 and welcome to Movement Matters. I'm your host, Christine Linter's physical therapist or certified orthopedic clinical specialist. Today I'm gonna talk all about neck pain. And I wanna ask you, who of you has neck pain or suffers from maybe frequent headaches? Maybe you've had some type of whiplash car accident or you've been told that you have arthritis, degenerative discs in your neck or even nerve compression in the neck area that can be leading to you having pain or tingling down your arm. If this is you, has anyone ever explained to you why you have pain or what you can do to quickly alleviate your pain? Today I'm gonna show you why you have neck pain or headaches as well as teach you simple stretches and exercises you can do anywhere to relieve your pain. One of the biggest culprits that I see in the clinic is poor posture and it's all about the alignment in your neck. And so if you are sitting, hanging your head down or slouching like this with your ear in front of your shoulder, it can cause a lot of strain on the muscles here, back here, leading you to having neck pain, compression in the area where you can get pain down your arm, headaches that kind of go into what some of my patients call eye grain. So posture is one important reason why you could be having neck pain. In addition to whiplash, I've had two rear end car accidents where I had whiplash and it rearranged my spine. So I know all too well when an x-ray looks bad and you think, oh my gosh, how could I possibly get rid of my neck pain? How is this ever going to get better? Because what you see as far as the canals and the nerve compression or arthritis in the joint or disc herniations bulging and contacting nerves, all of those things I've seen in myself and my patients on x-rays and MRIs. And what I wanna tell you is there's good news just because you have something like that on your x-ray or on your MRI does not mean that you have to continue to be in pain. One of the favorite things I like to tell people because I've experienced to myself with the car accident is I know that you were kinda hunching before and you had that posture and I know that you were enjoying looking down all the time reading, but now that you've had a car accident that has strained your muscles, you can't do those things anymore because now they're becoming very painful for you. So you need to change your posture and get into the proper position so that you can get yourself out of pain. So how do you do that? Let's go to image number one, where I'd like to explain how one of my coworkers has just a little bit suboptimal posture. And you can see on the left, I took a picture of her sitting. You can see I drew some little lines where you could see her shoulders relatively straight up and down in the picture on the left and her neck has an angled forward approach. So if you again, look at her ear, it's not sitting straight over the central axis. That banding kind of gives us a good view where the central axis is on her shoulder and how her ear is pushed further forward. So just biomechanically, those muscles on the back of her neck have to kind of reach out and hold her head up and your head weighs anywhere from six to eight pounds. So if we go back to the photo and you look at the picture on the right, I asked her to correct her posture and I'll show you that in a minute. Her arm's a little bit more forward, that's okay. You can still see that central access point almost like the bandaid and then look up to her ear. And now her ear has moved back over her shoulder and there's more of a straighter line from that central access point of her shoulder up to her ear. Now in that position, your neck is in homeostasis. She sits at a desk and just through her neck out about a month ago, she was washing her hair or fixing her hair and she sneezed and she got like, oh my gosh, I can't move my neck. So we were working that for the show. So let's talk a little bit about headaches before I go into the posture correction and how you can fix your posture. Headaches are a real problem when you sit forward like I showed in that image because it pushes your neck forward and the muscles right up here get really short. Now they're tiny, they're about this long and they run kind of up from the first cervical vertebrae here up to the base of your head and they run from the first cervical vertebrae here down to your spine. And they also have these little ones that run like this from your first and second cervical vertebrae up and your first and second cervical vertebrae up to the head, which is like a bowl sitting on top of that first vertebrae. Why people can get headaches when they sit like that with their head a little bit forward is those muscles get held in a more shortened position but also there's so many nerves that pass underneath and through those little muscles going here and those little muscles going here. And so it's very easy for a nerve to get pinched inside the muscle and you to get eye grain headaches or this side headaches or the piercing pain right at the back of your neck. So let's go to image number two which I got from sciencetrack.com for the purpose of this video. And you can see all the yellow are all those nerves and there's those little teeny muscles that I was kind of showing you with my fingers. Those nerves run all the way through there and then you can see it traces all the way up to your head. That's what's giving people a lot of headaches and I tend to call them neck headaches or posture headaches, eye grains. And it's just because you've got your head in the wrong position, your head and neck giving you a headache. So let's talk a little bit more about let's talk a little bit more about some questions that I got from a viewer. How are my neck and headaches related? So I just kind of think I kind of answered that question pretty well for you is if you can have your head and neck here where this gets kinked, you'll start getting a pinching on the nerves in that area where the muscles can clamp on theirs and give you all sorts of headaches. So how do you fix that? I know that wasn't part of the question but how do you fix that? You correct