EXERCISES FOR MY… NECK?
Our neck is extremely adaptive. Look up and down, left and right, or any combination of those movements and you get a sense of just how much freedom of movement we have.
But as with any body part, using it in a similar ways consistently leads to adaptive changes. Consider “text neck”, looking down at our smartphones and tables for long periods of time each day, or office workers hunched forwards and leaning it at their computers. Either of these static positions can lead to a forward head position and/or rounded shoulders.
WHAT’S THE PROBLEM?
Carrying your head in front of your body becomes extremely taxing on the muscles and joints. Obviously we are built with enough strength and stability to support the general movement of our head and neck, but when we start these movement with our head already set forward, we amplify the amount of stress our body has to deal with!
In particular, the muscles at the front of the neck, called the “deep neck flexors”, play a critical role in neck stability and posture control. The function of these muscles becomes limited as our posture begins to show a forward head position. This is bad! Past studies have shown that 70% of patients with chronic neck pain have limited muscle function of the deep neck flexors (Yip et al. 2008).
And where the muscles at the front turn off, muscles at the back of the neck and upper back are required to work much much harder. Some have suggested that for every inch forward your head moves, it is the equivalent of 10 additional pounds of work required by the muscles at the back of the neck and upper back (Kapandji, 1974). Other mechanical models (depicted in the image below) suggest that by tilting your head to just 45 degrees, the total weight that needs to be supported increases from ~10 pounds to ~50 pounds (Hansraj, 2014). This is often reflected in patients who present with achy muscles and joints, and increased headaches (Fernandez-De-Las-Penas et al. 2006).
From Hansraj, KK (2014).
HOW CAN NECK EXERCISE HELP?
It has been demonstrated that simple exercises for the deep neck flexors are very effective for resolving chronic neck pain and headaches. (Chiu et al. 2004; Jull et al. 2009). These exercises focus on redeveloping control and use of the deep neck flexors at the front of the neck. Kim et al. (2016) recently published an article following a group with chronic neck pain where they performed deep neck flexor exercises 3 times per week for 4 weeks, finding significant improvements in their overall pain rating and fewer functional limitations. And that is exercise on its own — imagine the effects when combined with other helpful therapies, like chiropractic (Bronfort et al. 2012), massage (Sherman et al. 2014), and/or acupuncture (Vickers et al. 2013)!
WHAT DO I DO?
The deep neck flexors exercise is extremely simple, and can be done nearly anywhere. When learning this exercise, the easiest position is laying on your back, face up, in a comfortable position, usually with the small towel behind the head and knees bent. There are a couple of descriptions given to patients — each with the same end goal — but you can select the description that makes the most sense to you.
- Exercise description A: Slowly feel the back of their head slide up the floor in a head nod action.
- Exercise description B: Slowly nod the head in an action indicating “yes”.
- Exercise description C: Slowly draw your nose straight backwards, so that you give yourself a “double-chin”.
The second stage — and the one people find more convenient — is to do these exercises sitting up. The same principles apply: head slides up in nodding action, nod to say “yes”, draw nose back and make a “double-chin”, etc. The benefit here is that you can do these anywhere. A lot of people find this exercise fits into their day much better — sitting at a stoplight in the car, at a transit stop on the train, or between emails at work. No equipment required, no obvious exercise position assumed — all you need is 10 seconds of your time.
The general aim is for a 10 second hold, repeated 10 times consecutively. Each case is unique, however, so you should always seek advice from a health professional to determine your specific needs.
If you would prefer a video to see an exercise for the deep neck flexors, here you go.
IN CONCLUSION – Your Deep Neck Flexors
If you are dealing with chronic neck pain or headaches, these exercises for the deep neck flexors have been shown to be beneficial in reducing pain and returning patients to better function. They are simple, equipment free, and discrete movements that make them ideal for beginning the road to recovery. Be sure to visit a health professional for a proper diagnosis though, and combine these exercises with other effective treatment options.
Dr. Jim Gilliard is a chiropractor in Burlington, ON at Endorphins Health and Wellness Centre— located in the Burlington Professional Centre at 3155 Harvester Road, Suite 406. If you have questions, comments, or wish to book an appointment, please feel free to contact him at your convenience.
Website: drjimgilliard.com
Email: drjimgilliard@gmail.com
Phone: (905) 634 – 6000
PRIMARY REFERENCES
- Bronfort G, Evans R, Anderson A V, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Ann Intern Med. 2012;156:1–10.
- Chiu TTW, Lam T-H, Hedley AJ. A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain. Spine (Phila Pa 1976). 2005;30(1):E1–7.
- Fernández-De-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Trigger points in the suboccipital muscles and forward head posture in tension-type headache. Headache. 2006;46(3):454–60.
- Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014;25:277–9.
- Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696–701.
- Kapandji, I. A. “The Physiology of the Joints, vol. 3.” The trunk and the vertebral column 2 (1974).
- Kim JY, Kwag K Il. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain. J Phys Ther Sci. 2016;28:269–73.
- Sherman KJ, Cook AJ, Wellman RD, Hawkes RJ, Kahn JR, Deyo RA, et al. Five-week outcomes from a dosing trial of therapeutic massage for chronic neck pain. Ann Fam Med. 2014;12(2):112–20.
- Vickers AJ, Foster NE. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–53.
- Yip CHT, Chiu TTW, Poon ATK. The relationship between head posture and severity and disability of patients with neck pain. Man Ther. 2008;13(2):148–54.