We treat more back pain than any other complaint, split about evenly between upper and lower back pain. Additionally, most of the people we see whose chief complaint is low back pain (LBP) also often concede that they have some upper back pain (UBP) as well – and vice versa.
So what do your head and neck have to do with it?
There is clear a correlation between low back problems and neck problems. Many causes have been suggested for this, but one of them seems obvious – most people have allowed their head to drift out in front of their body. In many cases the shoulders also round as the head moves forward, rounding the upper spine into a condition called kyphosis.
If our head is too far forward the weight of the head, neck and shoulders puts our Center of Mass(CoM) out in front of our Base of Support (BOS). When our CoM is over our BoS the Line of Gravity (LoG) drives straight down through our spine and leg bones. When the CoM is out in front of the BoS the LoG pulls us forward. If we didn’t do something to allow for it we would fall.
This is what happens when our head is forward in front of our body – a condition that is all too common these days. There are two common bad strategies we might use to try to move our CoM back over our BoS :
- Pull the shoulders back while attempting to keep the lower back flat (Military or Flat Back posture). This puts chronic load on the upper back muscles and increases UBP or…
- Extend the lumbar spine to pull the chest head and shoulders back over the BoS (Lordotic posture). This loads the spinal erectors and can lead to LBP. In many cases the rounding of the shoulders persists as well and result is known as Kyphotic-Lordotic posture.
Although there are many factors to consider when trying to improve posture, a better strategy here is to focus on moving the CoM of your head back over your body. To accomplish this, we want to strengthen the Deep Cervical Flexors – muscles that are buried deep in the front of your neck, behind your esophagus and windpipe. They are called longus colli and longus capitis. They work together with the muscles in the back of the neck to center your head and neck over your spine.
We recommend starting with a truly easy exercise that can be done laying down, seated or standing against a wall. We recommend laying down at first so that you can keep the rest of your spine straight and relaxed.
As with most of our self-care activities, we begin with the foundation of a good diaphragmatic breathing. Bring your attention to your breath and the combination of your diaphragm pulling down to allow air in and your transversus abdominis bracing against it.
- To initiate this movement, begin with slightly tucking the chin, then push your head straight back (down in this position) into the floor. Hold for one second.
Check in with your lower and upper back – did you use those muscles too? Try again and make a conscious effort to use only your neck and avoid using your back muscles to assist. Hold the position for two seconds and then a third time for three seconds.
Neck muscles are delicate so we’re going to stop there to avoid inflammation and soreness. Over successive days you can increase the number of repetitions to 10, holding each for 10 seconds. We are using repetitions to build strength and holding the position to build endurance. After all, these muscles are supposed to be assisting in keeping your head over your body all day!
If your Deep Cervical Flexors are weak, inhibited or fallen out of your awareness, you are more likely to use ‘helper’ muscles such as the SCM or the anterocciptal section of the trapezius to flex the neck.
However, these muscles also pull the head forward. Learning to use your Deep Cervical Flexors properly will allow muscles like the SCM to release the forward tension on your neck. If you search for other versions of this exercise, you will find it in many positions, but we recommend laying down at first.
As you improve you can transition to a sitting or standing position. With professional assistance and cueing you can also learn to add resistance safely. Due to the deep location in the neck, additional treatment of these muscles should only be done be a skilled therapist with training in this specific area. This might be considered when they are in inhibited by a neck injury such as whiplash.
Email us at Help@WestSubPainRelief.com or call us at 630 858-0000 to learn more about how you can reduce pain, increase flexibility and gain strength from simple self-care activities.