It’s fantastic, isn’t it? Luckily, we’re seeing more shampoo chairs that are highly adjustable–ones with longer and wider neck basins. The chairs move up, down, forward, and back, and the bowls tilt to accommodate a wide range of clients to ensure there’s a comfortable fit for everyone. Unfortunately, most of these shampoo bowls are still cost prohibitive, but I expect that’ll change in the future.

Thank you so much for your comment Dr. Sundgren! It’s spectacular!

The same problem described in this article can happen when a person turns their head to back up a car. It can happen with neck manipulation, often by untrained individuals and by those using self manipulation. Lastly, it can also happen spontaneously without any provoking event. Since chiropractic physicians are the professionals most associated with neck manipulation they often get blamed for these types of events, even if the injured individual never received treatment from one. This has been well documented.

These events are mostly secondary to injury to the vertebral arteries. (Involvement of the carotid arteries in these events is exceedingly rare because of the difference in their location relative to the vertebral arteries.) When an artery get damaged, either by repeated micro trauma or by acute severe trauma, the body works to repair the injured area by blood clot formation and arterial wall repair. The result is a thrombus. Like any injury, the area damaged can be painful, as well as refer pain to related areas like the neck. The thrombus may impair blood flow to the brain. If the thrombus becomes dislodged it is then called an embolus. That embolus can become lodged in smaller blood vessels downstream and cause occlusion of blood flow. This type of occlusion is what we call an occlusion stroke and can cause neurological problems like dizziness, nausea, distorted vision, numbness, difficulty walking or talking, and other signs and symptoms of stroke. The sum of these problems is often what we call a cerebrovascular accident, or CVA. That is the type of event described by this article.

The challenge is that predicting who is at risk for these types of vertebral injuries and CV accidents is extremely difficult, even by a trained physician. The most common population is middle aged women on birth control pills, but because this problem is so rare and occurs over such a wide range of ages and sexes there really is no definite demographic. The best thing to do as a service professional is be aware of the signs and symptoms of vertebral artery dissection (injury to the wall of the artery) and of stroke. The reason for this is that people can have an injury or be in the process of having a stroke before they even sit in your chair! New patients have had strokes sitting in clinic waiting rooms of chiropractic physicians. Can you imagine who might have gotten blamed if they had been incidentally treated with a neck adjustment the week before? The same can happen to you as a hair stylist. You may be completely without fault but still get blamed because the hair shampoo simply occurred before the stroke. NCMIC is an insurance company for chiropractic physicians and has assembled a summary article on this topic to help physicians decrease their risk exposure. I think the same principles of risk awareness can be applied to beauty professionals. Here’s the link.

http://www.chiro.org/LINKS/FULL/Current_Concepts.pdf

I believe that the key take home lesson for us as service professionals to learn is that the health of the customer is primarily their responsibility, not ours. It is their actions on a regular and daily basis that primarily determines the health of their vertebral arteries and remaining cardiovascular system, not the actions that we engage with them briefly and occasionally. Although many people would like to shift the blame of their poor health and bad treatment outcomes onto their physicians, or hair stylists in this case, the responsibility for, and the ownership of, their health is truly theirs. Not their physican’s nor hair stylist’s. It is wise for us as professionals to first be aware of the health of our clients, including warning signs of impending problems and problems in process, to protect both ourselves and our clients from injury by not engaging in a service where it appears inappropriate for that individual. It is also wise for us to try to adapt our services when it appears that a particular service could potentially be harmful to the average customer. Sean Daniel’s description of cradling necks to help protect them from injury is probably good practice, but may best be applied to those with apparently healthy necks.

Although following a traumatic experience in which we are being blamed it can be instinctive for some to try to rectify the situation by assuming fault or questioning their fault, it’s best to take a long view and consider all the factors that went into that event, including lifestyle decisions made by the injured individual long before the event in question occurred. This isn’t to say that responsibility shouldn’t be taken for likely harmful actions. Rather, that a more measured approach be used to assess and take responsibility in any particular exchange and relationship. Particularly one involving a highly emotionally charged subject like cerebrovascular accidents.

I hope that this input is helpful. This is a subject that our profession has had to deal with.

Dr. Sundgren

PS – One additional and confounding factor is that many of the signs and symptoms of vertebral artery dissection and stroke are similar to signs and symptoms found in vertebral subluxations. Ie, Those with neck vertebrae problems may also experience problems secondary to those musculoskeletal problems such as cervicogenic dizziness, vertigo, and nausea. These secondary problems may look like stroke symptoms, but they are in this case from a different cause. So it gets a little difficult determining cause of the symptoms relative to that person’s body and their experiences in life. Taking a longer view by looking further backward in history and digging deeper in examination and treatment helps partially resolve these challenges. For the hair stylist (or salon sink maker) accused of causing the CVA that means understanding these many factors that go into creating these types of symptoms and encouraging their attorneys to take a broader view of the circumstances surrounding the apparent CVA.

I hope I wasn’t too verbose here! I’m not sure how else to explain this problem and its potential solutions.

PPS – I never liked a hair shampoo personally unless a thick towel was used or the stylist cradled my neck as Sean Daniel described. Just uncomfortable otherwise!

I was not only shocked about this because I was never told of it, but who assumes liability for this woman’s injuries at this point? She’s suing the salon as if they should have known, but I highly doubt they did know. I can guarantee the bowl manufacturer did, though.

My arm is long enough so while I’m cradling the clients head I can rest my elbow on the back of the sink. Also… I use my weak arm to cradle (right arm… im left handed), so I stand on the clients left side.

Hopefully a few pick up this great trick and give great shampoos. I had the reputation in every salon I’ve been in as the best shampoo in the house. All you have to do is take your time, put some thought into your routine, and you will be too!

Too often is it a forgotten, rushed, sloppy affair. And they notice the difference, always.