How to do stretching and strengthening exercises for your neck and shoulder muscles
You will need a chair. Sit on the edge, straighten your back, lower and straighten your shoulders. Do each exercise for 10–15 seconds.
Turns and tilts
Turn your head to the right so that your chin is in line with your shoulder. Hold and then repeat the movement in the other direction.
Return to the starting position, tilt your head and look at the floor. Move your chin to the right and then to the left - this will increase the tension in the neck muscles.
Take the starting position, and then stretch your arms forward as if you are trying to reach something. Feel the stretch between your shoulder blades.
Chin to chest
Bend your head strongly, as if you are trying to reach your chin to your chest. Feel the stretch in the back of your neck and down to your shoulder blades.
Tilt your head again, but now clasp your hands and place them on top of your head, increasing the pressure. You can rotate your chin slightly to the right and left to shift the tension.
Dropped Shoulder Stretch
Lower your chin down diagonally to the right, while simultaneously reaching your left hand towards the floor. Repeat on the other side.
Semicircle head
Lower your chin towards your right shoulder. Without raising your head, slowly move it to your left shoulder, as if drawing a semicircle with your chin on your chest. Repeat on the other side.
Do not throw your head back at the extreme points: this creates unnecessary stress on the cervical spine. Do the exercise smoothly.
Sliding back and forth
Move your chin forward as if it were sliding in one line, then retract it.
Shoulder movements
Move your shoulders forward and then move them back and raise your elbows. Feel the stretch in your pectoral muscles. After this, raise your shoulders up, as if trying to reach your ears, and then lower them down.
Elbow circles
Spread your elbows to the sides, place your palms on your shoulders. Rotate your arms, trying to increase the amplitude.
Arm stretching
Lower and slightly spread your arms, palms forward, so that they do not touch the body. Stretch your fingers towards the floor, feel the stretch in your shoulders and elbows.
Relax and turn your hands with your palms back. Pull them down again and then pull them back without releasing the tension.
Strengthening the lateral neck muscles
Place your palm over your right ear. Half-heartedly press your hand on your head, trying to tilt it towards the opposite shoulder. Tighten your neck muscles, resist the pressure and keep your head upright. Repeat the same on the left.
Strengthening the front of the neck
Clasp your hands and place them on your forehead. Apply gentle pressure while trying to move your head back. Resisting the pressure, keep your neck straight.
Strengthening the back of the neck
Clasp your hands, place them on the back of your head and apply light pressure. Resisting the pressure, keep your neck straight.
Hands down with a towel
Take the towel by the ends, pull it tight and move your straight arms behind your head. Bend your elbows and try to lower them. The lower your elbows are, the better the muscles will stretch.
Transferring hands behind head
Take the towel by the ends, pull it taut and move your arms straight up. Bring your upper body forward and move your straight arms with the towel further behind your head.
Contraindications to massage for cervical osteochondrosis
Massage of the cervical-collar area should not be done if you have the following diseases or conditions:
- benign and malignant tumors;
- in the phase of exacerbation of osteochondrosis;
- intervertebral disc herniation;
- infections and non-infectious inflammations of the brain and spinal cord, the presence of hemorrhagic stroke;
- any problems with blood clotting;
- aneurysms of vessel walls;
- fever of any origin;
- thrombophlebitis;
- any infection in the acute stage;
- cardiac, renal, pulmonary, liver failure;
- purulent processes in any part of the body;
- skin rashes, ulcers, inflammations, skin irritations in the massage area.
Before starting massage procedures, it is necessary to conduct a full examination and consult a doctor.
The doctor should also look at the patient's medical history.
How to do yoga exercises
Follow the rules carefully and do not hold your breath. Maintain each pose for 30 seconds.
Half bend forward with emphasis on the wall (simplified uttanasana)
Stand straight, two steps away from the wall, facing it. Place your feet hip-width apart for comfort. From this position, bend at the hip and lean forward with a straight back to a 90° angle between your body and legs. Place your hands on the wall.
Try to straighten and stretch your spine as much as possible. Hold the pose for 20–30 seconds.
Warrior Pose II (Virabhadrasana)
Stand up straight, spread your legs wide, point your toes forward, raise your arms to the sides, connect and straighten your fingers.
Turn your right foot 90° to the right. Bend your right leg at the knee to a right angle or close to it, and move your left leg back. Distribute your weight between both legs.
Twist your pelvis, stretch your back, lower your shoulders. Try to open your pelvis and chest. Repeat the pose on both sides.
Twisting (Bharavajasana)
Sit on the floor, bend your right leg at the knee, point your shin outward and place your heel next to your pelvis. Bend your left leg at the knee, place your left foot on your right thigh.
