 I'm your host, Christine Linders, physical therapist and board certified orthopedic clinical specialist. Do you have neck pain or limited mobility? Are you contemplating neck surgery, but wonder if there's something you can do to prevent it? In this episode, you will learn the common culprits leading you to neck pain that you don't even realize you're doing on a daily basis. You will also learn simple tips to correct your posture and restore normal neck mobility, in addition to stretches and exercises to immediately decrease pain and improve the function in your neck. Neck pain often results as poor posture or poor positioning throughout your day. How you hold your head and your neck and even your upper back while you're looking at your phone, watching TV, reading, working on your computer or laptop, tending to your kids, gardening in your yard, they all contribute to whether or not you get neck pain in the future. So this is such an important topic and I was inspired to do this show because last Monday I got two text messages, one for my friends in Indiana and one for my friend in Connecticut, both asking me what to do with their necks. Both of them had, excuse me, C-456, which is the middle section of your neck compression, one causing nerve pain, a weakness in the arm and the other one having some other symptoms leading them to get x-rays and MRIs. And I thought, let me do a show on this because right now it's been seven, eight, nine months since this pandemic has been around us and in our lives every single day and people are more stressed, people are working from home, people are in altered postures that you're not used to being in or if you're not working because of the pandemic, you're doing more yard work or organizing in your home. So today I wanted to talk about the things that you could be doing that can be leading you to neck pain even without an injury. So let's go to video number one. Decided to go to Lanakai Beach this morning to show you why you have neck problems. So when you have poor posture, let me show you this side. When you have poor posture and you're sitting like this and your neck is a little bit forward of your shoulders, the back parts get more compressed and the front muscles get more stretched out. So you really need to work on getting your posture up so that you can open up the nerve roots and space around that. That's just a little touch on the biomechanics of neck pain. If you have poor posture, it pushes your head forward and you get more compression in that middle cervical region, the middle neck region. So let's go to video number two. Let's talk a little bit about the biomechanics behind poor posture and why it causes you to have neck pain, pain down your arm, all kinds of injuries to the back of the neck if you've never had an injury and you're wondering why do I need that cervical fusion all of a sudden? Why do I have this arm pain? Why can't I turn my head to be traffic anymore? And the reason is this, and it happens as we age. If you are sitting up properly, your ear will align right over the center axis of your shoulder and you will have a backwards curve to your neck. I'm not perfect, I've had two bad car accidents but I have been a work in progress over the last 20 years with myself and restoring my curve. But if you hunch like this, you can see how this curve becomes more accentuated and my ear goes forward of my shoulder. So up here, ear over shoulder, neck curve nice. Here, hunching, you can see what it does to my neck and the problem with that is you get compression around the canals where the nerves come in your neck when you're here or when you're looking up like this or as you'll see in the picture of me playing beach volleyball, looking up like this. All those nerves have less space when your head is in that position. So if you're doing a lot of bending or gardening during the day and you're like this, doing things, you have to think long neck. Tuck your chin and then use your eyes to look up. Think long neck, open up those canals, save those nerves from giving you pain down your arm, save those muscles from spasming because the nerves are getting irritated and sending messages to the brain to fire muscles to guard. So what I want everyone to do and this is your challenge is to focus on better posture. And a great way to do that is just to squeeze your shoulder blades back. So I just have my hands here, squeeze your shoulder blades back, squeeze your shoulder blades back. You can also rotate your arms out like this, squeezing your shoulder blades, squeezing your shoulder blades. It looks like this from the front. You wanna focus a little bit more on posture. You can set reminders on your phone. You can set reminders everywhere, but that's what you're trying to achieve is getting your head back over the rest of your spine to save your neck. That's such an important point to really understand as you go throughout your day, whether you're bending over to look into the oven, whether you're cleaning up the floor, taking out the trash, all these activities that you do where you could be looking up or bending down like this, create compression there. And so if you don't have neck pain, that's great. But if you're suffering from nerve compression down your arm or very painful aching spots in your neck, you wanna pay attention to those things during your day that you don't even realize that are contributing to your pain. Sleeping is also something I get asked about quite frequently. And what if you don't sleep on your back? What if you sleep on your side? What kind of pillow do you use? What happens when you sleep on your stomach? So sleeping on your back is optimal for many reasons. It keeps your spine in optimal alignment. You wanna use a pillow that is small or large enough just to support that natural curve in your neck. So you don't wanna have two pillows that push your head forward and you don't wanna have a small enough pillow. Let's say you're an older person and you've been very