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The Core Neck
The Core Neck: Did you know that you have core muscles in your neck and upper back?
All of the joints in our body have core stabilizing muscles. The research shows us that muscles around our joints perform different functions. Some are involved in creating movement, like rotating your neck, while others have a stabilizing role to maintain joint position. These core muscles stabilize the joints in a similar way to ligaments. Another term we use for this is muscle control. In the neck we have small core muscles that stabilize each vertebra, and in the upper back we have the muscles that act on the shoulder blades.
Treatment studies for neck pain show that strengthening of the core muscles in the neck and shoulder blades is effective for tension headaches, and also for acute and chronic neck pain. Sitting at desks actually deactivates these important stabilizing muscles, which is why we see so many clients with head forward posture. When the core shoulder blade muscles are not performing their function the neck muscles try to over compensate. When this has been going on for a while, we see rounded shoulders and a head forward posture. Not attractive!
When we sit for prolonged periods of time, certain muscles over-stretch and some become too tight. In the neck the long superficial muscles can become shortened and too active. This can then pull on the joints in the neck, causing joint compression and irritation. The core muscles become deactivated or just lazy, just the same way as they can with the abdominal muscles.
With prolonged sitting and computer work, the shoulder blades can become rounded, weakening the muscles of the upper back. This leads to round shoulders so that the long neck muscles become over-active. The neck muscles then try to stabilize the shoulder blades and arms, which they are not designed to do. This can cause a number of clinical scenarios such as nerve impingement, carpal tunnel symptoms, neck/shoulder pain, and stiff joints. We then lose mobility in the upper back, causing the neck to protrude further forward and a vicious circle of muscle imbalances.
Over-active muscles leads to pain, shortening of superficial muscles and inhibition of the core neck muscles.
Correcting this scenario requires careful programming of exercises with very little resistance. Adding too much weight will just recreate the wrong muscle patterns. I have found over the years of working with this condition that the Pilates method is ideal. The preciseness of the exercises together with the specialized equipment, allows us to wake-up the core muscles. The muscles that need targeting are the lower and middles trapezius, and the deep neck flexors. Once these muscles are working then the program can be progressed to increase strength and integrate different movement patterns. Studies have demonstrated that activating core stabilizers in the neck can reduce activity in the superficial muscles that can cause neck pain. There are also good studies that help us identify which patients will benefit from this approach, depending on their assessment findings. Sometimes joint and soft tissue mobilizations together with the stabilization approach are necessary.
Lesson learned: keep proper posture, sit straight, and take frequent breaks from sitting in one position for too long
About the Author
Damian Wyard trained is a Registered Physiotherapist and Stott Pilates Rehabilitation Instructor with 20 years experience in his field. He is the owner of Pilates4Physio in Toronto. You can reach him privately at firstname.lastname@example.org, or at his Pilates studio www.pilates4physio.ca www.facebook.com/pilates4physio