your posture. So let's go to video three where we see how to correct your posture. Now correct your posture. So move your head, tuck your chin and lift your chest. Move your head back and now relax into your other posture. Okay, so move your head back between your shoulders. Yes. Go ahead, move your head. Yeah, there you go. Back, that's perfect. Okay, good. That's a very simple correction. And so if you're just sitting, you can see my ear here. If you're just sitting here, all you do is there's a couple of cues. You can lift your chest which can bring your chin and your head level because your body's gonna do whatever it is to keep your eyes level. So you lift your chest. If your head is very forward, you can bring your head back between your shoulders. So it's sitting more over the central access point of your shoulder. And you will notice a big difference that the trouble in the beginning is if you're not used to sitting in good posture, you need to find a way to remind yourself. And you can do that lots of different ways. You can use your cell phone, set the timer to go off every 15 to 20 minutes that acts as a posture reminder. So you hear the buzz and you're like, oh, that's right, I gotta sit up if you're working at your desk or like me looking down at a patient, you're like, oh, okay, I gotta get up, I gotta get up right. A lot of things that I do are just to kind of put my hands behind my head and squeeze my shoulder blades back like that. And that just corrects my posture. It reeducates the muscles in the back of my body to hold my bowling ball of a head up. So okay, so you've got that forward posture and you know it and you realize, geez, yeah, I look down at books, I've got a new baby, my neck hurts all the time, I've got headaches, you might have nerve compression down your arm or tingling from a car accident or some other sort of injury. What do you do? These exercises are so simple, you don't need a band or anything else. Let's go to video number four where we learned the first one. In this exercise, I call the chin tuck, many people to call the chin tuck, you lie on your back on a flat pillow or no pillow and you nod your chin down towards your chest. When you nod your chin down towards your chest, you get two things that happen at once. The first thing is you're re-educating the deep cervical flexors, which help to stabilize the vertebrae in your spine, each individual bone. So you're re-educating those. Now, if you stick your neck out like this, those get long and you wanna re-educate those so they can stabilize your spine, but also the second beautiful part of this exercise is when you tuck your chin down, you are elongating all the muscles on the back of your neck, all the muscles that maybe have gotten short because you've been sitting with a fuller head like that. So initially, while you're doing that exercise, some people will say, oh, wow, I feel a pulling on the back of my neck when I do it, it's really stretching. So you can use it as a stretch while you nod your chin down and you can use it as a strengthen where you're getting these muscles. So that's your beginner part. You can do it sitting in the car seat at a light, your head against the head rest, nod your chin down, especially if you wake up in the morning and your neck is stiff from sleeping on your side. I'll talk a little bit more about bed position in a minute, but let's go to video number four where we show the second part of the chin tuck exercise. This exercise I call the chin tuck press press for the chin tuck and squish. So what you need to do is, we'll see it in the next loop, you tuck and then you squish the pillow, nod your chin down toward your chest and then squish the pillow, good. Nod your chin down, oops, she lifted her neck a little bit like that, but chin down, squish the pillow. It's a very delicate exercise, chin down, squish the pillow. I suppose you could do it into your hands, chin down and push into your hands and resist. Chin down, push in your hands and resist. That's a great exercise that I have used to get rid of my headaches. When I have caught myself looking down and working on patience, I'm working on someone's low back where I have to have my head hanging forward for a duration of time. And the key with these exercises is that those two are best to do in the morning, let's say, when you can lay down or in the middle of the day if you're working at home, you can do them or in the car, like I was saying, I did so that you can elongate your neck and get ready for your day, but you can't always lie down. And so you need to have a few things that you can do sitting, standing. And that's where I came up with this one where you just nod your chin down and push back into your hands. Nod your chin down, elongate those posterior muscles, push into your hands and free your neck and head from pain. I have another question. My doctor says my neck shows degeneration and arthritis. How can these exercises help me if there's already damage? That's a great question. I hear that all the time in the clinic and for my friends actually can say yes, but the doctor said that there's compression in my spine. The doctor said that I've got arthritis. The doctor said MRI showed X. And the doctor is telling you everything that's wrong on the inside of your neck and that's what they see on the scans. But what's important to take away from that message is that you still need to fix your posture. You still need to get these muscles functioning better. You still need to elongate the muscles in the back. You still need to stretch those upper cervical muscles if you're having headaches. Like all of those things on your X-ray and MRI are true, but it doesn't mean you have to continue to have pain. And that's why a lot of doctors will send people to physical therapy or chiropractic or massage or acupuncture is to try to fix all the other aspects that are leading to your pain other than the internal damage or derangement that's in your spine. That's a great question. So let's go to video number six where we show a very simple, it does involve a band, very simple exercise that I used to get out of neck pain and