hunched and your head is very far forward of your shoulders. You wanna have enough pillow so that your head's not kinked up like this, that it supports the curve in your neck so you're not strained or in poor alignment all night long. The same goes for if you're a side sleeper, I have pretty broad shoulders. So one pillow for me on my side doesn't work because my head will be tilted like this all night long. So I have to fold it in half so it supports this so my neck and my face stay in alignment while I'm on my side. Also, if you're a stomach sleeper, stomach sleeping is troublesome for the neck because it takes your neck and it cranks it usually one way all night long. And so if you are a stomach sleeper and you cannot transition off your stomach onto your side or on your back, you will need to put a pillow from your chest down through your stomach and it will lift your body a little bit so that when your head is turned, it won't be so twisted while you sleep. And that will help take some of the compression off your neck. So let's go to the image three where it's a picture of me getting ready to play beach volleyball. Now this was up at Saturday and my friend was taking some pictures I didn't even realize then when I saw it, I said, this is perfect because if you can see my head is completely almost resting on my back and that's a huge amount of cervical extension. So I have healed my neck over the last couple decades but right here, that's pretty amazing that I can actually be looking up like this and not have any pain because now I've restored a lot of the dysfunction in my neck and so I can do that now. And I'm only doing it long enough for my partner to serve the volleyball. So I'm in that position so the other team can see because I'm up at the net blocking and why I wanna show you that also is because after playing and having to look up to pass the ball, look up to hit the ball, look up to set the ball, everything that I do, I need to do some exercises to undo the positions that I was in similar to you all needing to do exercises after you garden, after you spend time on your computer, after looking down, nursing a new baby, anything that you have to do, we need to work the opposite muscle so that we don't get repetitive strain over time. So I have a question, what do you think of using home traction on your neck and how often should I do neck exercises? So home traction over the course of my career has been successful, especially if somebody has nerve irritation or they've been in a bad posture. It's supposed to help open up the space around the nerve roots and I have a video coming up where I'll show you what that space looks like, but also even if it didn't do that, it helps to elongate and lengthen the muscles that have short end abnormally because you've had your neck in that kind of a forward head posture where it's like kinked like this. So when the home cervical traction does what say a physical therapist would do while they're stretching out all your neck muscles and loosening up all of these muscles that connect your shoulders and the base of your thoracic spine up to your neck. So how often should you do neck exercises? That varies for everyone. If you're ever in a altered posture like I was playing volleyball, you wanna do them right after you're done. If you have pain in your neck, you wanna do your exercises then to get yourself out of pain to help restore normalcy. So let's go to video number four where we look at the skeleton and learn more about the anatomy. Here's your neck. It's not a very good picture because it almost looks like it's rounded here, but what you can see is the nerves passing through these canals right here. And you can see the joints on the back of the neck right here. That's this one and this one and this one and this one. So when you look up towards the ceiling or when you're slouched forward with your head up and your chin up, these joints slide down and these canals get more narrower. And as we age, even in the third decade of life in our 30s, little bone spurs and osteophytes form in here. So it crowds these nerves as they exit and go down your arm. You can see them, I think, from the back. No, maybe you can't. Oh yeah, there's one. It's popping out from the side and it goes in down your arm and feeds all the muscles in your back. So those canals where the nerves come out get more narrow and then you start getting pinches and nerve symptoms here. They aren't right here, are they coming out? So that's why it's so important to have good posture so you don't increase your chances of getting nerve injury or pain or damaged nerve from how you sit or from kinking your neck that way. I hope that helps to give you a better understanding of what's going on in your neck if you have held yourself in an abnormal posture. And I also hope that I've called your attention to some of the positions that you might be in during your day that you have no idea could be harming your neck or contributing to the pain that you have. I had a question earlier in the week about what the best treatment was for a bulging disc at the C6-7 level, which is the last two vertebrae in your neck before it starts your thoracic spine, which is kind of that upper middle back area. And one of the things that's important to do if you do have a bulging disc is immediately try to restore normal posture. You can stand against a wall and squeeze your shoulder blades against the wall and try to get your head to touch the wall. But you just wanna make sure you don't lift your chin up to get your head back, because then as I showed you in the video, when you look up or bend back or slouch forward, those canals, they get narrower when you do that position. So that's one way that you can help to restore that posture. And I'll show some more exercises too. So it's important to decompress your neck if you're having a bulge. It's important to avoid aggravating positions and it's important to stabilize the front muscles and stretch the rear