In this final edition of our Posterior Chain tri-series, we shall discuss the effect of neck pain and the best way to tackle it!
Neck pain is a very common dysfunction in general public, athletes and the elderly. When associating neck pain, there are four categories for it. First of which is traumatic neck pain, this derives from a traumatic experience causing a whiplash style injury which then develops into neck pain. Traumatic injuries are sometimes unavoidable, sometimes you cannot avoid being back ended in your car, or getting your head in the wrong position when making a rugby tackle, or tripping over and falling on your back. This massive trauma has caused a giant amount of force once upon the head/neck/upper back area which has caused significant damage to the area. This could be fractures, spinal nerve damage, severe concussion or even organ damage. Sometimes these one off traumas can cause paralysis, which can be incurable.
Our least common source of neck pain derives from a pathology, this is where something is seriously going wrong with your system. This may be pain in the neck caused by a mystery lump, or unaccounted for weight loss, loss of bladder control or vomiting. If this sounds like you then you should go to your hospital/doctors immediately.
However our more common neck pain derives from our third and fourth category, these are overtension (missing ranges of motion) and open circuit faults (moving in a bad position). Overtension is where for XYZ reason, someone may only has 50% movement in a joint, for example someone with poor posture, has a forward head position which reduces available movement in the shoulder joint. Open circuit faults, is where the body moves in a position which is not powerful and has the potential to cause injury, for example when pushing over head, having a large curve in your lower back. Both overtension and open circuit faults can cause serious neck pain, however these can both be solved with good mobility, corrective exercise and rehabilitation.
So if you have neck pain, ask yourself if you have any of these issues below:
- Rounded upper back
- Shoulders rolled forwards
- Over extended lumbar spine (lower back)
- Head tilted forwards/backwards
- Unable to straighten arms above the head
If you do, then don't fret, there is an answer and we will go through what can be done to solve these issues.
If you do have neck pain it is vital that you strengthen your muscles in your back, especially the rhomboids, lats and trapezius - the large muscles of the upper back. We can do this by getting you to sit up straight and retract your shoulder blades. Retraction is the process of pulling your shoulders back so they sit around the spine as oppose to sitting away from your spine. If you can hold this position of slight tension, you will find not only will your rounded upper back straighten, but your shoulders will roll back in the process. You will lose this position and revert to norm, but test yourself. Set a timer for 30 seconds, hold this good position at your desk and then relax. Reoccur the alarm every 10 minutes and continue. Once you feel comfortable you can increase the period in a good position. Before you know it you will have a straighter upper back and less rounded shoulders.
Here is an example of a woman with retracted shoulder blades, you can clearly see the musculature and shoulder blades surrounding her spine
Over extension of the lower back, this is less associated with neck pain but is a function we have discussed before with regards to the posterior chain. It is advised that keeping some level of abdominal tension is the answer. Essentially yes, yes it is, that 20% tension of abdomen will be enough to rotate your pelvis correctly and straighten that slight curvature in your lower back.
Head tilted forwards or backwards suggests that either your extensors/flexor muscles of your neck are over acting. This means the muscles under your chin are over working so you appear to be looking down, or your muscles in your traps/back of the neck/head are over working so you are tilted upwards. You can correct these issues by applying a movement called a chin tuck, no this is not plastic surgery. A chin tuck is when you pull your chin back as far back as you can, not downwards towards your chest but back towards your spine/neck. If performed correctly, you will feel the muscles just below your chin contract and your spine feel straighter once again. Perform this for three sets of twenty reps whilst at work today and feel how your chin and neck feel during and after the movement. Over time you should feel like your head is in a much more natural position which should help deter the neck pain you have been experiencing.
Our last modality we want to assess is if you cannot straighten your elbows when your hands are directly above your head. There may be many reasons for this however the most common causation for this is tight lats. Lats are the muscles which are beneath your arm pits, these muscles act as a sheath covering the rib cage all the way down the lower back. Not only do they act as a protective layer for the posterior rib cage, they are a prime mover when bracing the body, keeping our mid-line stable and pulling towards the body. However this muscle can become tight when under used, especially in a generation of desk bound and sedentary lifestyles. When this muscle becomes tight, it has a knock on effect on the muscles above it. The triceps (back of the arm) and posterior deltoid (back of the shoulder) become tight which prevents them from completing their function of elbow and shoulder extension!
This links back to our over tension we discussed earlier, where a range of motion is missing. We can correct this by stretching our lats by using an exercise we have discussed in a previous blog, the side flexion childs pose! In this position we can stretch our lats effectively, with our arms straight mimicking the overhead position without gravity taking it's toll on the body. This is an easily completed exercise and can be done at home. Simply start on your knees, bring your heels to your bum, hands overhead and crawl your hands to the left as far as you can, when you get to the end range physically try and push your rib cage to the right. You will find an intense stretch in the right lat, you will hold this position and stretch for 2 minutes, controlling your breathing before swapping sides.
So now you have combined a straighter lower back, reduced tension in your lats, a straighter middle spine and better head position, this is known as closed circuit. This is the optimal position humans were designed to live and breath in, if you can maintain this, then you are on a one way road to reduced neck pain for sure.
So that completes our three part series on the posterior chain and how important it is in the body. We have assessed hips, lower back. hamstring, posterior shoulder and the neck. Hopefully after reading these articles you have a much better understanding of the posterior chain and how it can effect our body! If you have any questions then please leave a comment below or feel free to ask a question via email!
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