IOL Strength and Conditioning

Many of us have an overuse neck ache of some type, especially as the decades of gravity add up. An overall, non-specific aching neck is usually caused by one of two things. Either the head is being held too far forward in all postures, especially during excessive computer time, or the neck is being used to handle all the weight of the head, rather than allowing the chest and shoulder girdle to take some of the load. These usually go together, but relying too heavily on the neck muscles happens both in forward-head posture and in optimal postures. When the head is forward, neck muscles will always be overworked; in optimal posture, neck muscles can be activated habitually, always turned on, even when not needed.

You want your head in a position that requires the minimum work, one where the neck barely works at all. When the head moves forward of the spine, the neck muscles go to work to fight gravity, a job for which the whole body foundation is much better suited.

In healthy posture, the head sits in the middle of the shoulder girdle. It just rests there, and there’s no stress at all in the neck. One way to lighten the weight of the head is to put your attention to your chest: In sitting, simply focus your attention to the top of your sternum and off your neck. Try it right now and see if you can feel it.

If your head is excessively forward, you probably won’t be able to move the pressure from neck to chest. It’s going to take some time to loosen up your thoracic spine and stretch the chest and lats enough to get your head back into its proper position. I wish there was some magic; it’s not magic, but it works pretty fast if you put your attention toward the corrective work to fix it.

The other major neck issue is a pain on one side. This is caused by something else; three main culprits come to mind.

First and easiest: Look in the mirror. Is your head tilted to one side? Look again, and again. It’s sometimes hard to spot because you’ve been seeing it for so long or perhaps, like me, you don’t really observe anything when you’re using a mirror.

If you see it is, realize that tilt is pulling on the muscles on the side of your neck. You should be able to fix it naturally once you’ve discovered it. It’s just a habit that came from somewhere and stuck around, and it’s up to you to ditch it.

Beyond that, neck pain only felt on one side usually comes from either the clavicle or the scapula not working properly. When either of those don’t move right, they pull on the muscles above, causing pain in the levator scapula along the back of the neck, or the scalenes in the front. Of course, it can come of a list of causes ranging from arthritis in the neck to diaphragmatic problems during exercise, but for our simplistic purposes here – what we can check at home with limited knowledge — these are the two main causes.

Your clavicle is kind of a strut that attaches your upper arm to your sternum in front and the shoulder blade in back. When checking its motion, you’ll be looking for movement to the front and to the back, up toward your ear and down toward the floor, and rotation, turning like a key in a lock, with the lock being the point of connection at the sternum.

Put the palm of your hand on the opposite clavicle so you can feel the length of it move…. either side, because you’ll want to check both. The clavicles should move easily up and down, in and out and around. Then, raise the arm on the side you’re testing so you can rotate it; when you lift and turn your arm, is the clavicle rotating? Check both sides. Is the painful side not moving so well? Does moving it cause pain?

When a joint is not moving optimally, it causes trouble, either pulling on the surrounding soft tissue bringing on tightness and pain, or perhaps launching a trigger point that radiates pain. Maybe the faulty movement uses nearby muscles to get the job done, but because that’s not their purpose, other problems arise.

In the case of the clavicle not working well, the most common pain problems would be an aching shoulder, elbow or a pain in the neck.

On the backside, the culprit is most likely the shoulder blade. The scapulae are flat triangular-shaped bones that sort of float in position on both sides of the upper back. When one or both of the scapulae aren’t working properly, either due to a neurological issue – the brain forgot how to use it well – or attached muscles that are either stronger or weaker or shorter or longer than they’re supposed to be, the levator scapula, a long muscle that runs from the shoulder blade up the neck, gets tight. And that hurts, a dull ache that seems like it’s going to last forever and that’ll drive you to drink.

A neurological failing in the scapula is surprisingly easy to fix if you know what you’re looking for. Still, without someone to show you, it’s going to take some attentive imagining on your part.

What the heck, let’s give it a try. Sitting there at your desk, bend forward at the hip in such a way that you can move your arm up to shoulder height, parallel with the floor. Move your arm up and down, toward your ear and back, not toward the ceiling and floor, very slowly so you can pay attention to the shoulder blade movement. Try it even slower; you want to find out if there are any hitches or jerkiness in the motion. Then move your arm in and out — toward the spine and back out, again looking for smooth, floating movement.

