Do your upper shoulders and neck ache!?Many people develop muscle tension in the neck and shoulders from working at the computer for long periods of time. It almost seems like this posture is inevitable and gravity is dooming us all! Stiffness at the base of the neck is often due to a lack of mobility in the upper back or upper neck. When someone adopts a forward head position, several joints are placed in an inefficient position, which limits their full movement. DECREASED MOBILITY often = PAIN and STIFFNESS. Fortunately, there are solutions, but it does take time and awareness to break these habits.
‘Chicken Wings.’ In previous videos, I have mentioned that the region of the spine just below the neck becomes very stiff in people who spend hours typing, texting, etc… For example, imagine someone with their chin pressed forward looking intently at a computer. If this part of the spine remains stiff for years, it can sometimes develop into the ‘humpback posture’ seen later in life (many of my female clients ask me how to avoid this posture- this exercise can help!). Heafner Health Advice: Perform mobility exercises on the middle back EVERY day. Our societal and technological demands naturally place us in unnatural prolonged postures. When performing the shoulder chicken wings, use the pressure on your hands to help expand the upper chest. Press the back of your head into your hands throughout the motion. THIS IS AN EASY EXERCISE TO PERFORM AT YOUR DESK! Cow Pose with Neck Rotation Both flexion forward and extension backward are so important for the middle back. If these motions cannot occur, stress often translates to the neck, shoulders, or low back. THIS IS WHY MOST PEOPLE HAVE NECK OR LOW BACK PAIN & NOT MIDDLE BACK PAIN. Heafner Health Advice: When performing today’s exercise, move fully into the Cow pose first. Tension should be felt in the middle back as if a heavy weight is sitting between your shoulder blades. If stress is noted in the low back, draw in the abdominals. Be sure to keep your neck long (and not arched back). With the chin tucked, rotate your neck side to side. Upper rib mobilizations Heafner Health Advice: The upper ribs often become stiff and tight in people with neck tension. Grab a partner or simply use a barbell at the gym. Use the bar to open up the ribs and decrease tension across the shoulders. Thread the Needle I have recently treatment 3 people with neck pain that did not have a neck issue at all! All of their pain was rooting from stiffness in the upper and middle back. For example: have ever noticed that your neck feels stiff when looking over your shoulder? You are not alone. In order for you to look over your shoulder, the neck and middle back must work together! Heafner Health Advice: Thread the Needle targets extension and rotation of the middle back. A KEY COMPONENT THAT IS OFTEN MISSED make sure your eyes are following the thumb. This ensures that your neck is rotating! Also, don’t let you hips drop to the side at the ends of the movements. Quadruped T’s (a.k.a All 4's position) This exercise targets the middle back stabilizers while maintaining a tucked chin position. The T’s motion engages the middle portion of the Trapezius muscle, which helps hold the spine and shoulder blades in an upright posture. If the middle trap is weak, the head and neck often suffer! Heafner Health Advice: When starting out, place a small hand towel underneath the chin to avoid the forward head posture. This cue will open up the back of the neck and further isolate the mid trap muscles during the arm lift. We Treat Neck Pain in 2-3 visits!While neck pain is common from typing and texting, we see many cyclists, runners, and recreational athletes for neck and shoulder issues as well. If you are having neck tension, contact Heafner Health today for an evaluation!
1 Comment
Do you have pain in the front of your shoulder?
Why does it occur? 1) Stiffness in the middle back 2) Weakness of the back shoulder blade muscles- middle and lower trapezius 3) Weakness of the Serratus anterior (Google it!) 4) Poor resting posture of the shoulder How Can You Self-Treat Shoulder Pain?Mid Back Extension Over a Foam Roller To better understand shoulder mechanics, let’s do a quick test. First, slouch down and try to raise your arms overhead. Second, sit upright and raise your arms overhead again. Hopefully you had further range of motion while sitting up tall. Why? THE POSITION OF THE MIDDLE BACK DETERMINES HOW MUCH SHOULDER MOTION IS POSSIBLE! Since many people naturally rest in a rounded shoulder posture, the middle back is often slouched. Attempting to lift a weight from this position can place extra stress across the front of the shoulder. Do this exercise PRIOR to lifting to open the mid back. This will protect the shoulders DURING the workout! Dolphin Presses The shoulder blade muscles (in the back) are arguably the most important muscles for raising the arm overhead. One of these muscles is called the Serratus Anterior. It is known as the Boxer’s muscle because they often have strong Serratus muscles from the punching motion. I often refer to the Serratus Anterior as the glutes of the upper body. Both muscles provide stability to their respective areas of the body and are frequently under-utilized. Without this muscle, the shoulder blade tips forward and limits full arm movement. Dolphin presses are an advanced exercise that work the Serratus Anterior muscle in an overhead position Chin Nod with Shoulder Flexion Have you ever noticed how far your head presses forward when texting or working on the computer? The habits we develop while performing repetitive tasks transfer to our habits when we move. As the head moves forward, the shoulders naturally round forward and the middle back slouches. As we discussed in Day 1, THE POSITION OF THE MIDDLE BACK DETERMINES HOW MUCH SHOULDER MOTION IS POSSIBLE! This exercise keeps the chin tucked as the arms raise overhead. If you notice the head starting to jut forward (think of THE TURTLE COMING OUT OF THE SHELL), extra stress is placed across the neck. Keep the chin tucked against the foam roller as the arms lift. Rotator Cuff Warm-up with Dowel Warming up the rotator cuff should be a must for any adult. When you are younger, you can get away with jumping right into a sport or exercise; however, with age the muscles are less elastic and slower to adapt. Warming up the rotator cuff will provide added stability and protect the front of the shoulder while lifting. Using a dowel will ensure that the arms move in a single plane of motion. All 4's Arm Raises Before reading this, shrug your shoulders up toward your ears. This engages the UPPER TRAP muscle. Now, draw your shoulders down and together away from your ears. This engages the LOWER TRAP. Both muscles must work together when lifting overhead. This exercise targets the lower trap muscle. In all fours, alternate raising the arm while drawing the shoulder down and back at the top of the movement. ATTENTION: it is easy to cheat this movement by shrugging the shoulders toward the ears. What is the IT Band?
