Resolving Pain - Part 3: Neck pain

For the third part in our Resolving Pain series, we look at the neck and structures that influence its ergonomics and function. 

The neck is as complicated as the low back (highlighted in our last post) due to its reciprocal relationship with the upper extremities.

Nowadays, bench press and pec lifts are at an all time high. As lifting posture and habitus (body type) are effected, individuals start to demonstrate “bro shoulders.” This term refers to over dominate pec musculature and try to compensate by lifting back with their shoulders. The more technical term is upper cross syndrome.

Posture is the key to fixing this issue during certain lifts but also in everyday activities.

So what is upper cross syndrome?

Upper cross.jpg

In short, it is the chronic over activation of the pec musculature on the anterior (front) side and the suboccipital, trap and levator scapulae musculature on the posterior (back) side. Rhomboids and cervical neck flexors get stretch weakened, in turn becoming inactive. Because of this the tight, over active muscles pull your neck and shoulders forward. 

This can be caused by poor posture and also lifting ergonomics. Lets look at some movement/postural issues and how to correct them.

First lets look at sitting.

This demonstrates the propensity to “slouch.” Most of us spend several hours sitting and a majority of the time is spent in front of a computer screen. The shoulders round while the mid to low back compresses into flexion which in turn causes neck extension and protrusion. The best way to reduce this is to practice a relief position. Here is a link to homecare instructions for Brueggers relief position.

Now let's look at exercises and their postural components.

The push up is an exercise that requires specific scapular positioning. In order to preform a proper push up, scapular protraction/retraction are as important as the muscular effects the exercise itself can have on the pecs or triceps. The scapulae should be depressed against the rib cage to provide the most stability during the push up. At this point, protract at the scapulae to push up and then retract as you descend to the ground. Spinal alignment is also key as a too rounded back or flexed neck can lead to (or be due to) upper cross biases.

Now let's get into some lifts!

The overhead press is part of most routines and many coaches give physical cues for proper form. However, misconceptions have caused significant issues with said form. A common example is the head “through the window” cue. If done in concert with the shoulder girdle the cue can be helpful, but if taken literally the form is terrible and can lead to pain or more serious issues. Below is an example of the form taken too literally.

The dramatic neck movement without scapular activity compounds upper cross postural issues as you protrude forward.

If you perform the overhead press with proper scapulae movement it will allow you to put your neck into place without repositioning. Scapular upward rotation is necessary to press the bar overhead, and depression and retraction will complete the movement properly with the neck naturally moving into place.

The final lift we’ll look at is the shrug. If this isn’t clear yet, the neck is heavily affected by scapular motion. The shrug is the most misunderstood exercise. It is not a trap/levator lift where shoulder elevation is the goal. This concept plays into the upper cross syndrome, especially if neck movement is paired with the elevation.

The shrug should be a shoulder girdle movement,  so elevation WITH retraction must be the main plane of movement. 

To conclude, upper cross syndrome is an issue created by poor shoulder and neck posture and ergonomics. By correcting the posture of the neck along with good scapular movement you will achieve better posture, cleaner movements and better performance in the gym.

If you are suffering from unresolved neck pain, please contact us for an appointment.