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Three things you think are helping your neck, but aren’t – Some controversial thoughts about the neck

The subtitle of this article is “controversial thoughts about the neck” because we’re about to contradict some of common sense wisdom about caring for the neck.

In fact, this information may contradict some information you’ve received from some really great providers who you know and trust. And the point isn’t to cause you to distrust this person. It’s just to take a look at healing from a different perspective.

If you’re someone who has struggled with chronic pain, especially neck pain, this information may be very, very helpful.

Related: This is why you shouldn’t do crunches- and what you should do instead

It’s time to stop making big neck circles

If you believe you should move your neck in all planes of motions just because you can, including big neck circles, you should probably stop.

If there was one motion that I could stop all my patients from every making, it would be the classic workout neck circle that we see in all kinds of popular media and workout videos. The head is made to rotate like a gyroscope, often with exaggerated flexion (nose toward belly) and extension (nose toward sky).

This is why this motion (and some others) can be a problem. (The video below is what not to do.)

The neck has more motion than other areas of the spine

The neck has far more intersegmental motion (total motion between segments) than other areas of the spine. The shape of the neck is unique with its special joint arrangement at the top of the spine (trochoid joint), and joints called uncinate joints near the body. These uncinate joints (also called uncovertebral) allow for movement called “translation,” which means that there is some side to side and forward-back slide of the neck vertebrae.

the neck has coupled motion

The neck has coupled motion. The whole neck moves as a unit, and moving in one direction, will cause motion in another plane of movement.

So it’s impossible to isolate one area of movement in your neck without creating another complimentary motion.

For example, imagine you’re driving down the highway and decide to look toward the lane toward your right. For the his rotation of your head to happen, upper neck segments rotate a lot, lower neck segments rotate a little, and the whole neck tends to curve toward the side of rotation with a little bit of translation.

As you near the end of the turn of your head, your eyes should stay level, and in order to do this, your third neck bone will often lilt up on the opposite side (left) while the skull drops in on the turning side (right.)

This coupled motion exists to be able to give the head as much motion as possible, which is absolutely necessary for a human infant to be born and for mom and baby to survive childbirth.

This freedom of movement also allows our major external senses (sight, hearing, taste, and smell) to perceive the environment in a fast, and efficient way, as well as allow us amazing hand-eye coordination that allows us for the tool-making ability that we have as humans.

But just because we have this kind of motion doesn’t mean we should explore this motion to its end ranges on a regular basis, especially if we have had a neck injury in the past.

neck motion is limited in its extremes by ligaments, which are often injured

And the reason is that that most motion in the spine is limited by ligaments. And ligaments have often been injured in the neck in those with chronic neck and head symptoms.

Big neck circles and deep side to side motion can stretch and stimulate ligaments that are either in recovery, or have been weakened by prior injury.

And many ligaments are loaded with pain receptors, especially the joint capsules of the zygapophyseal joints.

In addition to capsular ligaments (among other ligaments), the outer third of the intervertebral disc is full of pain receptors, and is often stressed in neck positions that are pushed to end range of motion.

As a chiropractor, I know several different orthopedic tests where the patient’s head/neck are placed into some of these big neck circle positions in order to stimulate a pain response!

It’s time to stop stretching your upper neck

If the neck hurts you should stretch it. That is the common wisdom of most neck practitioners and the instinct of a lot of people with chronic neck problems.

If neck pain largely coming from pain receptors of the large neck muscles (trapezius), it may be possible to stretch those muscles into some relief.

However, it is very difficult to actually stretch and small muscles of the neck (just below the head for example), or the smaller muscles of the neck/shoulder without moving the sensitive joints of the upper neck into an extreme range of motion. In these extremes we run into the problem just outlined in the above section.

There are safe ways to calm neck the neck muscles, that include a few, limited stretches of the neck, and a greater concentration on mobilizing the shoulders and upper back. Please see below.

It’s time to stop doing “chin tucks” (cervical retraction)

In response to neck pain, tech-neck, for forward head posture, there is plenty of advice by practitioners to do “chin-tucks.” Chin-tucks are accomplished by pulling the head back and temporarily making a double chin, and then releasing.

This exercise and stretch is meant to:

  • engage the muscles at the front of the neck,
  • stretch the muscles below the back of the skull,
  • and help the neck have proper ear-over-shoulder alignment.

Sometimes these exercises are called cervical retraction exercises, because they aren’t really a “tuck” of the chin.

(These can be confused with “chin-drops,” also called “chin-tucks,” which is a slight forward flexion of the head in order to initiate a neck reflex that will tend to create neck stability when lifting.)

Whatever you call them, many (perhaps most) people with neck and head symptoms often have a straight neck, with a flattened neck curve and shortened muscles of the front of the neck.

Engaging muscles in the front of the neck with neck retraction actually makes this straightened neck worse. It also closes down and potentially compresses the sensitive area at the front of the neck, and behind the jaw, where the internal jugular vein and vagus nerve leave the skull.

But what about stretching the muscles at the base of the skull? What about proper ear-over-shoulder alignment?

Neck extensions aren’t necessary for these either. The small muscles at the base of the skull are better released than stretched, and proper ear-over-shoulder alignment really begins with pelvic position and thoracic mobility than it does with neck.

Does this mean that there isn’t any reason to do this exercise ever? There may be some situations where “chin tucks” are helpful, but for most of the necks I work with, there are better options.

What to do instead of chin-tucks, neck circles, and upper neck stretches

So, does this mean we should avoid most neck motions, most neck stretches, and most neck exercises?

No, moving the neck is an absolutely necessity for proper neck health. It just means we need to do it smartly. Here are some ways to avoid creating problems.

  • Focus on slow movements with one plane of motion at a time.
  • Don’t grip the jaw or pull on the head for leverage.
  • Don’t side bend to the end range of motion.
  • Focus more on shoulder mobility and thoracic mobility.

Safely stretch the neck with these how-to videos

Current and past patients can access the following video sequence to help achieve the above.

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