Our past couple blogs have revolved around neck pain. Why? Because it’s 2021 and we are a year and half into our “new normal” caused by the global pandemic, which means more time working from home, which means increased time spent behind a computer screen, which means more neck pain and more headaches. Throw on the added stress that people are experiencing and it’s starting to feel like there’s a different kind of pandemic going around with all the neck pain and headaches we’ve been treating at Athletes’ Potential.
In our previous blogs this month we’ve given a ton of great information about how your neck is the source of your headaches and why looking down at your phone all day may not be the best idea. (If you missed those, you can find them here.) While all that may be great, there’s one area that frequently gets missed when people get their necks looked at by a medical professional, and that area is their back.
While there are certainly fasial lines, misaligned joints and muscle tensions in the low back that can cause changes “up the chain” that lead to neck pain, those situations are a little fewer and far between and aren't necessarily the part of your back that I’m talking about. Instead, we’re talking specifically about your thoracic spine, or your upper back.
A little anatomy lesson for you to make sure we are all on the same page. Your spine is divided into three separate segments: cervical (neck), thoracic (mid back), and lumbar (low back)...in other words your thoracic spine connects your neck to your low back. Now, there are a couple of things that are pretty cool when we’re talking about your thoracic spine.
Going back to that first fun fact...the upper portion of your thoracic spine has to be able to move along with your neck. Hypomobility leads to pain. In other words, if one joint isn’t moving properly, then that causes other joints (above or below the stiff joint) to have to move in an excessive range of motion (hypermobility), which leads to pain in those joints. That is exactly what we see when it comes to the upper thoracic spine and its ability to cause neck pain. If your upper back has excessive stiffness then that causes your neck to have to rotate, extend, etc in excessive ranges of motions to do simple tasks (think looking over your shoulder to check a blind spot), which will inevitably lead to pain.
Luckily there a ton of drills you can do to help improve your thoracic spine mobility and two of my all time favorites are listed below:
Thoracic Spine Self Release:
Open Book Exercise:
The second way your thoracic spine can cause neck pain actually has more to do with that second fun fact. One of the most important functions of your rib cage is to protect some very important structures such as your heart, lungs, liver, diaphragm, etc. Your lungs and diaphragm in particular are what we want to focus on here. You see, when people sit at a desk for prolonged periods of time or are experiencing high amounts of stress, what tends to happen is people start taking shorter breaths and use the accessory muscles found in the neck when they breath instead of the more appropriate muscle being their diaphragm. When this happens we’ll start seeing muscles like the scalenes, sternocleidomastoid (SCM), and subclavius start to develop too much tension which will lead to neck pain and even referred pain causing headaches.
Lucky for you, we have some favorite drills that can help with that too and a lot of them focus on proper breathing. Now, before you roll your eyes and think, “proper breathing?! Breathing is breathing!”, That’s what I used to think too but thanks to our good friends over at Shift, in addition to the thousands of people we’ve helped improve their breathing, I can promise you, that thought process couldn’t be further from the truth. Give the drills a shot and see for yourself, you’ll be amazed at how effective cleaning up your breathing patterns can be.
90/90 Diaphragmatic Breathing:
In review, improving your upper thoracic mobility and appropriate breathing patterns could be effective treatment options for you if you’re dealing with neck pain and, at a minimum, will help you live a healthier life. However, these treatment options are just pieces of the ever elusive puzzle that make up neck pain. If you’re dealing with neck pain, reach out with any questions. We design and implement programs to help people just like you, whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience. It is our goal at Athletes’ Potential for the people we work with to get out of pain and return to their sport or activity performing better than they did before.
Thanks for reading,
Dr. Jake, PT, DPT, CSCS
Every day, all day, you are carrying a bowling ball with you.
Not literally of course. Hear me out.
You wake up, you go to work, you care for your kids, and the entire time you have this massive ten pound object sitting on your shoulders for which you are responsible! It’s propped up by a few supportive structures, each of which are organized and arranged to be wonderfully supportive of this object.
You can probably guess by now, I am talking about your head and neck. Your head being the bowling ball and the neck being the structures that support it!
Now if I was to tell you to arrange this head and neck in an ideal way, you would likely put the head perched nicely on top of the neck without much lean. Intuitively as well as seen in the research, if you see a neck that’s leaning, you know that neck is likely working harder than a neck that is more upright.
We are living in a world that is more phone-focused than ever, and in the world of physical therapy, we are seeing a HUGE uptick in phone and screen related pain. So what are a few things you can do to help alleviate this “text neck” that we see so often at Athletes’ Potential? Try a few of these things and see how you feel after a week:
1. Foam roll your upper back 1-5 minutes 1-2x/day. These will help relieve tension in your upper back that can throw your neck and head forward. Enjoy these!
2. Chin tucks 3x10-15 with light effort 1-2x/day. These will help align and exercise your neck by putting it in the right position. Be gentle! Feel the deep muscles lightly working to pull your chin down and back. Aim for a “double chin!"
Moral of the story: care for your bowling ball. Over time, you will lose strength, coordination, and mobility if you don’t work on them occasionally. These two simple exercises can help start to get you out of your text neck positioning. If you are still having problems, feel free to reach out to us at any time to help you improve your neck issues.
Thanks for reading,
Dr. Marcus Rein, PT, DPT, CF-L2
About ⅔ of the population will suffer from neck pain and headaches at some point in their lifetime. Stress, posture, and muscle tension can all lead to headaches. Some common causes that can predispose you to headaches are: staring at a computer screen all day, lifting heavy weights overhead at the gym, or limited mobility of the neck, upper back or shoulders.
Tension headaches refer to headaches related to muscle or fascial tension, and the postural changes that accompany the muscle tension. This increase in tension might be from stress, a physically demanding job, or poor posture and muscle fatigue at the end of the day. Tension and stress can lead to trigger points and tightness in your postural muscles. This muscle tightness can directly refer pain into the head and face creating headaches on one or both sides of the head.
Muscle tension in the neck can result in compression and squeezing of the nerves going into the base of your head. Compression of these nerves can lead to pain behind the head, along the temples, as well as behind the eyes. Usually this compression is felt directly below the base of the head in the upper neck region, and is associated with a more forward head posture.
You can also get headaches from dysfunctional jaw mechanics (TMJ) associated with upper neck stiffness. The upper neck region can tilt the head and jaw creating abnormal muscle tension in the neck, jaw and face. If you have headaches associated with eating, notice your jaw clicking this may be an indication of neck and jaw dysfunction, also termed TMD.
Incomplete mechanics of the joints of the neck and upper back, as well as shoulder stiffness can create additional stress on the muscles of the head and neck. What steps can you take to relieve or reduce your chances of getting headaches caused by incomplete mechanics?
If you have tried these methods of headache relief, but continue to have symptoms contact us below to see if physical therapy is a good option for you.
Thanks for reading.
Dr. Sam Gillespie
Dr. Danny and staff's views on performance improvement, injury prevention and sometimes other random thoughts.