Neck injuries can lead to similar problems as that experienced in the back. However, the neck is much more mobile than the lumbar spine, the spinal cord is at its thickest, and more weight is transmitted through the facet joints in the rear than through the discs. This is significant because the facet joints at the back of the neck are much more richly innervated and thus become irritated quite easily.
To make matters worse, several neck muscles have a nerve supply that is directly tied into defensive posturing during the stress response, so that they become chronically spasmed, irritated and fatigued when exposed to prolonged stress, worry, anxiety or depression. Also, this stress response influences your jaw muscles so that it also becomes irritable and stiff, making it prone to noises, deviation and irritability. The net effect is that your whole upper back and neck will change its posture, eventually fatiguing and causing pain, headaches, pins and needles in the arms and even face. Serious cases can have balance disturbances, dizzyness, nausea (sick -to-the-stomach feelings), ringing in the ears and light-headedness. Many headaches that arise from this severe irritation are mis-diagnosed as “migraines”, but respond quite well to Chiropractic care.
Acute Neck Injuries
An acute neck injury should be treated with the same first aid procedures as any other region, so remember to rest, icepack it every couple of hours and wear a neck brace only if it is too painful to hold your head up. Do not do any of the following exercises if you have symptoms radiating down your arm or if you have a headache without first consulting your therapist.
These exercises are a guide and resource for our patients and are not meant to replace professional consultation and advice. Like all exercises, stop if they cause pain or other symptoms and call the clinic for further advice.
The basic exercise routine used in neck rehabilitation involves improving range of motion in the three fundamental planes-
1. Sagittal Plane (forward and back banding, or flexion and extension)
2. Transverse Plane (rotation side to side)
3. Coronal Plane (side bending)
Exercises come in 3 basic types:-
- Active (where you move your neck on your own)
- Passive (where you allow your relaxed neck to be moved by someone else)
- Resisted (where you resist the active movement of your neck through counter contraction). The most common form of resisted exercise is known as Isometric exercise, where you apply resistance to the movement of your head by opposing it with your hand. There are also several variations on this basic premise, which include alternately stretching, then resisting that stretch at several points along the movement.
On this page we will look at first improving the Active Range of Movement, then we will perform an Isometric Neck Routine, and finally a Progressive Resisted Range of Movement Routine. Generally these routines are done 3 times each, though it is not necessary to do all of them at any one time. Do as many as you feel able, but the most important are the Active Range of Motion exercises, so focus on them as your basic routine.
Learning to understand what your body is trying to tell you is a challenge most of us are not very good at. And when we do manage to figure it out, most of the time we ignore it anyway and keep on doing what we want to. Understand that you are not made of stainless steel and will ALWAYS pay in the end. Back off and give it a rest. In fact it can take almost as long for soft tissue injuries to heal as fractures (i.e. 6 – 8 weeks!), so don’t think that just because it feels better the next day, that everything is fine. It can take 2 or 3 days for swelling to peak so that you can actually feel worse on day 3 or 4 than you do on day 1.
Active Range of Motion Exercises
Start by sitting Comfortably in a chair with your head centered forward. This is the neutral position from which you begin all exercises, and where you return following a stretch. It is often helpful to sit in front of a mirror, so that visual feedback can help you improve your routine.
1. Flexion and Extension
Tuck your chin in, but keep your teeth clenched. This will tension the muscles just under the back of your skull.
Then slowly bend your head forward into flexion. Hold for 3 seconds then return to neutral position.
Don’t just drop your head forward or you wont stretch the whole neck properly.
Next, keeping your teeth clenched poke your chin forward and upwards, causing extension at the neck. Lean forward, thrust your chest out and hold your shoulders back to feel a stretch at the front of your chest also. This is important since the anterior neck muscles extend down the front of the chest. Hold for 3 seconds then return to neutral.
Many people think the aim of neck extension is to flop the head as far back as you can. This is not true. In fact, you can jam or pinch your neck in this way so it is not recommended.
Next, resist the rotation of your head first in one direction, then in the other, again building up the strength of contraction over 3 or 4 seconds, being careful not to move your head from the midline.
3. Lateral Flexion (Side bending)
Place the palm of your hand on the side of your head, above your ear, being careful not to compress your jaw joint. Keeping your head still, push against your hand with gradually increasing force over 3 or 4 seconds. Repeat on the other side.
Progressive Resisted Range of Movement Routine
In this exercise routine, you will perform an isometric contraction (as in the exercises above), but will perform the contraction at neutral; half-way through your range of motion; and at the end of the range of movement you are moving in. These exercises can be considered a kind of combination of the active and isometric routines already described, but the reason for doing them is that when you contract and subsequently stretch a muscle, the stretch becomes more effective.
Perform an isometric contraction as you rotating your head into the left side against resistance, holding each isometric contraction for 3 or 4 seconds.Then rotate half way to the right and from this position again resist the opposite way to the left into your hand.
Finally move all the way into right rotation, then resist the opposite way into your hand.
Finish by giving a final stretch into right rotation as far as you can for an extra stretch at the end.
Repeat for the opposite side
2. Lateral Flexion (Side bending)
Begin by isometrically pushing your head to the left, resisting with your hand. Hold for 3 or 4 seconds.
Then sidebend half-way to the right side, and then from this position perform another isometric contraction toward the opposite side.
Finally, move all the way into right side bending, and from there again resist the opposite way for 3 or 4 seconds. Finish by finally stretching into right side bending as far as you can.Repeat for the opposite side.