Chronic neck pain is another common ailment of our busy, wired life. It is often the result of muscular tightness and postural imbalance, with a gradual and pervasive onset of symptoms. Think of the neck as the hallway between the head and the upper back — vulnerable because it houses a large number of nerves, vessels, bones and muscles in a relatively small area. If the upper back rounds and the head juts forward, the neck is strained because the head weighs a stunning 10 to 11 pounds. The eyes search for level despite the position of the head, so the neck does a heroic job of balancing the head to best utilize sight and our other special senses of hearing, smell, taste and balance. As a result, the neck often gets pulled into positions of stress, particularly forward extension/craning. This [article] is for people who are suffering from neck pain due to muscular strain and postural stress.

Ideally, the head should be positioned above the shoulders. A healthy neck should have good pain-free range of motion and possess a slight concave curve while the upper back maintains its slight convex curve. A posture of forward craning can happen at multiple intervals throughout the day, such as when viewing computer screens, or can be a result of chronic occupational stressors and/or lifelong postural habits. In a forward-craning position, the muscles in the neck are both weak and tight because a contracted muscle cannot contract and therefore can’t work! Good head and neck alignment are important because reduced range of motion in the neck is related to a higher risk of falls. An increased risk of falls occurs because peripheral vision is reduced, as is the body’s capacity to adapt to sudden changes in balance. Unfortunately, elders or those living with disabilities are especially vulnerable to this risk.

In the back of the neck, the muscles at the base of the skull and upper shoulders are often contracted because they overcompensate for weakness in the deep neck extensor muscles (splenius, semispinalis). It is a similar story with the muscles in the front of the neck — the anterior and side neck muscles overcompensate for weakness in the deep neck flexor muscles (longus colli and longus capitis). Both of these important intrinsic muscle groups succumb to stretch weakness by remaining in an elongated posture of forward craning.

Headaches associated with tension from tight neck and shoulder muscles can be found in individuals with this forward-craning posture. Tension headaches, especially ones involving the occipital nerve at the base of the skull, can cause symptoms associated with migraines, including nausea, vomiting and blurred vision. Migraines are notoriously difficult to manage, and common treatment options generally include medications, therapy, rest, dietary changes and avoiding specific triggers, such as sunlight, caffeine and alcohol. Neck muscles are very responsive to emotional stress, so massage, heat and gentle stretches can greatly help with chronic neck pain and muscle shortness.

YOGA THERAPY

The following yoga therapy aims to increase body awareness of the neck and head by balancing the actions of deep and superficial muscles of the neck. We want to stretch out tight muscles and strengthen the weakened muscles to relearn to correctly hold up the head. Additionally, the upper back, upper shoulder, and anterior chest wall have been dragged into dysfunction by poor posture, so we need to better educate those muscles as we aim to balance the head over the shoulders and the shoulders and upper back under the head and neck. When the shoulder blades are fixed, the trapezius extends the neck and retracts the shoulder blades, keeping them well positioned on the back.

Note: When working therapeutically with a forward-craning posture, the gaze might naturally have to be directed about 5 to 10 degrees below the horizon to stretch the back of the neck. In the opposite situation, where the back of the neck is overstretched (I have this problem), the gaze might have to be slightly above the horizon to put the curve back in the neck. For those lucky enough to have a healthy curve in their neck, the gaze may naturally fall on or around the horizon.

Two Neck Strengtheners

• Sit in a chair, facing forward with your feet flat on the floor.
• Your back should be straight and your chest broad and open.
• Place a hand on top of your head.
• Press your head into your hand and your hand into your head.
• Feel your head and neck extend upward and try to move your ears over your shoulders.
• Your gaze should be forward at the horizon, above, or below.
• Hold for about 30 seconds and repeat 2 or 3 more times.
• Place a beanbag, eye pillow, or other soft object on your head.
• Keep lifting and balancing your head as the beanbag stays balanced on top.
• Hold for as long as feels good.

Notes: This action strengthens the intrinsic spinal muscles of your neck. Balancing an object on the top of your head is a great way to help the muscles relearn to hold your head up through the use of small neuromuscular responses in your neck to subtle changes in balance and positioning.

Two Neck Stretches

• Sit in a chair, facing forward with your feet flat on the floor.
• Your back should be straight and your chest broad and open.
• Place your left hand on your right shoulder.
• Gently pull your left elbow with your right hand.
• Tilt your head directly sideways, away from the hand on your shoulder, by moving your left ear toward your left shoulder.
• After several breaths, gently and slowly roll your chin slightly upward and downward, and feel different muscles stretching.
• After several more breaths, release your arms, draw your chin to your chest, and lift your head.
• Repeat on the other side.

Notes: This action stretches your superficial neck and upper shoulder muscles, including the scalenus, levator scapulae, upper traps and sternocleidomastoid. It is easy and can be done at any point throughout the day, sitting or standing. Excellent for when you are stressed out!

• Sit in a chair, facing forward with your feet on the floor.
• Your back should be straight and your chest broad and open.
• Place both hands at the top of your sternum.
• Pull your skin downward while lifting your sternum upward into your hands.
• Slightly tilt your head and look upward on the diagonal and toward the ceiling.
• Lift your chin to stretch your front neck.
• Hold for about 30 seconds on each side.

Notes: This action stretches your anterior neck flexors, the sternocleidomastoid and the platysma muscle. The platysma muscle is like a turtle’s neck, spanning your entire neck, chin and collarbone. A simplified variation of this is simply looking straight upward toward the ceiling with both hands on your sternum. Increase the effect of these stretches by pulling your lower jaw over your upper jaw in the position of an underbite when your face is lifted.

Excerpted from Yoga Bones: A Comprehensive Guide to Managing Pain and Orthopedic Injuries Through Yoga by Laura Staton. Copyright © 2021. Available from Hachette Go, an imprint of Hachette Book Group, Inc.