Injury prevention and rehabilitation are major interests of mine (hence my quest to become a physical therapist) so I’ve decided to have a weekly series addressing common pains and injuries that come with active lifestyles (because what active person wants to be stuck on the couch due to an injury from being active– the thing thats supposed to make us less likely to be sick or injured). In these posts I’ll discuss injuries, the anatomy of these injured areas, possible causes, prevention, and remedies. As a huge disclosure: I’m not a medical professional (yet), please do not follow my advice if it goes against your doctor’s orders or your better judgement.
This week I’m going to focus on the neck.
There are 2 reasons I’m starting here: 1) Pain in this area affects so many people 2) This area has given me significant trouble lately. I have always had very tense neck and shoulder muscles, and recently, it’s led to tension headaches especially after my upper body workouts (Booooo!).
Some significant contributors to tension in this region include:
- The scalenes and sternocleidomastoids (SCMs) on the sides and front of the neck
- The large trapezius, the levator scapulae, and lots of other little sub occipital muscles along the back of the neck
- And the pectoralis major and minor in the chest, below the clavicle (collar bone) and attaching to the arm
My hypothesis is that a big factor of tension/tightness in the neck is poor posture and, more specifically, a forward head and associated forward-rounded shoulders.
How do we end up in such a posture? Well, 2 major culprits are this:
and this: 
Despite my best efforts, I’m guilty of both. As you can see in diagram above, the more forward the head is positioned relative to the body, the heavier it pulls on stabilizing structures (i.e. the bones and muscles of the neck). The scalenes and SCMs on the front and sides of the neck spend many hours each day in a shortened state (contributing to the “tightness” we feel there). The sub occipital muscles, levator scapulae, and upper trapezius are constantly overstretched and overworked, which may be why many experience muscle spasms leading to knots and trigger points (and tightened muscles) in those areas.
And, yes, there are other causes of neck pain and tightness including stress, prior trauma, structural conditions in the vertebrae, nerve irritations, etc. but posture is the only one I’m going into now because this is a blog not a book.
Weekly Rehab Fix:
Firstly, we are going to be mindful of our sitting and phone postures.
Secondly, here is a routine to try 1-3 times each day for the next week. Please, listen to your body as you do these activities. Pain is the body’s signal that something is not right. If you have pain with any of these, modify the range of motion to eliminate the pain or don’t do the exercise.
- 1-Arm Doorway Pec Stretch, 3X 30 seconds on each side
Start with the arm against the wall, at a 90-degree angle to the body, and lean forward (keeping your head and neck in a neutral position) until a slight stretch is felt in the chest. - Scalene Stretch, 3 X 30 seconds on each side
This stretch comes from Kelly Starrett who has a youtube series called “Mobility WOD” (WOD=Workout of the Day). Place one arm behind the back. Tilt the head toward the opposite side, ear toward the shoulder, and from that position rotate the chin slightly toward the ceiling. To increase the stretch, press down gently on the tightened scalene and SCM just above the clavicle (collar bone). Follow this link to see Kelly’s video demonstration at 2:25. He uses a band to anchor the arm behind the back. Try it that way if a band is available, but you should feel a good stretch even without the band. - Levator Scapulae Stretch, 3 X 30 seconds on each side
This is another stretch from Kelly Starrett. Place one arm overhead, bent at the elbow, as if doing the typical triceps stretch. The palm of this hand should be oriented toward the ceiling.
Anchor the arm in this position by using a band (recommended by Kelly) or a stationary object (I place the palm of my hand against the underside of my fireplace mantle). Tilt the head toward the opposite shoulder and roll head forward until a slight stretch is felt along the back of the neck. To see Kelly’s video demonstration, click here and watch it at 3:00. Also, stay tuned into my instagram (K8IrelandActive) this week for my demonstration of the stretch. I feel this stretch very intensely, so I don’t need to apply any pressure to my head with my opposite hand. My hand also goes numb quickly in this overhead position so I only hold it for short 30 second intervals. While doing this stretch it is very important to listen to your body’s pain signals and move into and out of the stretch slowly, with caution. - Small ball soft tissue work in the pecs: 1 minute each side of the chest
Using any kind of moderately firm small ball (tennis ball, lacrosse ball, softball, racquetball), massage the chest muscles by sandwiching the ball between you and a wall and moving side to side and up and down. Make sure to focus on the area in front of the armpit where the pecs cross to the arm and the area below the clavicle (collar bone). Side Note: I try to do this exercise from the comfort and privacy of my home, especially being female. - Small ball soft tissue work in the traps: 1 minute on each side of the spine
Using the same ball as in the previous exercise, sandwich it between your upper back and the wall. Move side to side, up and down pressing against the ball to massage the area. Hug the arms across the chest to work between the scapula (shoulder blades). When you feel big “knots” or bumps in the muscles, move back and forth over them for a little bit.
I’m going to follow my own advice on this and perform this routine at least once a day for the next week, and I encourage you to give it a try because it only takes 13 minutes. Stay tuned into my instagram, K8IrelandActive, for videos and pictures of my progress, and please let me know if you give it a try!
Strength Coach K8 