headaches and my patients love it. This exercise, you need to get a band, a red or a green thera-band is excellent. You just hold the band so it stays flat so it's not balled up. You put your head right in that bump in the back of your head and you see her ears lining up right over her shoulder. So you just statically chin tuck, push back into the band and then you just move your arms forward and backwards. So you're getting a contraction of your deep cervical neck flexors as well as getting a contraction of all of the posterior postural muscles that help hold you up all day while you're at work. Cause sometimes your posture muscles are just weak from being forward and you actually just need to exercise them and then your neck doesn't hurt anymore. I know sometimes that seems counterintuitive to strengthen a muscle that's screaming out in pain but it actually is often the reason why it's in pain. So here's another variety. Let's go to video number seven to see the second part of that exercise. What you wanna do now is let's say you have pain turning your head to view traffic or you have pain to look over your shoulder because you hurt your neck or you had a car accident. That same exercise, the second part of it is just to hold the band static kind of in the V position and then turn your head gently left, gently right and then you exercise the rotators all those little muscles that are attaching from one vertebrae to the next so that you'll be able to turn your head again without pain. The neck is a very intricate part of the spine. It's the part that holds the head up. It allows for incredible amounts of range of motion turning your head left and right, tilting your head, tilting your head one way, looking the other way is so amazing. So all these little exercises are very simple. You see, you can do them in minutes and enjoy the benefits of a pain training. So now what about stretching? When I had my car accident in college, I remember one of the only things that helped me to be free from pain was stretching. I had the eye grains all the time and I wanna explain a little bit about an eye grain or those my grains that you get in one part of your eye. The most common reason for that is there's a muscle that runs from the top of your shoulder blade right here all the way up to the base of your head. And a lot of times people, it's the dominant side often. A lot of times people are using their, let's say their right arm, their mouse clicking, they're holding their phone and your elbow is not supported. Now that muscle is called the levator scapula. And the reason why it's called that is simple, it's its function. Is it elevates your shoulder blade? Another word for shoulder blade is scapula. So when you're constantly like this, that levator scapula touches from the base of your head to the top of your shoulder blade is held in a constant contraction. And so what it starts to do is it starts to pull your neck like this. And all those nerves that I showed you in the beginning get compressed in that area and you start getting that headache right in the front. So simple way to do it if you're at a desk is to support your elbow on the surface. Don't let your elbow be free. If you're on your phone, maybe you fold your arms, you'll see them up for a second. Maybe you fold your arms like this and use your phone so it's not hiking up like that. So you can rest your arm on something so you don't get that levator scapula headache, but also let's, this is my right arm. There's a stretch I wanna show you that I love and how I do it is I'll take my hand, put my hair up for this, I'll take my hand and I will run it up the back of my neck like I'm going up towards the ceiling that elongates my neck and then I pull over towards the opposite side. You'll get a nice stretch in here. It stretches out your upper trapezius from the front, you pull up and over. Now that gets your upper trap. If you keep your face facing forward, you'll feel a nice stretch right here. If you wanna feel the levator scapula, all you have to do in that position is look toward the armpit on the same side and then you get all of this right here, all of this and while you're pulling your hand up, that's giving you a nice stretch in this muscle to free yourself from pain. So let's go to video number eight where you can see a little bit more about that. Okay, so a great stretch to relieve that neck tension is to grab your hand and pull up toward the base of your skull and then pull your neck over towards the side of the hand that you're using. It really stretches out these two critical muscles that can be responsive for headaches and neck tension. My coworker Noelle reminded me that I'd given her that stretch a while ago and she said to me, I just need some stretches and exercise that I can do at the desk without a band. What can I do? And that was one of the ones that I use all the time for me to get rid of my neck tension. And I have to say it's been about 20 or so years since I've had my first car accident and my neck is better than it has ever been. Now I have gone through this huge process of learning on myself before I was a physical therapist and as I became a physical therapist and now now to develop different exercises that I've found to work and why they work. So I'm feeling great. I sleep on a flat pillow. That's another important thing is your pillow when you sleep is kind of critical to having a good neck in the morning and a pain-free neck in the morning. So one of the biggest problems that I see is people will lie in their bed with their head kind of propped up on many pillows and do some reading. And then you're kind of stressing your neck in that bent position like I showed in the first video except for you've got your weight and gravity pushing your neck forward. So that's not a great way to start before you go to sleep. But it's also important. You wanna have a soft pillow that keeps your head in line. If you're on your back, which is like the best position, you wanna have a pillow that supports this part of your neck and a little bit on your head, not a pillow that pushes your head and neck forward this way. You wanna have it