Jill Murphy, DPT, LAT, CSCS
Part of our Build A Better Body Series
We are back this month working on improving our body strength and stability, and we have finally made our way to the top of the body. How do we stabilize our nearly twenty pound heads using just the tiny muscles in our neck? It’s a great question that’s not addressed very often in gyms and weight rooms. My bet is that not a lot of people include neck stabilization exercises in their work-out routine, but I hope this article will help you re-consider.
Similar to one of our earlier articles on the abdominals, if you google “neck strengthening,” you will get some very crazy ideas of how you should strengthen your neck (see the picture to the right for just one of many interesting ideas). Now before you run out to buy one of these contraptions that allow you to hang a plate or dumbbell from your head, there are important things you should know. If you consult the research, it isn’t as important to strengthen the neck as it is to stabilize the neck. For people who suffer from neck pain, tension headaches, shoulder pain, scapular pain, TMJ dysfunction, and even migraines, or just those of us who spend hours in front of a computer or texting each day, exercises for neck stabilization should be incorporated into any work-out routine intended to make you stronger and/or to treat and prevent your pain.
The neck contains many large and well-known muscles that tend to be problematic. While helping to do something they were never intended to do, these muscles become overworked, tight, and eventually become painful over time. The scalenes, upper traps, levators, and sternocleidomastoids (SCM’s) were never intended to be utilized as neck stabilizers. However, since most of us have a very under-developed and under-recruited group of neck muscles called the deep anterior neck flexors that are supposed to do the stabilizing, our other neck muscles are just doing what they have to do to keep your head on your shoulders.
For example, the upper trap muscle gets a bad rap, because many of us use this muscle to assist us in lifting our arms overhead. However, over time this muscle is over-worked from lifting our arms, as well as being over-stretched by chronically poor forward head posture, resulting in pain, tension, and even tension headaches that feel like a sword through the eye. The scalenes and SCM’s are muscles that many people use to assist in breathing, but these muscles are only intended for breathing under duress or extreme exercise, when it is hard to catch your breath. Over-utilizing these muscles for every breath contributes to muscle tension that pulls your neck into forward head posture, neck pain and loss of motion, and perhaps tension headaches in your temple (scalenes) or your forehead, jaw, or sternum (SCM). Due to its attachment on the posterior first rib, excess tension in the scalene muscle group can reduce the space the brachial plexus has to travel between this muscle and the first rib and clavicle, causing numbness and tingling in the arm, hand, and/or fingers due to nerve root compression (otherwise known as thoracic outlet syndrome or TOS). The levator scapulae, in combination with other nearby muscles, elevates and rotates the scapula (shoulder blade) to assist in lifting your arm overhead. This sounds like a good thing, but when we over-use this muscle to stabilize our neck along with upper trap and SCM, we end up with the same result of neck pain, tension headaches, and even scapular or mid back pain.
What can prevent all of this over-compensation around our neck and shoulders? Your deep anterior neck flexors are just waiting to be called into action! This group of muscles consists of the longus capitus, longus colli, rectus capitus anterior, and rectus capitus lateralis. The first two muscles, longus capitus and longus colli are located in front of the vertebral bodies of the neck and attach to nearly every level of the cervical spine. Situated in the upper cervical spine, rectus capitus anterior and lateralis are two distinct muscles located behind the longus capitus and lateralis. Don’t let their small size fool you. These deep anterior neck flexor muscles have the critical job of stabilizing the neck and counter-acting the pull of the muscles in the back of the neck, preventing forward head posture, whiplash-type injuries, and postural strain and fatigue.
Whether due to disuse, poor posture habits, or lack of extended periods of crawling as infants, the majority of us demonstrate poor activation of these muscles, even with cuing. The results of this poor activation are displayed all around us and take little imagination to recognize. Have you seen your teenager texting? Or playing video games? How about typing on a laptop while sitting on the couch with your laptop on your lap?
With poor activation, these muscles have little chance of being strong enough to stabilize our head and neck position against gravity all day long. So this month we have some beginning exercises to activate the deep anterior neck flexors and a few progressions to keep you challenged. With these exercises, less is more; if you move too far or too fast, or move on to the progressions too soon, your exercises will backfire, and instead you will further over-work and irritate the compensating muscles of your neck.
Chin Tuck: Deep Anterior Neck Flexor Activation
Position: Lay on your back with your knees bent, with a pillow under the head (recommended if you have a rounded back and need a pillow for your head to rest in neutral).
Directions:
1) Tuck your chin down, lengthening the muscles that connect your head to your neck, but only the distance of the lead of a sharpened pencil.
2) Move slowly down and up, taking one second to tuck your chin, and then another second to bring it back up to the start position.
3) Repeat 20x, 2x/day.
Hint: This is a very small movement. Most people move too far, tucking their chin way too far down toward the chest; however, this will just activate the large neck compensating muscles, which defeats the purpose of this exercise!
Deep Anterior Neck Flexor Isometric Strengthening
Position: Lay on your back with your knees bent, with a pillow under the head (recommended if you have a rounded back and need a pillow for your head to rest in neutral).
Directions:
1) Tuck your chin.
2) Move your head upward as if you are lifting it straight up off the surface, and use one hand to resist this movement, so little to no actual movement occurs.
3) Hold for 3-5 seconds. Repeat10-15x, 1-2x/day.
Hint: Make sure your chin and your forehead are lifted at the same height; do not lead the upward motion with either your chin or your forehead (don’t tilt your head up or down).
Head Lift: Anterior Neck Flexor Strengthening
Position: Lay on your back with your knees bent, with a pillow under the head (recommended if you have a rounded back and need a pillow for your head to rest in neutral).
Directions:
1) Tuck your chin.
2) Move your head upward as if you are lifting it straight up off the surface the distance of 1-2 inches.
3) Start this exercise by just raising and lowering the head slowly, with no hold. Once you have mastered this exercise, progress to holding the head lifted position for 3-5 seconds.
4) Repeat 10-15x, 1-2x/day.
Hint: Make sure your chin and your forehead are lifted at the same height; do not lead the upward motion with either your chin or your forehead (don’t tilt your head up or down).
Read the Entire Build A Better Body Series
Part I Hips: Laying the Foundation
Part II: Myth Busting Abs
Part III: Stabilizing the Scapula: The Secret to Strong Shoulders
Part IV: Strengthening Stabilizing the Neck
Part V: The Big Picture
Part VI: Have a Ball
Part VII: Advanced Exercise Ball Routine
You can now Build A Better Body at MotionWorks by joining one of our Build A Better Body fitness classes!