 mostly the point that sticks out is how to help a client… Read more »

Melissa

Interesting article about the complexities of headaches and the myriad contributing factors…fear, posture, and daily movement patterns all play such a huge role. Your idea to empower clients with a sankalpa to help them find lasting change is great.

Maya Bogatch

Thank you for this article, Todd. I find that my trigger spots change every time I roll the general area of my neck and shoulders. A move that one day I can feel the moment the headache is triggered will be fine any other day. I love the idea of a Sankalpa at the ready for rolling the general area so that I am already in the mindset of removing the fear. I also love that the balls have given me the ability to sense that I have pressed the trigger point so I can start doing what I need… Read more »

Josiane O'Rourke

I find migraines to be very complex, and often the people having to deal with them in their lives could not find out exactly what factors or combination of factors cause them. What I do know is that they are very painful and they can prevent us from doing many things – we do live in the fear of ”when is the next one”. This is why I absolutely love your suggestion of working with a sankalpa in that particular situation, Todd. Thank you.

Lee-Anne Heron

Love your suggestion to consider rolling uptown, downtown and around the corner, front and back. And…that time and pressure make a difference. Will be recommending your blog to clients on their self care journey.

Marie streich

Thank you for addressing this important issue Todd, I didn’t know that too much pressure may cause headaches or migraines I will tread lighter in these areas with clients.

Sholina

Thank you for this – this is a very helpful approach to getting new clients as well! Sometimes when people say “Oh I can’t do yoga b/c I have a bad back” I shy away and say “Well yoga is actually meant to help your back but if you are not ready yet, then I understand.” Meanwhile, I could be encouraging them to try it, avoiding any positions that may “compromise” the back until I gain their trust, and then ease them into the poses that would help them. I don’t feel comfortable giving people a sales pitch about anything.… Read more »

Kayla Lee

Todd I love your connection to fear and sankalpa in this pose. As someone who gets frequent migraines and headaches, I have never actually triggered a headache from rolling my upper back and neck, I have however, eliminated a headache by doing so! I now turn to my balls over the tylenol and although it is not always complete relief of the headache, the pain and tension is definitely lesser and more tolerable without having to take over the counter drugs.

Miao Zhang

This is the first time I read anything written by Todd and I really enjoyed it. I’m a victim of frequent migraines and I love how he wrote that the clients need to really tune in to their own bodies in their daily lives and analyze what they do on a regular basis that is making these migraines so frequent and easy to be triggered. A lot of time it’s all the little things that we do but so much and so often that are making the different. Awareness is key!

Tiffany

While I hope to never trigger a headache in a student/client, I do hope I can make them realize they should work on themselves and figure out what works on their body. I know I’ve given myself a migraine from going too hard, which helped me better understand what to do and what to avoid for myself.

Shari Williams

I rarely get headaches, thank goodness! And i am new to YTU, in my first certification. I cant wait until my balls get broken in a bit more. I feel there is so much potential to be had, and i get so hung up on if im in the absolutely right place that i appreciate you saying that it’s okay to go into adjacent areas when the exact point are too triggered. What I really appreciated were some of your references, for example we are guides in the ball rolling, this takes pressure off my perfection issues. And the Sankalpa… Read more »

Ali Bell

As someone who always ramps the intensity up I wonder if even the recognition or permission to lower the intensity is beneficial in and of itself. Although easier said than done, a good thing to recognize in ourselves or others we work with, are our tendencies to be ‘pushers’ instead of ‘let it go-ers’. Thanks Todd.

Christina Summerville

I like all the suggestions in this article Todd. I agree that when treating clients that are sensitive, usually “less is more”. It can be surprising how working indirectly can help decrease pain in an area that is quite a distance away. I appreciate your suggestion to help them come up with a sankalpa to overcome any fear they may have of the treatment triggering pain. This can help tremendously I am sure! And of course empowering them with education on proper posture can make a significant difference in how they feel on a day to day basis, decreasing pain,… Read more »

Lulu Goodman

This is very useful information. As I am not a headache sufferer, I had not given much thought to the possibility of overworking to the point of causing a headache. I very much appreciate the sankalpa suggestion. It certainly has been a recurring theme for me this week. And of course, the continual recurring theme— posture!

