The neck is a complex structure of muscles, tendons, nerves and ligaments. In order to determine the cause of pain, we must first look at the anatomy of the neck….
The neck is made up of the posterior triangle which includes the muscles:
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Trapezius
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Sternocleidomastoid,
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Middle and posterior scalene,
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splenius capitis.levator scapulae and
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omohyoid muscle
The Anterior triangle triangle consists of:
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Prevertebral muscles &
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Rectus capitis muscle
So what is neck pain caused by?
Neck pain can be caused by dysfunction in 4 main areas:
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Muscles/connective tissues (Myofascial)
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Bones/Joints/Ligaments (Articular)
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Nerves, coordination, and brain issues (Neural)
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Medical reasons (tumors, blood vessel problems, psychological conditions etc)
Bio-mechanically, sustained forward flexion of the neck results in increased compressive loading on the cervical spine and a creep response in the surrounding soft tissues.
The source of pain is excessive loading of the cervical and shoulder girdle muscles, especially in low-load repetitive work which promotes over-activity of low threshold motor unit.
The superficial muscles of the neck-shoulder region, i.e., the sternocleidomastoid, anterior scalene and upper trapezius muscles, demonstrate increased activities compared to deeper postural stabilizers like the deep cervical flexors. Excessive tension in the upper trapezius muscle is also a contributor to neck pain.
Why you get neck strains?
It is important to identify and address the underlying cause, not just treat the site of pain. Often it is caused by misaligned: hips, spine, shoulders and the head being stuck forward
Muscles in the upper back and neck then tense up, meaning they are continually under strain and become weak and fatigued causing you pain.
How to relax the neck underload:
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Neutral spine in sitting and standing with the head over the thorax which is over the pelvis
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Shoulders need to be square…not with scapulae depressed or retracted nor protracted and elevated.
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Your hips and pelvis needs to be able to remain square and the pressure in the socket needs to remain centered.
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Avoid excessive extension, especially if you have any pinched nerves.
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Use supported positions until you develop the strength to maintain those positions yourself.
Prescribing exercise for neck pain!
Pain can be reduced by strength and endurance training. Improvement in strength, coordination, increased motor unit recruitment, and an increased firing rate will help improve and delay muscle fatigue.
When prescribing exercise for neck pain you need to ensure you increase the stability of the area at the same rate as you increase flexibility. Stretching without learning how to control the new range of motion can result in injury, the same as getting stronger without increasing your range of motion can.
Learn to maintain a neutral position of the head when sitting and standing. No forward head tilt or rounded shoulders. You should also be able to changing the angle of your trunk while keeping your spine, pelvis, hips, knees, ankles, feet and shoulders in good positions.
Starting off in neutral sitting or standing posture, learning how to move 1-4 limbs while maintaining stability.
Be sure to add load gently and progressively. The load must be challenging but not so heavy that your technique or form suffers.
Give these 5 exercises a go to reduce your neck pain today:
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Legs up on wall, or at 90 degrees to a bench
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Segmentation, cat/cows
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Sitting floor (head/neck/shoulders touching the wall)
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Frog (reposition hips to be in a better position to support your head and neck in the right place)
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