The IT Band does NOT stretch! Foam Rollers and side stretches are NOT permanent solutions! How to Treat IT Band SyndromeSide plank clamshells This exercise targets the outer hip muscles, known as the hip abductors. These muscles are really important for stabilizing the hips and keeping them level. Adding the side plank targets the internal and external obliques as well. How does it prevent IT band tightness? The IT band attaches to a hip flexor muscle (tensor fascia latae muscle) on the front of the hip. This hip flexor also turns the leg inward (imagine the movement of the knees collapsing together). In many people, the tensor fascia latae works really hard (i.e lots of knee collapse). Consequently, the gluteal muscles in the back stop doing their job. The clamshell specifically targets the outer gluteal while turning off the front hip flexor (research has proven it!). Strong gluteals + Minimizing tensor fascia latae muscle activation = less IT band tightness! Hip Kicks in a Hover Plank Hip kicks (similar to the bird dog exercise) are great for strengthening the gluteal muscles, specifically the gluteus maximus. This powerful muscle helps stabilize the knee and low back! Adding the hover plank targets the core muscles to a greater demand as well. How does it prevent IT band tightness? Many people with IT band tension have trouble isolating their core muscles from their legs. For example, they may have increased trunk sway while running. The plank keeps the spine in neutral while moving the lower body. This movement teaches the trunk to remain stable while the legs alternate. Hip Clocks The hip joint is built for mobility. Unfortunately, most people sit to much and move to little. Hip clocks are a Heafner Health favorite because they target both hip internal and external rotation. How does it prevent IT band tightness? The hip joint and surrounding muscles contain tons of small receptors that communicate with the brain. These receptors are a key component of muscle memory. When the hip loses rotation, the small receptors become less sensitive and communicate less with the brain. This leads to overall less awareness and perception of the hip joint and decreased ability to target specific muscles. Single Leg Bridge Research has shown the single leg bridge to be a good glute strengthening exercise. ATTENTION: it is easy to cheat this movement by using the low back or hamstrings! Heafner Health recommends to start with a smaller lift and be sure the hips drive the movement. How does it prevent IT band tightness? Glutes, glutes, glutes! Stronger muscles on the back of the body will keep the trunk upright and in good alignment. Additionally, the bridge opens up the front of the hip joint and provides a stretch to the hip flexors. Hip Flexor Stretch The IT band does not stretch! Seriously, it is impossible. It can withstand THOUSANDS of pounds of strain. However, tissue around the IT band does get tight and needs mobility work. The hip flexor stretch opens the front of the hip and allows for better mobility of the hip. The added side bend increases the tension across the outer hip muscles. How does it prevent IT band tightness? As mentioned on Day 1, the hip flexors work hard and often become shortened. When shortened, they do not allow the leg to fully extend backward. For example, a runner trying to take a full stride may be limited by tension in the front of the hips. Since the IT band attaches to the hip flexors, the tension translates down the outer leg and can cause knee pain. Movement is the Key to Longevity!-Dr. Jim Heafner PT, DPT, OCS
Do you have recurring low back pain?Nearly 80% of the population will experience low back pain at some point during their life. Of the 80%, nearly 1/3 of those people will have a recurring episode of pain. This means if you have low back pain, you will likely experience it a second or third time. This information is not meant to be scary or threatening. The body is not fragile or frail. Pain or tension is simply an alarm indicating something may be wrong. Even in the presence of pain, the spine is extremely strong and resilient! However, this information should be a call to action. If you are experiencing any low back pain or discomfort, DO SOMETHING ABOUT IT! The symptoms will not disappear. You need to change your daily habits or routine. It is important to incorporate new healthy movements and positions for your spine. What should I do for daily maintenance of the low back?I was recently working with a middle aged man who was experiencing tension on the right side of his low back. He described the sensation as 'grabbing' or 'catching' when lifting or going up the stairs. Additionally he reported a lack of power from his leg muscles. After watching his movement analysis and going through a few basic tests, the source of the symptoms was quickly diagnosed. His low back pain was due to a lack of mobility. In other words, his spine and hips lacked adequate movement. The exercises below were performed on his initial physical therapy visit.
Why these exercises?There is a popular phrase in the fitness and rehab community that states, "mobility before stability." In other words, we need to get tight or stiff areas moving better before we can strengthen them. With this particular person I was treating, he needed mobility exercises first. Once the motion in the hips and spine improved, I finished the treatment with the fourth exercise, the bird dog, We needed to build a foundation of mobility before strengthening in his new range of motion! Dr. Jim Heafner PT, DPT, OCS Medical Disclaimer:
The above information is an example rehab program. The information contained herein is not intended to be a substitute for professional medical advice, diagnosis or treatment in any manner. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition or before engaging in any physical fitness plan. |
Heafner HealthPhysical Therapy Archives
April 2022
Categories |
RSS Feed
Photos used under Creative Commons from imma-ty-grr, colros, WODshop, Rev Stan, -Jeffrey-, North Carolina National Guard, NeighborLink Fort Wayne, Artur Tomaz Photography, wwward0, Akuppa, Stewart Black, eccampbell, ArkansasOutside.com, ton.schulten
