Why does my neck hurt?

Many gym clients ask about neck tension. They felt they got in a good workout the other day, and are not sure why but they wake up with a stiff neck. They didn’t notice anything feel off during the workout. Sound familiar to you?

So what happened?

It’s a combination of weak and tight neck muscles (tight muscles are always weaker) and elevated shoulders (overly active traps and levator scapulae muscles for the most part).

Elevated Shoulders and lack of independent movement

It’s become pretty common knowledge that our modern chair-bound life has created a lot of physical problems for us. We do move less and we actually move in fewer ways. For example, how often during your work week do you overhead carry reams of paper up the stairs, climb a wall, bear crawl across the floor, do a back bend to grab a pen? We have gotten so tight and weak that we can not do many independent movements. Our shoulder stabilizers are not strong, our lats and external rotators may not be functioning properly and we are so used to hunching our shoulders up to our ears with daily stress. The neck and shoulders now move in unison instead of producing independent movement. For example, picking up a cup of coffee. Did your shoulder come up to your ear along with it?

If you pay attention you’ll start to notice that you elevate your shoulders, over recruiting your upper traps for a lot of movements. They don’t need to come along for the ride.

Hold your head up

Then you add in weak neck flexors. Due to years of doing a bazillion crunches while holding the head (improper ab training), most of us are recovering from over developed trunk flexors (rectus abdominis) and weaker neck flexors to hold our heads. From this imbalanced training, the trunk flexors have gotten stronger and the neck flexors, which should work together, have been left behind. Our head can not function self-supported and we must actually hold it up with our hands during exercise.

Look at the body you can see the connection and that functionally these muscles should work together .

When the head is supported it promotes an imblance of strength between the trunk and neck.

To stabilize the neck, you must maintain proper tongue position. Your mouth should remain closed with your tongue resting naturally at the roof of your mouth, behind your teeth. Say the letter “N”…..”nnnnnnnnnnn” that is where your tongue should rest. About the same position as when you swallow.

The tongue should comfortably rest behind the teeth at the roof of the mouth.

Why do this? Why does this matter?

1.When your mouth is open your body compensates to open up the airway for you to breathe by moving the head forward (you’ve probably heard that forward head posture is something to avoid. And…it doesn’t look so good.)

2. This helps stabilize your neck. Deep neck flexor muscles are not properly activated to support the weight of your head unless your tongue and jaw are in proper position.

Studies have shown that a low-load program of craniocervical flexion exercise focusing especially on motor control of the deep neck flexors has been shown through clinical trials to reduce neck pain and headache.

So, in conclusion…

Pay attention to your neck and shoulders. Are you elevating your shoulders and over recruiting your traps? 

Keep proper tongue position when doing ab work with your head unsupported, and stop once your neck gets tired so that you can balance your neck and trunk.

Sharp pain in the top of your shoulder?

Shoulder impingement typically causes pain as you try to raise your arm overhead. The pain you are feeling is due to pinching of the supraspinatus tendon underneath the acromion process of the scapula. The scapula is pulled too far forward by over developed internal rotators of the shoulder. Posture, overuse and repetitive movements overhead are all contributing factors. Targeted tissue work to “unstick” tight fibers in the indicated muscle groups along with strengthening external rotation is effective. Strengthening is always important to regain balance. Plus, a stronger muscle responds better to treatment according to biomechanics specialists Dr. Ivo Waerlop and Dr. Shawn Allen.

Image adapted from Visible Body.

How massage can help you increase your “studliness”

1. Massage can help you rebuild muscle more quickly.

A new study published in Science Translational Medicine found that a massage session can reduce inflammation, which can help your muscles recover after a hard workout. Vigorous exercise causes tiny tears in muscle fibers, leading to an immune reaction — inflammation — as the body gets to work repairing the injured cells.

“What massage seems to do is … it reduces the inflammatory response as a function of the damage you incurred while you’re exercising,” explained one of the study’s authors Simon Melov, a molecular biologist at the Buck Institute for Research on Aging.

2. Massage can help muscle adapt to increased demands of exercise.

Massage also seems to help cells recover by boosting amounts of another protein called PGC-1alpha, which spurs production of new mitochondria — tiny organelles inside cells that are crucial for muscle energy generation and adaptation to endurance exercise.

“The bottom line is that there appears to be a suppression of pathways in inflammation and an increase in mitochondrial biogenesis,” helping the muscle adapt to the demands of increased exercise, said the senior author, Dr. Mark A. Tarnopolsky.

3. Massage aids in avoiding abdominal fat storage.

Cortisol directly effects fat storage and weight gain in stressed individuals. Prolonged stress can lead to enhanced lipogenesis (fat creation), visceral obesity (deep abdominal obesity), breakdown of tissues, and suppression of the immune system according to Christine A. Maglione-Garves, Len Kravitz, Ph.D., and Suzanne Schneider, Ph.D. from the University of New Mexico. In reducing cortisol, massage is a powerful tool for keeping your body healthy and avoiding fat storage due to the stress response. It is certainly not a replacement for proper nutrition and exercise but will help you be successful with a great health plan in place.