muscles so that you can have your head and neck back over your shoulders. So let's go to video number five where we learn a few neck stretches. So if you notice that you maybe can't turn your head to the left as far as you can turn your head to the right, it could be because you're starting to get some arthritis or overlap or some osteophytes or bone spurs in that and those neck joints, which happens in our 30s, by the way. So if you're sitting like this, you're just contributing to the problem. In order to gain range of motion so you can turn and view traffic, turn to look right and left equally, you wanna make sure you get your posture upright. Let those joints slide like they were designed to do. And then once you're up properly, you can stretch your neck. I like to put my hand in the base of my neck and pull up towards the top of my head and over to stretch. Up and over to stretch. Also now it's like ear to shoulder stretch. You can look down at your armpit and stretch that nice muscle in the back. Look down to your armpit, then you come up again, pull your neck up towards the top of your head to eat a long gait. Bring it over. Now I'm in good posture. I'm not cranking my head forward. I'm pulling up and then over to stretch that I'm gonna look at my armpit. Stretch this nice back muscle here. Then you can do the stabilization exercises to make sure you have a better feeling neck. Those are just some simple stretches that have saved my neck over the years while I am working on patience. And when I'm working on patience and I'm sitting down, I have great posture. And a lot of times my patients will comment on my posture and I let them know that when I was 19, I think I had a terrible car accident. I got T bone from the side. The guy didn't see the red light plowed into my dad and I. I was driving and I got whiplash side to side. So I've always had, well, I'm better now, but I had many, many years of neck pain. And so I found when I was in college that if I sat up very straight, my neck hurt the least. And also stretching my neck like that and stretching my neck like that relieved a lot of the tension that was giving me neck pain. You can stretch too much. So I remember my brother saying to me one time, you stretch your neck all the time. What would happen if you didn't stretch it? And I thought, I don't know because I wasn't in PT school. Yeah, I was an actuary major and we would do math problems all day long. I said, I don't know, let me try. And I didn't stretch it for a while and my neck kind of got tight, but it actually helped me. And then later in PT school, of course I learned lots of things to do. So I think you don't wanna overstretch your neck. If your muscles are tight, which you'll find out if you see a physical therapist or if you're in bad posture, you'll need to stretch out the muscles to allow yourself to come into a better posture. But don't overstretch. We need to have a balance of stretching and exercise. That's my little tidbit for you. So let's go to video number six where we learn how to correct your posture to allow your neck to move into a better position. Stretching out on the foam roll is an excellent way to restore your posture and take tension off your neck, but also to improve your neck range of motion and decrease your shoulder plane. So if you lay on a round foam roll, this is a 36 incher. So you get your tailbone on the thing and your head on the thing like this. So you get your neck up here. You wanna make sure your shoulders are down like this. And then you put your arms out to the side like you're in the letter T, like this. So they're right at shoulder height. What happens when your posture is more rounded here is you may see like this. You might be like this and your shoulders are up. You wanna get a pillow on your neck so you can keep your face parallel to the floor. And then what you wanna do is you wanna lean a little to one side. I'm leaning towards the camera. My right shoulder is stretching out. Take three deep inhales and three deep exhales. So stretch out the pec muscle. You may feel it in your chest and a little bit in the front of the shoulder. It shouldn't be painful. Then after three breaths, then you lean and roll over to the other side. Let your head fall over to the other side. Take three deep inhales. Feel all this tension here. Three big inhales. And release all the tension. So one of the things that happens if you're one of those people that's kind of up like this is that your chest releases and then it allows your spine to come back into a more normal position. And then your neck into a more normal position. So once you release these, it's holding you like this. Then your spine can relax back and you no longer get the compression in your neck that can be causing herniated discs to give you pain down your arm that can be causing arthritis, congestion around the nerve roots, giving you pain and numbness and tailing down your arm. So it's so important to pay attention to your posture if you're one of those people that is having neck pain or arm pain or narrowing of the canals, causing nerve symptoms into your arms. You really need to get back, this middle part of your back into the proper position by releasing your chest. You can also do modified snow angels, which is from that T position up over. And I tell everybody long neck, nod your chin down, you might feel a little double chin there and do modified snow angels. So you're tucking your chin down, tracing. I do 10 of those. Then you bend your elbows, touch your thumbs or the backs of your hands and go up and down, squeezing your shoulder blades. You can also just go here, keep your ribs down, chin down, raise your arms up over your head. It's not this, it's here. Raise your arms up over your head to stretch out and also take a breath. Expand your rib cage, I'm not flaring it, I'm just expanding it and then come down. So I really hope that helps you and your neck get into a better position. It's helped me since my car accident 