Megan McDonald

For awhile I would work my masseter pretty thoroughly with the therapy balls, I so wanted to relieve the tension in my jaw! Upstream was no problem, temporalis got served, but yet, I repeatedly forgot to consider downstream. My jaw tension actually got worse! I had some pretty major cracking that alarmed me. I finally reviewed Treat while you train and low and behold the scalenes came into play. Of course! Downstream!!! My jaw painful tension is gone, all because I finished rolling out the rest of the picture. I have not yet worked with people with migranes, yet I… Read more »

Stephanie Boxall

I have always chosen to skip any rolling on the trapezius, cervical vertebrae or facial muscles in effort to avoid a migraine or headache and know that this is a fear/avoidance response. In working “around” the areas of fear – namely the cervical vertebrae and facial muscles, I have not done myself any favors. I think that working in moderations is a great suggestion as well as the addition of a sankalpa. Thanks for the suggestion…will see what happens when these parts become a focus in class.

Janie Hickman

I am encouraged to learn Therapy balls used correctly can help with migraines. I definitely relate to a fear of migraines because they can be debilitating. Your suggestion of a toolkit which includes , positive sankalpa and working in many different ways, upstream, downstream starting with moderate pressure reduces the element of fear. Not to mention reinforcing the importance of proper posture.

Meredith Hutter Chamorro

This post was enlightening. I am new to ball work and hope to incorporate it into my yoga classes. I was unaware that it could trigger headaches, so it is very helpful to know that in advance and to know appropriate ways to deal with the issue. I appreciate that you included the sankalpa work in this area, in particular. Thank you.

Lynn

A lesson in moderation, less can be best.

Aracelly Latino-Feliz

This is so true. Todd, I really liked that you mentioned going upstream, downstream and around. This is why it’s called a practice. The education part is key. I think trust is also important to discuss and verbally explaining this to patients and clients that have never heard of the YTU method will help build that trust. I’ve just been introduced to sankalpas as I am not a yoga instructor but I believe setting an intention to any practice, sport, goal, etc should be something that is revisited every session. Thanks for sharing.

Kimberlee Ott

Really enjoyed this article. I have several clients who have regular migraines and just by looking at some of them i can see how tight they are and how this could cause a constant pull on the fascia in and around their skull giving them reoccurring migraines. I have also highly encouraged a daily rolling plan and to be more mindful of patterns of living and how there exercise routine also can play a part in triggering there migraines.

martina stürm

Although migraines can have many trigger, from hormone imbalances, to food and environmental triggers and certainly stress, it can be a challenge for patients to find methods of relief. I have had patients go as far as botox and even stapling their stomach in desperation to find relief. And avoiding triggers is certainly no cure for the underlying root cause. Acupuncture and herbal medicine is safe and effective approach in long achieving long term relief, by rebalancing the neuroendocrine system. As in any Holistic Medicine practice patient empowerment is essential , and this is where tuneup come into the picture… Read more »

Melinda

Great article Todd. I love the idea of having clients come up with their own personal sankalpa to help move them towards positive change and help calm their fears. Will definitely help me to be mindful of anyone dealing with an injury and/or recurring pain.

Kristin

Great article. Particularly tying in how awareness of daily habits, posture, stress and fear all have the roles behind the issue at hand. It is not only the responsibility of the person to stop needlessly grind away at an issue but take a softer, lighter approach that includes the ability to look at the issue from different angles. Our focus cannot always be a pin point sometimes you have to step back and look at the big picture to address the little picture.

