Neck Strengthening Program

Oct 15, 2020 | Written by Kon | 0 comments

Our physical strength and fitness are aspects of our health that we often take for granted, not fully appreciating them until they are compromised. Physical injury to the neck due to overload, poor posture or trauma can result in serious pain and impairment. Appropriate targeted muscle activation is essential in rehabilitation of the compromised neck. Having suffered a serious car accident which required complex neck surgery, I was faced with the challenge of suffering from extensive pain while not being able to maintain normal activity. I will provide a brief description of the rehabilitation process that I used in conjunction with physiotherapy treatment that enabled me to get back on track.

Maintaining Range of Motion

Muscle spasm of the neck muscles is a common complication that can cause tightness and apply pressure to the spinal nerves as they pass from the neck down into the shoulders and upper limbs. Initial rehabilitation simply involved maintaining my range of neck movement in all directions as dictated by my pain levels. This helped to alleviate muscle spasm, prevent joint stiffness while maintaining adequate movement about the cervical spine. As pain levels improved I gradually increased the range of motion and gently pushed into the pain barrier, while adding stretches of the various neck muscles to enhance flexibility.

Deep Neck Flexors

Neck retraction is an important exercise for stimulating deep neck flexor activity which have an important role in stabilising and supporting the cervical spine. Initially, simply tucking the chin inwards while applying a slight downward tilt and exerting slight pressure activates these muscles. This can be done in the sitting or lying position, whichever is more comfortable. With time, I gradually increased the repetitions, duration and intensity of sustained retraction as a means of building muscle endurance.

Scapular Stabilisation

The shoulder blades act as an important fulcrum, where important muscles like the rotator cuff and neck muscles attach. Correct positioning of the shoulder blades is essential in maintaining an appropriate length tension relationship of our neck muscles. This allows for the generation of efficient forces while not overloading them and causing excessive muscle tightening, which can lead to restricted neck movement and pain. Repositioning the shoulder blades so that they are in a retracted position closer to the spine is essential in neck rehabilitation.

Initially, I would simply retract my shoulder blades aiming to squeeze backwards and slightly downwards, imagining my shoulder blades drawing closer to my spine. During this movement, it is important that no muscle tension is produced in our upper limbs and neck muscles, allowing us to focus on our shoulder stabilisers. The key here is the generation of low-level sustained muscle contractions. Stability and not strength is important.

Photo credit – Yourbodyposture

Technique and good control are essential

As one becomes proficient in the repositioning the shoulder blades, scapular stabilisation may be progressed by the use of our upper limb body weight using gradually increased increments of shoulder elevation. When adequate stability using bodyweight is achieved progression may be achieved by incorporating resistance in the form of TheraBand or pulleys weights, initially ensuring correct form in neutral and then progressing complexity with gradual increasing range of shoulder elevation. I progressed to performing modified push ups against the wall while maintaining scapular retraction. Eventually, at an advanced stage I was even able to hang from a bar and gently lift my entire body upwards without flexing my elbows simply by activating my scapular muscles.

The key here is to gradually increase the complexity of our exercises as we build up our endurance, making them functionally appropriate while not sacrificing technique. Proper technique emphasising correct and specific activation of our shoulder and neck stabilisers as opposed to general overall strength generation is essential.