1. The AA junction - The C1-C2 vertebra is important for a number of reasons. Most notably it is responsible for roughly 50% of global cervical spine rotation. Secondly, as the head is drawn forward the upper cervical spine extends. This can increase the compression at the atlanto-axial joint, which can cause or perpetuate symptoms of cervico-genic headache.
2. Hyoid nation - Maybe the most under treated muscles in the human body. When the large muscles of cervical flexion draw the head forward, the hyoids begin to increase their downward pull. As a result they desperately want to open the jaw. To avoid walking around like zombies with our mouths open, we reflexively use the muscles of mastication to close our jaw. These little guys can perpetuate symptoms of jaw pain and headaches. Free up the hyoids, free up your jaw, free up your life!
3. The T Zone - No I’m not referring to that oily part of the face between the eyebrows. The thoracic spine is important when it comes to neck and shoulder movement. When the neck moves the thoracic spine moves down to approximately T4. As the head is drawn forward the thoracic spine flexes. Sustained flexed postures may lead to dysfunctional thoracic spine mechanics. This can very quickly lead to the loss of quality and quantity of range of motion in both the neck and shoulder.
4. Hold your breathe - Breathing, it’s all the rage. As the head comes forward, our nervous system prefers to shift the focus of our breathe towards the upper neck. This can not only create a literal pain in the neck, but can cause symptoms of fogginess and eye strain. A good mechanical breathe can not only reduce physical stress on the neck, but may give the nervous system a break from high threshold, distressful situations.
5. Dat Trap - The most popular scape goat for all neck pain. The reality is the upper neck sling including the posterior neck musculature, trapezius and levator scapula often get suspended in the upper cervical fascial with forward head posture. The end result is that classic “knot” in neck at the intersection between supraspintus, upper trapezius and levator scapula. Next time that stubborn area won’t relax on your patients, check neck position and see what results you get!
That’s it. I hope these little pointers have you thinking about how to approach your next neck case.
What tricks are helping you when dealing with neck pain?