12 Sep Prehab Your Neck Pain
Neck pain is one of the most significant health problems worldwide, as it is estimated that 22-70% of the population have neck pain at some time in their lives. It has also been suggested that the incidence of neck pain is increasing! It is ranked as the fourth leading cause of years lived with disability. Rates of reoccurrence and chronicity are reported to be high, which calls for preventive measures, or [P]Rehab! There is evidence suggesting you may reduce the risk of neck discomfort by approximately half with an exercise program. This article will take you through an evidence-based approach on how you can take actionable steps to rehab and prehab your neck.
How Do We Optimize Neck Health?
The neck is an area that is subject to a lot of physical stresses throughout the day for all individuals. As a result, we need to bulletproof our neck with many different phases of exercises. Not only do we need our neck to be mobile, but we need it to be stable, to be strong, and to have optimal movement coordination! It is a comprehensive approach, just like any other body region. A big culprit of neck pain is not having adequate postural awareness, as well as becoming victim to sedentary habits. We like to preach that there is no “perfect” posture; however, we need to move often to ensure our body does not adapt to a particular position that can place certain tissues and body structures at risk of becoming stiff, weak, and poorly tolerant to functional movements!
READ: IMPROVE POSTURAL PAIN
Next, we are going to break down the comprehensive approach to bulletproofing your neck. The article will break down exercises that are within the following categories:
- Neck mobility
- Movement coordination and strength
- Deep neck flexor endurance
- Thoracic Spine (Mid back) mobility
- Movement involving our nerves (neurodynamics)
[P]Rehab Your Neck Pain!
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How To Get Rid of Your Neck Pain!
Follow along in our [P]Rehab Youtube Episode that shows you some excellent ways to relieve your neck pain!
This video will demonstrate how to improve mobility, control, and strength of your neck with the end goal of keeping your neck healthy and supple!
Can you reduce the risk of neck injuries?
A recent meta-analysis of randomized controlled trials was conducted involving people without neck pain with an aim to prevent future neck pain. Moderate evidence suggests that exercise programs can reduce the risk of an episode of neck pain by approximately half. This review found low-quality evidence that ergonomic program does not reduce the risk of an episode of neck pain. This systematic review was specifically looking at preventing neck injuries. Being able to reduce the risk of neck pain is HUGE!
Neck pain is second only to low back pain in annual workers compensation costs in the United States. It has been reported that neck pain makes up approximately 25% of patients receiving outpatient physical therapy.
Prehab Your Neck With Mobility
Neck pain often presents with impairments in poor flexibility of lower cervical and upper thoracic spine muscles. A randomized controlled trial by Ylinel et al demonstrated that manual therapy vs. stretching both improved neck symptoms, with no differences between the groups. As a physical therapist, I often perform manual therapy in the clinic, however, this study demonstrates that mobility based exercises also show benefits. Shown here are a few exercises I commonly prescribe in the clinic to improve the mobility of these muscles.
Self Neck Traction
If you don’t have access to an inversion table or a neck hammock, here is an easy self-neck traction mobilization you can perform. You will feel a deep stretch in the back of the neck with this stretch.
Levator Scapulae Soft Tissue Mobilization
Lean onto a lacrosse ball with the Levator Scapulae tissue, this is the muscle mass just above and to the inside of your shoulder blade. You have the option of rolling up and down or from side to side. Workaround this area and see what feels good for you. Focus on your breathing as you perform these mobilizations.
Neck Mobilization With Lacrosse Ball
Lean onto a lacrosse ball with your upper neck region. The ball will stabilize that segment of your neck as you move over the ball. Rotate your neck towards the side the lacrosse ball is on while maintaining a chin tuck. If the ball is slipping you can use your hand to stabilize the ball. Focus on your breathing as you perform these mobilizations.
LISTEN: HOW MUCH SHOULD WE STRETCH?
Your Neck Also Needs Coordination and Strength!