nice. And if you have a flat pillow but you feel like you just don't have the support, one of the things that I did and all you need to do is take a sweatshirt or a T-shirt and squish it up and put it in this part of your neck to support the curve in your neck. That's a big one to getting pain-free when you sleep is supporting the curve of your neck, especially on your back. Now find your side because my have wide shoulders. So if I just have a flat pillow here and I'm on my side, my neck is gonna have to bend to get to the pillow. So what you wanna do is use enough pillow on your side that your head is not bending down towards the bed. And at the same time, don't use too many pillows that your head is now being pushed up that way. So that's another way to set yourself up for a good night sleep and a happy neck in the morning. Now, if you're a stomach sleeper, that's a little bit more of a challenging thing for the neck because your head's gonna have to be twisted either one way or twisted the other way. And people tend to twist it one way when they sleep just out of comfort and habit. If that's the case, what I instruct my patients to do is to put a pillow under your chest or on your stomach to protect your back but definitely under your chest because if you put one under your chest, it moves your chest a little bit above the bed so your head's not so cranked like this. It's a little bit of a delicate twist to the side. Now, as far as other exercise that you can do without any equipment or bands, let's go to video number nine to show you how to open your chest to free up the tension in the neck. So you're gonna stand in the doorway with your hands in the shape of a T position one foot in front of the other. You're gonna bend the front leg and use your back toe to push your body through the wall, lift your chest and inhale. And then come back. Push through the wall, lift your chest and inhale. And you stretch out all these tight pec muscles here and then come back. Same thing, push through the wall, lift your chest, inhale. And open up that chest to take the tension off your neck. If you have been a viewer of Movement Matters over the past two years, you have seen that exercise pop up many times in my shows and that is because it is so important to having a healthy shoulder, a healthy neck, a healthy back. And the reason why is your pec minor attaches this little bone right in here to your rib cage and everything that we do is in front of us. So we're using our arms in front of us to type, we're cooking, we're cleaning dishes, we're making our bed, we're changing our clothes, we're working on projects, we're writing, we're using our phones. And if you don't have optimal posture, that muscle gets short. And when it gets short, you kind of see what it does, it pulls you forward and it pulls you forward into a bad posture. So let's say you're trying to be really good and you're trying to get your neck up and you're trying to get your head up and you're trying to get in good posture, but you feel like it's like straining yourself. All you have to do is stretch out that little pec minor muscle, get in your doorway, put your hands wide, get one foot in front of the other, bend the front leg, lift your chest and inhale and take that pec minor and lengthen it to help pull your posture up, try that. If you try nothing else that I showed you today, try that, your neck will thank you. One hand on either side of the door, straight out, not bent this way. It's really important to have it straight out. You can go a little higher than shoulder height as well. Bend the front leg, push yourself through the door and inhale and lift, lift your chest to the ceiling and then release. Lift your chest to the ceiling and then release. You can also use the back foot and push up onto your toe on the back foot. Lift your chest up and release. Let's go to video number 10 to show another easy exercise you can do at your desk in your chair and your sofa forever. So an excellent exercise that you can do at your desk without any equipment is to clasp your hands behind your head, push your head back into your hands. It's kind of like a chin tuck. So push your head back towards your hands. There you go and then squeeze your elbows back. Good and then release. Push your head back, that's it. Squeeze your elbows back. Another one that you can do is push your head back into your hands, lift your chest and then reach one elbow up towards the ceiling. Good and breathe and stretch. Same thing, chin tuck, press your head back into your hands. Good to maintain that perfect posture and lean the other way and take a deep breath in. My favorite, I have been doing that for several years now. I think I came up with it when I was in Connecticut in New York and I was trying to find a way to get people at their desk to get out of that forward position to open up their chest, to get movement in their body since sitting still is so harmful to our bodies. Try it, it's very simple. Clasp your hands behind your head, push your head back a little bit, inhale. Stretch, squeeze your elbows back. You can also lean. You'll feel a nice stretch in your thorax in the middle of the trunk, especially if you have compression or back pain when you're sitting. And I have another question. I've had a car accident and my neck hasn't been the same since. I can vouch for that. Will these exercises help? Yes, I am an attestation to that. My car accident was when I was 20 years old and so it's been quite a amount of time since then and my neck, while it looks not so good on the MRI, next right, my neck feels good and I play beach volleyball and I swim and I surf and I modify things and I do my exercises every day as I drive to work. I do that chest stretch. So I suggest you do the same. So I'm gonna wrap this show up. I hope that helps everyone out there that has neck pain or headaches to relieve your pain and know that you can do something about it. And I hope you join me in two weeks. Thank you so much everybody for joining me. Thank you to Think Tech Hawaii and all our sponsors and donors. And as always, life is better when you listen to your physical therapist.