Next, you’re going to be drawing circles with your arm to discover if you can draw a smooth circle in each direction. Test both sides.

This is a case where the test is also the prescription. When you find a spot where it’s not silky and easy, stop there. Slow down, make the movement smaller and slower until it gets effortless and the frustration eases. This may be kind of sickening at first. You may not be able to do this well, and as the brain is remembering the action, it can sometimes make you a little nauseous. Stick with it as long as you can, gently and relaxed, and the motion will get easy pretty quickly, within a couple of minutes usually. If you can’t tolerate it, do a little and come back to it later.

When we talk about muscles being weak or tight or strong or short, we’re heading toward corrective exercise – doing some activity to reverse the problem we’ve found. It gets complicated, but with the scapulae there are two things fairly likely to give you some success.

The first is to stretch the heck out of your pectoral group — group, meaning don’t just do the doorway stretch; change the angle and go again. Get the arm overhead and angled to make sure you get to the pec minor. Stretch a good, long time — this is one area where long duration stretches make a difference. As long as your hanging out there, massage the area at the same time. Really dig deep.

From the strengthening aspect, horizontal pulling will really help. We all know chins, but how many people around the gym are lying under the Smith bar, feet elevated on a bench or stability ball, pulling from the floor to the bar? Heck, there are some people reading who can’t do a single one. Now doesn’t that sound silly? Yeah, go try it, and as long as you’re there, do a set of ten.

Take note of what we did there: We stretched the muscles in front that pull the scapulae forward, and we strengthened the muscles along the sides and back that pull the scaps down and hold them in position. It isn’t magic, but it kinda works like it.

Any of the above problems will cause trigger points, and working on these will absolutely provide some relief. But the thing is, the cycle will begin again unless you work your way to the underlying cause. I also like chiropractic, but again, if the underlying cause isn’t fixed, the problem is likely to return.

One more quick thing. Lack of good head turning, even if it’s not painful, is troublesome, mostly in things like driving. A stiffness in head turning could easily be a simple mobility problem, like you’ve gotten accustomed to turning your head to one direction and over time stopped turning to the other. To start… to see if there’s some success — turn the head while lying supine.

Do it very slowly, very gently, making the movement as light as possible, making the weight of the head very small. If you give yourself a little private time when you can close your eyes and let the world go on without you, with experimentation you’ll find a pain-free path. Then, change from just rolling your head to rolling with an arc, more like tilting, where you bring your ear to your shoulder.

If you spend maybe ten minutes at this a few times a day, really gently, just exploring the territory, you’ll get better mobility in a matter of days. This is joint mobility at its core. Later, you might want to work on other directions, more speed and greater range of motion, but at the outset, just give yourself time to explore. You’ll learn a lot, and will enjoy the feeling of movement.

Over time, you may even begin to notice the movement growing. Turning or tilting your head might originate from the opposite hip, and when you feel those changes, your spine has become more integrated with your extremities, sorta like it was when you were a kid.

Another thing to look at with neck pain is simple overuse.  As the years pass, we start using the neck to do the job of the entire spine, and start getting neckaches. You want to retrain yourself to use the full length of the spine to move your head, or to hold it up during sitting or standing.

First step: Lie face down on the floor, hands folded in front of your face so you can rest your forehead on the back of the top hand.

Lift your head a few times to look at the floor or wall in front of you. Notice what muscles you use to lift your head.

Then rest your head on your hands, close your eyes and think about the length of the spine, neck to tail. Practice raising your head a few times, then resting and trying again, each time starting the movement just a little farther down the spine. Eventually you want to get just a hint of movement from the tail as you begin to lift your head.

This is an example of part of a Feldenkrais lesson, retraining more muscles to carry the load. An entire lesson takes between 45 minutes up to an hour and a half, and at the end of it, the entire spine is moving.

You can later practice this leaning against the kitchen counter where your legs at bent at the hips, spine extended toward the counter, practicing raising the head without using the neck much.

Do all this stuff with eyes closed. That helps zero the attention in — You really can’t get it at all with eyes open, too many distractions.
I’m living proof neck pain can be relieved. It took awhile to sort out since I had all three issues — forward head, neither clavicle nor scapula moving well — but today if I notice any straining in the neck, I know how to fix it. Shifting the base of support from the tiny neck muscles to the torso fixes the problem instantly. Happy daze, man! Pain-free movement.