Improving neck coordination and strength has been shown in numerous studies to be effective in reducing neck pain, cervicogenic headaches, cervicogenic dizziness. According to the Neck Pain: Clinical Practice Guidelines – it has been recommended with strong evidence for clinicians to consider cervical stabilization exercises for neck pain. Demonstrated here are a few great exercises to help improve the activation and strength of muscles surrounding the neck.
Quadruped Banded Chin Tuck
In addition to improving activation of your deep neck muscles, this exercise will activate the serratus anterior which is a crucial piece of addressing any neck issues.
Prone Y’s Neck Unsupported
It is important to note that your body does not work in isolation, many of your body parts work together as a unit. If you want to address the cause of your neck, you are likely going to have to work on regions that surround the neck, especially the SHOULDER! The prone Y and T are a great bang for your buck exercises, not only do we assure activation of the neck muscles, we are improving scapular stability. I especially like chin tucking during this exercise to help reciprocally inhibit the upper trapezius with scapula exercises. This will help bias the mid and lower trapezius with this exercise!
Prone T’s Neck Unsupported
Deep Neck Flexor Endurance: Chin Tucks
Here are progressions of the commonly performed chin tuck. First thing is first, improve activation and control to the target muscles- being primarily the deep neck flexor muscles.
Level 1 Chin Tuck
Begin lying face up. Perform a chin tuck, this is achieved by attempting to create a double chin or by pushing the small of your neck towards the table. You will feel the small muscles on the front of your neck working during this exercise. Avoid rounding your neck as you perform this exercise. If you feel discomfort while you perform this exercise, minimize the range of motion as you perform this.
Level 2 Chin Tuck with Head Elevation
As you feel comfortable with just a chin tuck, you can elevate your head to increase the demand of these muscles!
Level 3 Chin Tuck with Rotation
This is a real challenge! Never compensate form, if you feel this is too advanced rest your head as you perform neck rotations.
Optimize Your Neck Health!
Don’t wait for your neck pain, get in front of it with [P]Rehab!
What About The Mid Back?
There is great evidence to suggest that thoracic spine mobilizations are beneficial in treating neck pain. The rationale stems from the theory that disturbances in joint mobility in the thoracic spine may be an underlying contributor to musculoskeletal disorders in the neck.
Cat-Cow Thoracic Spine Bias
This is one of my favorite thoracic spine exercises when dealing with patients that present with cervical spine pain. Check this article out for other ways to improve motion at your mid back!
Thread The Needle – Foam Roller
Prone Thoracic Extension
Thoracic Spine Extension – Towel
Is Your First Rib Contributing To Your Neck Pain? Watch This Video To Find Out!
Is Your Neck Pain Causing Numbness and Tingling?
When numbness or tingling is present in addition to neck pain, there may be poor neurodynamic mobility. Neural mobilizations were shown to have favorable outcomes vs. when patients received cervical mobilizations, demonstrated by Alilison et al. Here are nerve gliders and tensioner. This will help generally mobilize the nerves of the neck that go into the arm. Begin with nerve gliders when first initiating nerve glides into your program. As you feel comfortable you can progress into the more aggressive nerve tensioners.
Nerve Glider and Tensioner
Want to learn more about treatment and assessment of numbness and tingling in the arm coming from your neck? Check out this article.
Median Nerve Tensioner
The take home message from this article is to approach your neck [P]Rehab from all different angles! If you solely work on the movement of your neck, but do not address the coordination or strength for example, you may not optimize your symptoms! The neck receives such a large influence from the anatomical structures surrounding it, and therefore it is important that we give it the proper foundation it needs!
- Vos, T., Allen, C., Arora, M., Barber, R.M., Bhutta, Z.A., Brown, A. et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388: 1545–1602
- Neck Pain: Clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association.
- de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ (2018) Exercise programs may be effective in preventing a new episode of neck pain: a systematic review. Journal of Physiotherapy 64: 159–165]