Julie

That’a a very interesting article. I have about one migraine per month and I always use to balls on my head and face to help relieve tension, but I ‘ve given it no extra thought. Now that I’m trying to learn more about anatomy and myofascial release, I’ll try to figure out what the unrderlying causes of pain can be (for me but also for other people who might ask me for advice) and remember your great suggestion about writing an appropriate sankalpa. I think this is gonna be the perferct solution for many of clients, especially the older ones.… Read more »

Beth

Perhaps I’m an outlier, but I get very frequent migraines (10+ per month–I’m now getting Botox treatments), and I’ve NEVER had use of the YTU balls trigger a headache. In fact, I get a lot of neck/shoulder tension with my migraines, so I actually love using the balls when I have a headache. Also, my migraines tend to feel the worse on the back of my head, and lying with the balls on the block pressing against my occipital lobe (as showing in the Massage Therapy Kit Head, Neck, & Jaw routine) is one of the ONLY things that actually… Read more »

lulu yen

well said. i had such a hard time to convince my own client to use yoga tune up ball to help him. it’s an art to empower people that have something they are avoid to dig into. thanks!!

Todd Lavictoire

Pete, I will be getting more info and really want to explain the interrelationship between the pelvic floor and complex chronic headaches, but here’s one interesting relationship that I found: “The muscles of the floor of the mouth can also compensate globally, but I find them most involved in bracing with the diaphragm and the pelvic floor muscles, similar to the Valsalva maneuver. This kind of “bearing down” is a very common compensation pattern often involved with emotional issues. When treating the muscles of the floor of the mouth, it is important to consider the diaphragm and pelvic floor muscles.… Read more »

Christine Heroux

Brilliant idea to use older balls on the temporalis. The last time I treated my temporalis was with brand new balls and it seemed way too intense….. Now to find those old balls…..

Pete Shaw

I mean CAUSE (see below)

Pete Shaw

Can we talk about how a tight pelvic floor may alleviate headaches?

Casey

So Melissa is asking about myofacial release strictly by stretching. The benefit to the balls is that the balls get into deeper tissues and release the fascia almost underneath and around then. I like Todd’s approach with sankalpa and avoiding fear by instilling trust with baby steps.

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Geoff Brown

Going to the wall is a great technique for those who are supersensitive. It is a great modification for those who aren’t as comfortable with the balls, feel like they have better control of their range of motion vertically, or are pregnant. The wall is a great starting point for the beginner student.

Lisa Swanson

Todd: Great blog. I’ll confess — I’ll avoid the area to not trigger a headache just like I’ll avoid perfumes or certain neck movements. But why does this happen to certain individuals? Avoid the area is definitely not the answer. On my first day of Yoga Tuneup, the ball therapy on the mat in my trap area was NOT working but I didn’t know (at that time) that you could stand at the wall and do the same roll out. It might have to start at the wall, or as you said, with a lighter ball, but eventually, I should… Read more »

Meghan

I totally agree that we cannot avoid the area because of a dysfunction,but sometimes those areas are too excitable and too overwhelmed or irritated with years of holding patterns. Sometimes it is advisable to start at the other end to treat the neck and head. The is joint and the mastoid bone have a powerful relationship as well as the hips and the jaw. The arms and hands can be a way in as well as the feet and ankles. These Microsystems are so powerful to drain and release pent up stagnation, so that it is possible to then get… Read more »

John

I agree with a number of points in your blog post, especially the point on educating people on the relevance of postural disfunctions that may be contributing to their pain, not just headaches. By helping them understand that they are active participants in their wellness, we can empower them to find the underlying causes to their pain and ways to help eradicate it, rather than just certain fixes to alleviate the pain for the time being.

Steeve

As a regular practitioner of Yoga Tune Up and former Jock, I find that “lowering” the intensity during some of my workouts is much more beneficial to my overall fitness, than having the intensity levels “amped-up” all the time. That said, learning to take the balls to the wall is key for the beginner Tune Up student, especially those with my type of mindset. That by no means is an excuse to avoid trigger points that case discomfort during rolling-out. On the other hand, triggering chronic discomfort, such as unwanted migraine headaches not something I wish to do “by mistake”.… Read more »

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Melissa

I completely avoid the shoulders & neck area all together from migraines – i realize what you are saying about working out the areas that are bringing up the most resistance. *IF* (and, this is a big IF), I work around the neck & upper trap muscles, I do shoulder flossing, or other shoulder exercises first so the area is a little bit warmer and I find it is a little less sensitive to have blood flow there first. Although, it may not be the correct way to really get into the myofascial stuff, I find this works for me!