Neck & Shoulder Mobilization and Stability Program

Neck and Shoulder Exercise Program

Rehabilitation of any area of the body starts with a proper diagnosis of a condition and ensuring the exercises are the correct ones for a particular set of symptoms, body type and person. That is why the exercises in this section should only be used once you have been properly evaluated and given the go ahead by myself for your condition.

Neck pain is often associated with poor posture of the upper body, therefore it is best to perform exercises daily and others hourly. Whereas, some postures are intended to be used always.

All of my active rehabilitation programs follow what I refer to as the ABCC's of Rehabilitation:

Activation - Activating the muscles (or area) that you are intending on rehabilitating.

Breathing and Bracing - During times of stress, after trauma, or chronically poor movement patterns will cause you to breath with your neck and upper chest which is inefficient and results in further damage to the cervical spine. Proper breathing is a combination of having the diaphragm perform what it needs to do, not your neck, while being able to brace the trunk and abdominal region with the muscles that should be doing the work. When breathing, it is best to ensure you feel the bottom ribs opening up and your stomach slightly expanding, while your abdominal muscles and gently tightened. See some exercises below

Centration - Ensure that your shoulder girdle, neck and head as well as jaw are in their proper position means that all joints are centrated, or placed in the ideal location so that the muscles pulling at the joints are creating equal pressures and stability is maintained. Once the body starts to move, all tissues are loaded properly and unnecessary strain is not being placed on any tissues.

Coordination - Coordinating muscle activation with movement can be a great challenge, especially once an area has been injured or poor posture has changed the way you understand what normal is. To ensure that you are getting the most our of your rehabilitation program, you must start slow and develop good control of small movements prior to increasing loads and developing more complex and larger movements.

GOALS OF THIS NECK MOBILIZATION AND STABILIZATION PROGRAM

  1. To improve the static (resting) and dynamic (movement) postures of the cervical spine, trunk and upper extremity (UE).
  2. To improve resting posture and ability for a person to breath properly at rest and during activities.
  3. To improve Eye-Head-Neck-UE co-ordination.
  4. To improve the strength, stability and endurance of the cervical spine stabilizers.
  5. To  improve the strength, stability and endurance of the UE and shoulder stabilizers.

Some of the exercises and postural movements below are only part of the Neck Mobilization and Stabilization program that I use with my patients and are in no way to substitute a proper evaluation and treatment plan. Each patient is an individual and specific exercises are to be used for specific conditions.

Proper Posture at your Desk is key, here are some Do's and Don'ts

  DON'T:  Rounding your shoulders, hunching your back and pushing your head forward is a sure way to increase pain in your neck and shoulder. This increases the chance of headaches, muscle strain and possibly shoulder injury.

DON'T: Rounding your shoulders, hunching your back and pushing your head forward is a sure way to increase pain in your neck and shoulder. This increases the chance of headaches, muscle strain and possibly shoulder injury.

  DO:  Try to sit at the edge of your chair (on your sit bones), with  feet in line with your knees and heels firmly planted on the floor. Pull your shoulders back and down and keep your elbow as close as you can to the side of your body.

DO: Try to sit at the edge of your chair (on your sit bones), with  feet in line with your knees and heels firmly planted on the floor. Pull your shoulders back and down and keep your elbow as close as you can to the side of your body.

  DON'T:  When using a phone at your desk, try not to work with the phone at your shoulders. This will irritate your cervical spine joints, shorten your neck muscles and irritate your jaw.

DON'T: When using a phone at your desk, try not to work with the phone at your shoulders. This will irritate your cervical spine joints, shorten your neck muscles and irritate your jaw.

  DO:  When working at your desk, use a hands free head set if talking on the phone for any longer than a few minutes. There are a lot of products that attache onto various phone devices. If you need a recommendation,  contact me.

DO: When working at your desk, use a hands free head set if talking on the phone for any longer than a few minutes. There are a lot of products that attache onto various phone devices. If you need a recommendation, contact me.

  DON'T:  Using your mobile phone while at your desk often makes you round your shoulders, tighten your neck muscles, strain your eyes and is just BAD!

DON'T: Using your mobile phone while at your desk often makes you round your shoulders, tighten your neck muscles, strain your eyes and is just BAD!

  DO:  If you have to use your phone (or mini computer as some of the devices are set up as), sit at the edge of your chair as above and bring the phone up to about chin height. This will help alleviate excessive strain on your body.

DO: If you have to use your phone (or mini computer as some of the devices are set up as), sit at the edge of your chair as above and bring the phone up to about chin height. This will help alleviate excessive strain on your body.

  DON'T:  Using your mobile phone while standing, the same applies as when at your desk. It will place strain on your neck, shoulder, lower back, abdomen and eyes. All of which I don't think you want.

DON'T: Using your mobile phone while standing, the same applies as when at your desk. It will place strain on your neck, shoulder, lower back, abdomen and eyes. All of which I don't think you want.