Distribute your weight between your two sitting bones and lengthen your spine upward. Place your right hand on your left knee and turn your body and head to the left, grab your left toe with your left hand. Repeat on the other side.
Acupressure of the cervical region
This type of massage affects acupuncture points. If you apply this Chinese technique correctly, pain disappears, tension and muscle spasm are relieved. Acupressure treatment has a relaxing effect on them, releasing pinched nerve endings.
The patient usually feels relief at the very beginning of the course of procedures. Blood supply to the cervical spine improves, various seals dissolve faster.
Acupressure for cervical osteochondrosis should be performed exclusively as prescribed by a doctor in order to relieve tension and pain.
Execution technique
Sequence of actions when performing a massage:
- Feng fu point. Acupressure begins with the area under the occipital protuberance. Screwing movements are performed clockwise for 1 minute. After a delay of a few seconds, switch to loosening movements counterclockwise.
- Feng chi point. The point between the sternocleidomastoid muscle and the occipital bone should be impacted for 3-4 minutes with medium force. This will lead to relief of pain and relaxation of the neck muscles.
- Chuntu point. Find a point on the line between the 6th and 7th vertebrae on your back, press it with the pad of your finger for 5 minutes. This will improve venous and lymphatic drainage from the paravertebral tissues and reduce swelling.
- Point da-zhui. This is the 7th cervical vertebra. The impact on this point has a relaxing effect and is the best end to an acupressure session.
To improve the patient’s well-being and increase the effectiveness of treatment, acupressure is best performed after classical massage. For this, several points are usually selected.
Neck pain with referred pain (radicular pain)
- BS with radiating pain in the affected limb.
- Dermatomal paresthesia or numbness of the upper extremities; myotomy muscle weakness.
- PS and referred pain reproduced or relieved during testing for radiculopathy: test cluster includes upper limb tension test, Spurling test, distraction test, range of motion testing.
- There may be deficits in sensation, strength, or reflexes of the upper extremity related to the involved nerve roots.
Stretching with a roller
The exercise is performed in a lying position.
Roll up the towel and place it under the base of your skull. Tilt your head back and relax your neck, shoulders and back. Stay in this position for 10 minutes or until discomfort occurs. It is advisable to practice on a hard surface.
Photo: istockphoto.com
This exercise gently but effectively stretches all the neck muscles and helps relieve stiffness.
Gymnastics for the neck: who needs it?
Every 7 out of 10 adults experience neck pain. Perhaps the most common cause of their occurrence is osteochondrosis - changes in the intervertebral discs, manifested in a decrease in their height and a decrease in strength. This is due to a colossal lack of physical activity, which has given way under the pressure of computers and gadgets, as well as bad habits.
Gymnastics for the neck is needed:
- For those who have problems with the musculoskeletal system.
Gymnastics will help you get rid of neck pain caused by osteochondrosis, cervical hyperlordosis (excessive forward bending of the cervical spine) and other changes in the structure of the spine. - For those who experience discomfort in the neck area.
Usually discomfort is associated with inactivity of the neck muscles. Being in one position for a long time causes them to stagnate, which leads to poor circulation, pain, memory impairment and fatigue. - For those who care about their health.
If your neck does not hurt or cause discomfort, prevent their occurrence. You need to stretch your neck! Otherwise, inactivity will provoke osteochondrosis, which means constant pain and stiffness in movements. - For those who care about their appearance.
Violation of the configuration of the neck and tightness of its muscles are the causes of the appearance of undesirable facial features: wrinkles, loose and sagging skin, swelling, fat deposits under the chin. Trying to get rid of wrinkles with miraculous creams and tapes with a tense neck pressed into your shoulders is a waste of time and money. This is the same as fighting extra pounds with fat-burning teas while continuing to eat fried cutlets and cakes. To restore the beauty of your face, you should start by working on the cervical spine!
Neck pain can be caused not only by changes in the structure of the spine, but also by muscle inflammation, infections, cysts, tumors, lesions of the thyroid gland, lymph nodes and other diseases. In such cases, comprehensive measures and the help of specialists are needed.
Muscle synergies - what kind of beast?
If we consider the remaining category of muscles (which move bones in relation to each other), then everything becomes more interesting. What's most important to us? So that after any movement or position of the head our vertebrae fall into place. And nothing was pinched, hurt or pinched. Right? Right! And for this we need to remember that the muscles on the right and left are not antagonists to each other! Consistent tension of the right and left muscles has nothing to do with the correct restoration of the position of the vertebra.
