chronic neck pain and the relationship to neck exercises / neck stretches

Neck Stretches and Neck Exercises.  Everyone knows that these always help people with CHRONIC NECK PAIN……  right?  Many of you who have struggled for any length of time with this problem know that this is incorrect.  While I highly recommend various Neck Strengthening / Stretching Protocols for my patients who struggle with Chronic Neck Pain, things must be done in a stepwise fashion.  In other words, a cart that is meant to be pulled by the horse, does not work so well if you use your horse to push it.   This principle can be clearly seen in my PHASE I & PHASE II posts for successfully helping people suffering with Chronic Neck Pain.

Although many of you will respond beautifully to Neck Stretching / Strengthening Protocols (whether these are “self-help” or prescribed by a physician / therapist), there are a significant number of you will actually get worse.  Why?  What gives?  After all, A COUPLE OF DAYS AGO I spoke about the importance of restoring / maintaining proper motion in the neck if you want any hope of conquering neck pain.  I wrote that, “There is an intimate relationship between loss of normal ranges of motion in your neck, and pain in the neck.  If you have poor mobility of the neck, sooner or later it is probably going to give you grief in the form of neck pain.  If left unchecked, this neck pain can easily become Chronic Neck Pain“. If this is true, how could a stretching and exercise protocol for your neck possibly be a bad thing?  After all, the very purpose of stretching the neck is to create more mobility in it.  It comes down to understanding the way that the neck functions.

As you can see from the picture on the left, the neck contains 7 bones known as the “cervical” vertebrae.  The top two vertebrae (Atlas and Axis) are known as the ‘upper cervicals‘, while the lower 5 are known as the ‘lower cervicals‘.   Movement is the stuff of life —- all of these vertebrae / discs have to move for the neck to work properly.  But here’s the catch.  The motion has to be both segmental and sectional.  Allow me to explain this concept using cervical extension (bringing the back of your head backwards towards your shoulder blades) as our example. 

When you ‘extend’ your neck, there should be fairly uniform joint motion at each and every vertebrae / disc of the lower cervical spine (there will not be much at the top two as it is more involved with rotational movements such as being able to put your nose over your shoulder).  If I simply measure a person’s overall (sectional) extension without checking the motion of each individual joint via motion palpation (for severely injured patients, some doctors use Video Flouroscopy for this), I can easily be fooled.  Allow me to show you an example of what I am talking about. 

It is very possible that a person’s overall range of motion of the neck could be within normal limits (this is the sectional motion), while certain individual joints in the neck are not moving properly at all (this is the segmental motion).  If each and every vertebrae / disc is not moving in the manner it is supposed to move, bad things start to occur.  The most common of these are Chronic Neck Pain, HEADACHES, and DJD.  But once you understand the definition of Vertebral Subluxation (see link below), you’ll begin to realize that there could be more at stake than meets the eye —– a whole lot more. 

So; are stretching and strengthening exercises for the neck a good thing?  Absolutely!  But only after you have cleared the FASCIAL ADHESIONS and SUBLUXATIONS — in that order.  Once you have begun to deal with the individual abnormalities in cervical spine motion (SEGMENTAL MOTION), and gotten rid of the SCAR TISSUE and Fibrosis that is so often the culprit in the hindrance of overall motion (sectional motion), exercises and stretches are a wonderful part of rehabbing and restoring motion, function, PROPER CURVE, etc, to the neck.  But put the cart ahead of the horse and and those good intentions could backfire.