What’s wrong with my neck?
Neck pain is common.
Most of us experience neck pain and tension from time to time. If we stop to think about it for just a moment we’ll often recognise that we get it when we’re tired, we’re stressed or we’ve done a little more lifting or carrying than usual. None of these things involve trauma and for the most part, none of these things involve any actual tissue damage or injury.
On the other hand, traumatic neck injuries such as whiplash type injuries caused by bingles, bike accidents and footy bumps are also reasonably common. But if you fall into this category you’re probably not asking ‘what’s wrong with my neck,’ you already know.
Regardless of the cause, some of us will go on to experience recurrent episodes of neck pain or pain that persists for an extended period of time. We don’t always know why this is. Pain is a complex and unwieldy beast. We can often help you work out what the triggers are for your pain episodes or what sorts of things might be maintaining a persistent pain state. There will often be some form of mechanical or activity based trigger which, if identified properly can be addressed.
In assessing for mechanical contributors to pain anywhere in the body we often start with a basic assessment of how well you’re able to control your own body weight.
In the neck this often means assessing the deep flexor muscle function, for no other reason than they are commonly deconditioned and poorly functioning. This is in part due to our sedentary, desk bound and device driven lifestyle but is also a well established consequence of whiplash trauma. Poor function here means other muscle groups are left to pick up the slack, and while they may be capable of doing this when conditions are just right, they can begin to struggle when we are over-tired, under-slept or when we ask them to do more lifting or carrying than they are conditioned for.
The first assessment in this video shows Paul activating this muscle group in a forward facing position and then with a slight rotation or bias to each side. This helps us determine how easily the muscles are recruited on each side in a very low load scenario. We then repeat this but take away his head support to see how effectively and efficiently he can control the weight of his own head.
When the deep postural muscles in the neck are unable to do their job well under low load conditions, it’s likely they will be regularly reaching their failure point in your day to day activities. When our conditioning and functional capacity are not adequate for the demands of our daily activities, we start to see people using high load strategies for low load tasks. High load movement strategies are things like gripping, grunting, bracing and breath holding – while this is appropriate when shifting a fridge, it’s far from ideal for tasks like getting out of bed or up from a chair.
At MOH we will always consider the condition of the back, shoulders and arms when assessing neck pain and tension. Inadequate functional capacity here can mean neck muscles are recruited for low load activities like lifting the arms overhead or even typing. Again, this can be a useful pattern in a high load activities like putting a heavy box on the top shelf, but not so much for typing or holding a pen.
The second assessment in this video looks precisely at this. Here, I am looking at how able the shoulders and thoracic spine are to move and control a low load in various positions, without unduly stressing the neck or over-recruiting the neck muscles. Of course when it comes to clinical assessment it really is horses for courses, this last assessment is clearly useful for someone who lifts weights, needs to mark a footy or does other work overhead but I wouldn’t do it for someone who plays cricket. And that’s how musculoskeletal health care should be, different for every individual.
A visit to one of our friendly osteopaths will provide a completely individualised assessment and treatment plan, and expert advice on ways you can help strengthen and support your body to do what you need it to.
For more information or to find out how we can help you recover from neck pain call us on 03 8370 3044.
Want to know more?
You can learn more about the MOH approach to neck pain and improving neck function by checking out blogs in the MOH Neck series;
- Osteopathic treatment of Neck Pain
- Mobility exercises for Neck Pain
- Clinical Pilates for Neck Pain
- Building Neck Strength
- Myotherapy for Neck Pain
For more information, ideas and exercises check out our Health Tips blog.