And we need muscle synergies! These are joint coordinated contractions of various muscles and muscle groups that ensure the implementation of a targeted motor act. Simply put, these are coordinated movements of opposing muscles, the correspondence of tension and relaxation of the muscles involved in the movement. It is this consistency that ensures that the vertebra returns to its original position after you tilt or turn your head. And as you already understand, muscle pumping is definitely not needed for this. We need to teach the muscles to work correctly and this is very far from the initial “strengthen and pump up”.
Differential diagnosis of patients with neck pain
If a patient's impairment falls outside the classification system or interventions do not improve symptoms, the clinician should consider underlying medical conditions or psychosocial factors as possible explanations for the patient's pain.
Test recommendations
Examination of the cervical spine
Use of outcome indicators (Class: A)
Outcome assessment tools can be used to assess, monitor changes over time, and diagnose and predict BS. When examining patients with complaints of BS, validated self-questionnaires should be used. The HD Disability Index and the Specific Patient Functioning Scale are two examples of such questionnaires. The primary reason for this recommendation is that these tools establish a baseline status of pain, function, and disability that can be used later to guide intervention selection and goal monitoring.
Easily reproducible measures of activity and participation limitations associated with HD should be used (Grade: F). This is necessary to assess change in function during the treatment episode. An example is the Spinal Function Triage tool, but this and many other tools are more specific to low back pain, which is partly why this recommendation is rated F. Trippolini (2017) found that a modified Spinal Function Triage tool had good reliability and validity for assessing perceived self-efficacy in performing work-related tasks, and the authors recommend it for patients with chronic musculoskeletal conditions.
Consideration of certain risk factors that may predispose the patient to chronic BS (grade: B)
When a patient first presents with acute HD, it may be useful to consider whether they have risk factors for developing chronic HD. Early identification of risk factors may allow the physician to implement strategies that reduce the likelihood of developing chronic pain (Kim, 2018). These risk factors include:
- Female.
- History of BS.
- High demands at work.
- Smoking.
- Low social support.
- History of low back pain.
- Elderly age.
- Depressive state.
- High stress levels.
- Perceived muscle tension.
Indicators of physical impairment (grade: B)
A physical examination should be performed to establish a baseline and monitor changes over time. It may also be useful in ruling out/not ruling out conditions/causes of BS. To classify pain, an algometric assessment of the pain threshold during pressure should be used. Below are screening recommendations for different types of patients with BS.
- BS with impaired mobility: range of active movements of the cervical spine, flexion-rotation test, testing the mobility of thoracic segments.
- PS with impaired motor coordination: craniocervical flexion test, endurance testing of deep neck flexors.
- BS with headache: assessment of the amplitude of active movements of the cervical spine, flexion-rotation test, testing the mobility of segments of the upper cervical spine.
- PS with referred pain: neurodynamic testing, Spurling test, distraction test, Valsalva test.
Patient classification (class: C)
Based on examination, clinicians should classify patients with BS into one of the four previously mentioned groups in order to create the most appropriate treatment plan. To categorize patients, the physician must conduct appropriate subjective and objective examinations. Below are the main outcomes that need to be assessed when placing patients into these categories. However, the categories provided are not exhaustive, and categorization of patients into categories requires individual clinical judgment based on the results of a subjective and objective examination.
How our neck moves
The photo below shows 3 photos taken from the Internet. Lateral projection (head straight), maximum tilt forward and maximum tilt of the head back. If you thought that at maximum amplitudes your spine in the cervical region can fold into a “donut” - you are mistaken). All inclinations are limited by the articular or spinous processes - as soon as they rest against each other, the movement stops. As you can see in the photo, the main movement occurs in the area of the lower cervical vertebrae and to a much smaller extent than, for example, in the lower back. The same thing happens when you tilt your head to the sides (ear to shoulder)! Considering that the structure of the articular surfaces is located in the anteroposterior direction, this is not the best exercise.
The neck joints are not very adapted to transverse bending. And in the presence of hypertonicity or shortening of individual muscles, the articular planes can shift within the articular capsule. And crunch finely, while limiting the already small mobility in the joint. Now we have found out that the spine in the cervical region is inactive - let’s move on and talk about “strengthening” and “pumping up”.
Neck pain with impaired mobility
- Central and/or unilateral BS.
- Limitation of neck range of motion, which reproduces symptoms.
- Referred pain in the shoulder girdle or upper extremities may be present.
- BS is reproduced at the end of the amplitude of active and passive movements.
- Limited mobility of the cervical and thoracic segments.
- Intersegmental mobility testing reveals characteristic limitations.
- BS and referred pain are reproduced by provocation of the involved cervical or upper thoracic segments or cervical muscles.
- Deficits in strength and motor control of the cervicothoracic spine may be present in people with subacute or chronic BS.