  DO:  When standing and using your phone, bring the phone to chin height and it will push your body into an appropriate posture. Pulling your shoulder back and down can help as well..

DO: When standing and using your phone, bring the phone to chin height and it will push your body into an appropriate posture. Pulling your shoulder back and down can help as well..

Taking micro-breaks every 10-15 minutes is ideal. If you cannot get out of your chair, try and change your position, or even do a stretch.

  STEP 1:  Start by moving to the edge of your chair so that your sit bones, ischial tuberocities, are at the edge of your chair (be careful not to tip your chair over).

STEP 1: Start by moving to the edge of your chair so that your sit bones, ischial tuberocities, are at the edge of your chair (be careful not to tip your chair over).

  STEP 2:  Externally rotate your arms and forearms so that your palms are pointing forward. Then spread your fingers and push your hands to the floor. At the same time move your elbows backwards towards the backing of your chair. Take 10-20 deep breaths, breathing from your lower rib cage and you will see an expansion of your belly.

STEP 2: Externally rotate your arms and forearms so that your palms are pointing forward. Then spread your fingers and push your hands to the floor. At the same time move your elbows backwards towards the backing of your chair. Take 10-20 deep breaths, breathing from your lower rib cage and you will see an expansion of your belly.

Improving the Range of Motion in the Thoracic Spine is key. Here is a great set of stretches and active warm ups when you are doing upper body workouts or are having issues with your neck and shoulder regions.

Chair Stretch

A great break from sitting. To be done on an hourly basis when at a desk or sitting for prolonged periods of time.

  STEP 1:  Start by standing about one full arm length away from a chair. Place your hands on the chair with your feet hip width apart.

STEP 1: Start by standing about one full arm length away from a chair. Place your hands on the chair with your feet hip width apart.

  STEP 3:  Take a deep breath in and then as you exhale tighten your abdominal muscles, arch your spine keeping your hands and hips in same position as Step 2.

STEP 3: Take a deep breath in and then as you exhale tighten your abdominal muscles, arch your spine keeping your hands and hips in same position as Step 2.

  STEP 2:  Make sure your feet are pointing forward. Bend your knees and straighten your back so that you are parallel with the floor. Do not pull on the chair.  

STEP 2: Make sure your feet are pointing forward. Bend your knees and straighten your back so that you are parallel with the floor. Do not pull on the chair.  

  STEP 4:  As you take a deep breath in, push your chest and belly towards the floor. Rest here for a moment and then return to Step 3. Repeat for a few minutes.

STEP 4: As you take a deep breath in, push your chest and belly towards the floor. Rest here for a moment and then return to Step 3. Repeat for a few minutes.

The Sphinx

If you wish to really improve the range of motion in your upper back which will help with your neck and shoulder condition, perform this as often as you can. Make sure the floor is soft on your knees and if you feel any cramping on your feet, come out of the position and then go back in. Remember, this position should be painless, everywhere. If you are experiencing any pain while doing this, feel free to contact me.

  STEP 1:  Begin by kneeling on the ground and sitting on your heels. Place your hands in front of your knees. Take a deep breath in and push your chest and belly towards your knees and hands.

STEP 1: Begin by kneeling on the ground and sitting on your heels. Place your hands in front of your knees. Take a deep breath in and push your chest and belly towards your knees and hands.

  STEP 2:  As you start to exhale, begin arching your spine and push your body away from your hands and knees as you tighten your abdominal muscles. Breath in and repeat Step 1. Continue moving between these two positions for a few minutes.

STEP 2: As you start to exhale, begin arching your spine and push your body away from your hands and knees as you tighten your abdominal muscles. Breath in and repeat Step 1. Continue moving between these two positions for a few minutes.

Thoracic Spinal Rotations

If you are good with performing the Sphinx, move on the spinal rotation which will help improve the range of motion in your mid back and shoulders, while strengthening the stabilizers of your shoulder girdle. If you feel any pain with this, feel free to contact me at your convenience.

  STEP 1:  Begin by kneeling on the ground and sitting on your heels. Place your hands in front of your knees. If you need to place padding under your knees, do so to make this feel more comfortable.

STEP 1: Begin by kneeling on the ground and sitting on your heels. Place your hands in front of your knees. If you need to place padding under your knees, do so to make this feel more comfortable.

  STEP 2:  Take your right arm off the floor and gently place your hand behind your ear. Make sure you keep your weight evenly distributed between your legs and your left hand on the floor. Take a breath, inhale and then as you exhale begin moving towards Step 3.

STEP 2: Take your right arm off the floor and gently place your hand behind your ear. Make sure you keep your weight evenly distributed between your legs and your left hand on the floor. Take a breath, inhale and then as you exhale begin moving towards Step 3.

