Neck and upper shoulder pain are very common and affect about 50-70% of people at some point in their lives. Neck pain can come from direct injury like a car wreck or other trauma, but 85% of the time it has a mechanical cause often due activities we do throughout the day, such as workstations, sleeping, watching tv, looking at our phones, workstation set ups, exercise performance and other general life activities.
The job of your neck may seem relatively simple. But when you think about it, your neck is carrying your head all day and night. Your head is heavier than you might think (about the weight of a bowling ball) and is balanced on top of your neck (imagine a bowling ball resting on top of a 6” stick).
Your body will compensate anyway, it needs to make sure that your head is safe, your vision is level and that you are able to get air in. These compensations can occur through changing your bite, locking your rib cage, forward head to open airway, anterior pelvic tilt for stability, twisting and torsion of the neck to keep vision upright and parallel, twisting in the throat, rolling or weight bearing more through one side or your body for balance, compression of the joints, over lengthening of ligaments, pelvic floor dysfunction, and hyperinflation/poor breathing patterns.
Below are some good tips for healthy shoulders and neck:
Breathe: Many of the muscles of your neck can be involved with breathing, especially forced inhalation (exercise, stress, smoking). Try this every hour: set your watch to remind yourself to pause and take 5 deep easy breaths. These breaths should have a slow and silent inhale and a full and long exhalation and then pause for 2-3 seconds before taking a deep relaxed quite inhalation again through your nose. Repeat 5 times.
Backpacks or Purses: Carry backpacks on both shoulders: Carrying a backpack on one shoulder causes your shoulders to become uneven and your neck to side bend. Share the load by wearing your backpack on both shoulders to keep your head and shoulders level by using both shoulder straps. If you have to carry a bag or backpack on one shoulder, carry it on the right to allow your left abdominals to work harder for balance.
Workstation Evaluation: Have your workstation evaluation by a PRI trained physical therapy: Your computer monitor should be set up so that you are looking at it at eye level. Your workstation should be set up so that things you use are reachable with both hands. Utilizing both hands, and not doing the same thing over and over with the same hand, keeps your body moving with variation and avoids strong postural habits. Make items you use often easier to reach sand things you use less often harder to reach. Have a comfortable chair. You should be able to sit all the way back in the chair with your knees slightly higher or at least level with your hips. Set an alarm to get up at least 1x/hour to move around your space. When you sit, avoid finding yourself leaning forward and sitting on the edge of your chair. Your head and neck should relax on top of your body and not advance toward the screen.
Phone at work: A lot of people use their necks to hold their phones to their ears – not a good idea. Try using either Bluetooth or to get a headset for your phone.
Vision: Have your eyes checked. Get an eyes exam. If they have the ability to test your vision while standing in a well-lit room, even better. If you are straining to see, you will often find that you try to move your head and neck forward to be able to see whatever you are looking at. This causes far more work for your neck by causing a forward head position stressing anterior neck muscles, joints, and cervical spine discs.
Pillows: Pillows for back sleepers and side sleepers: Pillows should fill in the gap between your head and the bed. If you are a side sleeper you will need a pillow to fill the gap between the outside of your shoulder and your ear, so that your neck stays aligned. Try to avoid sleeping on your belly, as this forces your neck to twist and extend. See the link below for a good pillow option.
Therapeutica (off PRI website)
Sleep number ultimate: three available “centers” to adjust the depth
PlushComfort™ PillowShop for Sleep Numbers
The Original Coop (removable foam for depth adjust)
The Original Crescent Coop Pillow (remove foam)
The Original
Made with premium cross-cut memory foam and microfiber, our pillow is fully adjustable, for back, side, and stomach sleepers. Experience pain-free, better sleep every night with our medium-firm pillow.
Bed Gear: Quiz to find size and firmness.
https://www.bear.com/shop/performance-pillows
Performance Pillows | Comfortable, Breathable & Cooling | BEDGEAR
Do not use your neck to lift your body when rising from a lying position: People often just wake up with neck pain one morning and wonder why? Many times, individuals use their necks to lift themselves up out of bed or to roll over in bed. This is not what your neck was designed to do. Let your neck relax, and rather roll your neck and trunk as a unit. If you need to, you can use your arms or legs to help you reach the direction you are going to roll.
Tongue position: Your tongue is the largest muscle in your head and neck. When you are not talking or eating, it should rest on the roof of your mouth just behind, but not touching your teeth. If your tongue is positioned correctly, it will have a positive influence allowing relaxation of the muscles in your neck, head and spine. Mouth Tape is a great way to keep the tongue properly positioned at night when we are not conscious of the tongue position.
MyoTape: I like the kids’ version of myotape as it has a bit more resistance
Somnifix: more aggressive hold
Azazar: good middle ground between Somnifix and Myotape
Use the headrest in your car and set up the mirrors so your head can relax: If your mirrors are positioned correctly, they will be a constant reminder to let your neck relax back against the headrest.
Do Intentional Breathing Activities to Help Decompress the Head and Neck: Try one or all of these activities to help with neck and shoulder pain.
90-90 Right Arm Reach as taught by Postural Restoration Institute:
Supine Hooking Bar Reach as taught by the Postural Restoration Institute:
Again, these are just a few ways you can work towards better neck and shoulder health. If you are looking for more insight in to neck and shoulder health please reach out to me for a consultation.
Please let me know if you have any questions or need help with your on/off/chronic neck discomfort and pain.
Paige, MPT, PT, PRC, PCES, CKTP