**Disclaimer – if you have symptoms of numbness/tingling or weakness in your arm(s), see a doctor or physiotherapist to rule out more serious problems **
So you “slept wrong” again and now you can’t turn your head. You say “It’s ok, it will loosen up after a couple of days” and if you’re lucky, it won’t happen again for a few months… Or maybe you’re chronically stiff in your upper trapezius (tops of your shoulders). You say “It’s just where I carry my stress”. While stress is certainly a factor, it’s more likely the activity you are doing while your are stressed -staring at your computer for several hours without a break – that has lead you down this path.
These are common problems. But just because they are common, does not mean they’re normal! These issues are telltale signs of a mechanical neck problem. What does this mean? As you habitually sustain certain positions for hours and hours every day, there is strain put on various structures in your neck. The longer you sustain a position, the longer it takes for these structures to bounce back to normal. Unfortunately, this ratio is not 1 to 1. In other words, if you spent 30 minutes hunched over your phone, it will take much longer than 30 minutes for things to return to normal. Chances are you’ll spend another 30 minutes staring at your phone or slouching over your computer before your tissues have recovered. As you repeat this process week after week, things slowly build up to the point where those tissues have had enough and they will let you know via symptoms of pain, stiffness and/or loss of range of motion
- insert photo of staring at phone and HFP at computer
Fear not! There is a simple approach to fix and prevent mechanical neck pain. The majority of mechanical spine problems have a direction of preference. This is a direction that you can move your neck that will gradually return those tissues back to balance, freeing up your range of motion and decreasing your pain/tightness. This direction is typically the opposite to the direction that got you in trouble in the first place. For the majority of people in today’s workforce, the direction that has created this issue is anterior (forwards) and the direction of preference is posterior (backwards).
The fix will involve two simple steps
- Decrease the amount of anterior directed forces on your neck
- Do your direction of preference exercise regularly (posterior directed forces)
Anterior Directed Forces
- insert pictures of head forwards posture, cervical flexion staring at phone
With these two positions, there is significant compressive load being placed on the structures of the anterior (front) of your cervical spine (neck) and tensile (stretching) load placed on the posterior (back) structures. These are positions that need to be avoided as much as possible so that your direction of preference exercise (see below) can work its magic. For some additional tips on how to better set up your workstation, see my article on improving your posture.
- insert link for improving posture
Posterior Directed Forces: Repeated Cervical Retraction
- insert video of repeated retraction and repeated retraction with overpressure
In these two videos, there is an inverse of the above loading pattern – compressive force of the posterior structures and tensile force on the anterior structures. The idea with these movements is to move as far as you can with each individual repetition. The use of overpressure (pushing with your hand) is often needed to get to this end-point. When you are adding the extra pressure with your hand, try to allow your neck to relax and have your hand guide the movement as much as possible. Both versions of the exercise work best when sitting on a chair with a high back to help isolate the movement to your neck, as opposed to leaning your whole body backwards.
This may initially be sore/stiff, but should loosen up as you repeat them either within an individual set or after several sessions through the day. If this exercise worsens your pain or makes your neck stiffer, stop immediately and book an assessment with your friendly neighbourhood physiotherapist!
How much is needed?
The general guideline for these exercises is to do 10-15 repetitions every 2-3 hours throughout the day.
You will likely need to continue with this regularly for anywhere from 2-4 weeks to return things to balance. Once things are feeling good, then it is a good idea to continue with these exercises 1-2 times per day indefinitely in order to keep your neck happy moving forwards.
If this approach does not resolve your neck pain, you likely have a different direction of preference or your neck might need a little help to get moving via some manual therapy. In these situations, you should seek out a physiotherapist for further evaluation.