4. Massage boosts recovery of muscle tissue.  

In another recent study, researchers put 11 young, healthy men through a strenuous workout and took muscle biopsies of both legs—before and after exercise, and after 10 minutes of Swedish-style massage. The brief massage affected two specific genes in the muscle cells. The first gene decreases inflammation caused by exercise, similar to the relief anti-inflammatory medications. The second gene turned up production of mitochondria in the muscles, which are the energy producers of cells. Mitochondria use oxygen and other nutrients to generate energy needed by the cells. As muscle cells become adapted to endurance exercise, the number of mitochondria increases. Massage seems to help this process along. Ice baths and anti-inflammatory medications can reduce inflammation, however, studies show these methods tend to block muscle repair and growth; whereas massage, appears to not only make you feel better, but also reduces muscle recovery time.

5. Get better sleep. 

Sleep is of utmost importance for recovery. Fluctuations in several types of brain waves either stimulate sleep or tell you to wake up. Massage increases delta waves — those linked with deep sleep — according to a study at the Touch Research Institute. That’s why it’s common for clients to drift off on the massage table. Massage is especially beneficial in treating sleeping problems that stem from stress, migraine headache, pain, and muscle and joint stiffness.

6. Massage decreases pain.

Touch Research Institute (TRI) at the University of Miami School of Medicine has found massage may boost immunity and seems to help soothe pain from arthritis. Massage creates chemical changes that reduce pain and stress throughout the body. One way it does this is by reducing a brain chemical called substance P that is related to pain. In a TRI study, individuals with a form of muscle pain called fibromyalgia showed less substance P in their saliva, and they reported reduced pain, after a month of twice-weekly massages.

7. Massage may boost immunity.

Several studies have measured the stress hormone called cortisol in subjects before and after massage sessions, and found dramatic decreases. Cortisol, produced when stressed, kills cells important for immunity, so when massage reduces your stress levels and by lowering cortisol in your body, it may help you avoid getting a cold or another illness while under stress.

8. Massage reduces blood pressure.

Massage reduces hypertension, suggests a good deal of research. High blood pressure patients demonstrate lower diastolic blood pressure (measures the pressure in the arteries between beats), anxiety, and stress hormones. This may be because it stimulates pressure receptors that prompt action from the Vagus nerve, which regulates blood pressure, as well as other functions.

Reduce Stress and Expense

Experts estimate that upwards of ninety percent of disease is stress related. And perhaps nothing ages us faster, internally and externally, than high stress. Although we can never truly avoid stress, massage can help manage stress while helping you make faster gains in your fitness regimen.

Just like a good exercise program, regularly scheduled massages can play a huge part in how healthy you’ll be and how youthful you’ll remain with each passing year. Remember, just because massage feels like a pampering treat doesn’t mean it is any less therapeutic and you can save money by using tax-free funds. If you have a Flexible Spending Account (FSA) or Healthcare Savings Account (HSA), massage therapy can be a qualified medical expense, as long as a physician recommends it with a written prescription. Consider massage appointments a necessary component of your health and wellness plan.

In my practice, I see many chronic conditions from the wear and tear of bad body mechanics. The trinity of resistance training, mobility work and massage is a powerful combination to bring people back to health.

Pull your weight

A female gym member asked how I learned to do dead hang pull ups. She has trouble getting through the first 1/3 of the pull. This makes sense because most people have trouble with shoulder stability and the rotator cuff muscles.

For me, and I think many starting out, it’s about learning how to recruit your full body to stay stable. At first we think we are supposed to just pull with our arms. Just like it says in the name right?

To strengthen shoulder stability, start out by just hanging from the bar while protracting and retracting your scapulae (basically shrug your shoulders and pinch them back together). This should help with initiating the pull.

Also work on strengthening the lats for the pull: Bent over rows, ring rows

And practice using the glutes and abs to keep the body tight as if you are in a plank.

Breaking Muscle does an excellent job of outlining how to progress to pull ups.

Daily Grind

We know repetitive habits and schedules make up our day. We eat roughly three square meals a day. We wash dishes and do laundry because it always needs to be done. Yet we forget that we need to keep up with body maintenance and recovery.

Frequency is key for keeping all your parts well functioning. Think of your foam rolling and stretching and movement like cleaning your house or eating your meals. It’s a daily practice. It’s a daily requirement.

Getting bodywork (massage, chiropractic) is important but it will not last without daily self-care.

It seems like too much work until you realize it’s just like anything else you do on a daily basis to keep you going through life. Sure you can let it slide for a bit, but what happens when you don’t take out the trash for a week or three months? What happens when you don’t take care of your recovery and exercise for a day or three months or three years? The trash builds up until it can no longer be contained.

Hello world!

Working with clients on the table and in the gym has lead to many new insights. My goal is to share them here and add to the ever present discussion on optimal health.