  STEP 3:  As you start to inhale, begin rotating towards the right and arch upwards. Try to keep your pelvis at the same position. Make certain you do not push down on your neck and head. Rotate as far as you can go with good form.

STEP 3: As you start to inhale, begin rotating towards the right and arch upwards. Try to keep your pelvis at the same position. Make certain you do not push down on your neck and head. Rotate as far as you can go with good form.

  STEP 4:  As you start to exhale, return to the Step 2 position. Repeat on the same side for 30-60 seconds and then switch sides.

STEP 4: As you start to exhale, return to the Step 2 position. Repeat on the same side for 30-60 seconds and then switch sides.

Shoulder Mobility on Floor with Towel

Often the issue with creating good stability withing the neck and shoulder regions is the inability to hold your shoulder blades in place. This exercise not only gets your muscles working properly it also opens up your chest in order to improve your posture.

  STEP 1:  Lay on your back with a towel that has been rolled up (about 2 - 3 inches or 5 - 7 cm) and placed along the spine. Try and keep the head on the floor.

STEP 1: Lay on your back with a towel that has been rolled up (about 2 - 3 inches or 5 - 7 cm) and placed along the spine. Try and keep the head on the floor.

  STEP 3:  As you maintain the abdominal brace and shoulder blade squeeze, bring your elbows to the floor next to your shoulders. As you keep your body braced, push your spine against the towel and your elbows against the floor.

STEP 3: As you maintain the abdominal brace and shoulder blade squeeze, bring your elbows to the floor next to your shoulders. As you keep your body braced, push your spine against the towel and your elbows against the floor.

  STEP 5:  Keeping your spine pressed against the towel slide your arms as high as you can without your hands leaving the floor and not loosing your abdominal brace It is much tougher than it looks, but very effective.

STEP 5: Keeping your spine pressed against the towel slide your arms as high as you can without your hands leaving the floor and not loosing your abdominal brace It is much tougher than it looks, but very effective.

  STEP 2:  Bend your knees, perform an abdominal brace and gentle chin tuck (see below). Raise your hands over your shoulders and squeeze the towel with your shoulder blades.

STEP 2: Bend your knees, perform an abdominal brace and gentle chin tuck (see below). Raise your hands over your shoulders and squeeze the towel with your shoulder blades.

  STEP 4:  Still maintaining the shoulder squeezed position and with your elbows pushing against the floor, externally rotate your shoulders so that hands touch at the level of your head.

STEP 4: Still maintaining the shoulder squeezed position and with your elbows pushing against the floor, externally rotate your shoulders so that hands touch at the level of your head.

  STEP 6:  After you have reached the highest position with proper form, go back to Step 2 and repeat. Repeat this a few times a day for one minute each time. You should not feel any pain during this movement, if you do, please stop and contact me.

STEP 6: After you have reached the highest position with proper form, go back to Step 2 and repeat. Repeat this a few times a day for one minute each time. You should not feel any pain during this movement, if you do, please stop and contact me.

Chin Tuck - Deep Neck Stabilizers

Many of the muscles of the neck that stabilize the cervical spine become weak with poor posture and trauma. Strengthening these muscles can help decrease neck and shoulder pain.

  STEP 1:  Lie on your back (on the floor or bed) without a pillow under your head. Place your arms next to you with your palms facing the ceiling. Perform an abdominal brace by gently pressing your back against the floor and tighten your pelvic floor like you are stopping the flow of urine.

STEP 1: Lie on your back (on the floor or bed) without a pillow under your head. Place your arms next to you with your palms facing the ceiling. Perform an abdominal brace by gently pressing your back against the floor and tighten your pelvic floor like you are stopping the flow of urine.

  STEP 3:  While keeping your tongue pressed against the roof of you mouth, tuck your chin inward without lifting your head off the table. Think of the back of your head being pulled up by a rope.

STEP 3: While keeping your tongue pressed against the roof of you mouth, tuck your chin inward without lifting your head off the table. Think of the back of your head being pulled up by a rope.

  STEP 2:  Bring your head back making sure that you do not lift your head off the floor. When you reach all the way back you should feel a stretch in the front of your neck. At this point, press your tongue to the roof of your mouth with your mouth closed.

STEP 2: Bring your head back making sure that you do not lift your head off the floor. When you reach all the way back you should feel a stretch in the front of your neck. At this point, press your tongue to the roof of your mouth with your mouth closed.

  STEP 4:  Gently lift your head off the floor the bed keeping the chin tucked in. Hold this position for a few breaths and gently lower to the ground. Repeat continuously for a minute.

STEP 4: Gently lift your head off the floor the bed keeping the chin tucked in. Hold this position for a few breaths and gently lower to the ground. Repeat continuously for a minute.

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CAUTION: The above exercises are only a guide and should be performed without pain. If you have any questions about if they are suitable for you and your condition, please feel free to contact me at your convenience.