20 years ago. Aloha. If you don't have a foam roll, that's okay. You can roll a beach towel or a yoga mat. Just make sure that your head and your tailbone are firmly on the roll, firmly on the towels. You can use two towels, a big throw rug, something to get yourself into that extension so you can get your head back into alignment. So you can also stretch in the doorway to release your chest muscles. There's lots of other stretches I've shown in previous shows. I had a question two days ago about VR headsets, virtual reality headsets. One of my friends was doing boxing workouts on a virtual reality headset and was noticing neck strain afterward and wanted to know exercises to do, to kind of undo that strain when he was done working out or playing on the VR headset. And it reminded me of a show I did, I think in March or April with my two friends, Doug and Scott, we were talking about posture, the Hilo hunch, helicopter pilots having to fly in this position where they're hunched over and how do they avoid neck pain wearing night vision goggles and other things like that. And so now, actually I was talking to Doug last night and he said nowadays they have this counterbalance with the batteries in the back, so it balances, so it's not pulling your head forward where you have to use your neck extensors to off weight the weight in the front. And so with the VR headsets that don't have a counterbalance, it's important because your head's being pulled forward and you're exercising the muscles on the back so much to really do that stretch. I showed at the beach where you got your head and you're pulling it up and over, bringing your chin down to stretch out those muscles and the exercises that I'm gonna show right now in video number seven. Here are two of the simplest exercises to help you re-educate the muscles on the front of your neck that have stretched from having that forward head posture and to re-educate the muscles on the back that have been held in the shortened position continuing to help compress those nerves and those joints in the back of your neck. So you need a kind of a flattice squishy pillow, something soft and you will, I'm on the edge here just so that you can see. So you wanna lay on your back and the first one is called the chin tuck. So your face should be level. If you're like this, you might need another pillow here so that you can get a level face position. That's if you have really bad posture and your head's too far forward. I'm okay. So the first one is a chin tuck. So you just nod your chin down. You nod down and relax. It or it's a double chin exercise. You can also nod down, hold for a few seconds. The next one is called the tuck and squish or the chin tuck press. You tuck your chin that engages these front muscles, stretches the back, and then you gently squish the pillow. Now it engages the back muscles to help pull your head back between your shoulder blades. Tuck, squish, tuck, squish. It's a very small motion, tuck, squish. There should be no pain, no nerve pain, no arm pain. Just a tensing felt here and a stretch in the back. Enjoy. Those exercises are fantastic to get you going, to get these muscles working in the front and the back muscles to move your head back over your shoulders. Those are very simple. They're very easy. There should be no pain, just tensing and stretching. So go easy, start easy, do what you can. Also, you need to work the upper back muscles. So let's go to video number eight, where we show that. Aloha, I'm shooting on location at Waimea Bay, playing some volleyball here. And we are going to show you how to undo neck pain, shoulder pain, whether you've been playing ball, sitting at your desk, or looking down at your phone. So it's important if you've been looking forward or bending down to keep your neck long to do these exercises. You lift your chest and pull back and not this way. Lift your chest and pull back. I call this the eye. Then you're going to do a T. Same thing, squeeze your shoulder blades. Don't lift your chin. Keep your chin down. Long neck. Then you're going to do an X on an angle of an X. Again, long neck. Keep your chin down, but not bent forward. The other X. And then the last one, which is my favorite, is a W. Long neck. Pull back. There's one last one that you can do to really educate your neck, and that's to put the band behind your neck. Keep it flat. Make a little bit of a double chin, but don't tuck your chin down. Keep your head straight, push into the band, and then you rotate like this. So enjoy those. Those are my favorites. I have so many shows where I highlight those exact same exercises. And so the tips that I was saying, like long neck, is don't keep your head up like this. Long neck. Tips that I say to my patients, I said it yesterday as one man was leaving, was grow tall. He tends to be very forward like this, and I tell him grow tall, and all of a sudden he's up. Grow tall. Imagine like a string is pulling you up. I think it's so important for us to self monitor how we're holding our bodies during the day and have more awareness of that, because if you're shoulder, I mentioned that in that one little video, but number eight, and your back, but it will also help you to feel better and have less muscle tension and work, use your body more optimally. So I hope that is helpful for everyone to learn about your neck, the mechanics of your neck, so that you don't have to injure your neck. And if you do have neck pain and you're working with a doctor or a physical therapist to restore your posture or whether you're getting ready to have surgery, really pay attention to how you hold yourself now. Stretch out your chest muscle. Get yourself in better alignment. Start exercising those muscles. They're delicate. There should be no pain. Work on the upper back muscles to help support your head and neck. And enjoy. Thank you so much. Thank Tech Hawaii, our sponsors and donors for allowing us to be here with you today. And thank you for joining us. Aloha.