self neck ready · however, it is not always possible, that is why there are the seated and/or...

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SELF NECK

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All of the stretches described in this chapter are detailed to stretch the right side.

Key Points for Success:

Recommended seating: Your chair should be firm enough to allow you to easily keep your pelvis in a neutral position. It should also have a back to help you monitor and maintain good posture.

Keep both of your shoulder blades touching the back of the chair.

Keep your pelvis in a neutral position.

Keep your movements slow and precise.

Breathe in before you move and breathe out while you move.

Body Awareness:

• Alternately focus on the muscles moving the joint and the muscles being stretched.

• Check for tension during the movement.

Use a mirror whenever possible to be aware of how your body is actually moving.

Remember to move your head first and then assist yourself.

Never force your assist.

Never strain with your movement.

If your muscles are shaking, you are working too hard; breathe and relax.

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Incorrect: Leaning forward

Movement Tips

Correct: Roll your chin towards the floor.

Maintain your tucked position throughout the movement.

Correct: Tuck your chin.

.

Correct: Keep your breastbone up

towards the ceiling.

Correct: Keep your shoulders

back and down.

Correct: Keep your chin tucked on the

return.

Incorrect: Extending your chin on the

return. Extending your neck when you

tuck your chin.

Incorrect: Shrugging your

shoulders.

Incorrect: Jutting your chin forward.

Dropping your chin without tucking.

Incorrect: Leaning Backward

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Sitting/Standing vs. Lying Down

The consideration here is the effect of gravity. Remember; gravity is always pulling down. The moment your head and/or neck move away from a neutral plane, the muscles that are stretching are also contracting. They must maintain some tone to work against the pull of gravity otherwise your head would fall; uncontrolled, in the direction you are stretching.

Asking your muscles to work against gravity creates a superior result every time. However, it is not always possible, that is why there are the seated and/or standing options.

Sitting/Standing:

The effects of gravity in the sitting or standing position create compression on the spine. If you are suffering from degenerative disc issues, the spaces between vertebrae and possibly the bones themselves are already compromised. Further compressive forces may lead to aggravation instead of relief. If you are weak or suffer from hypermobility, you may suffer pain from poor articulation of the joint as the compressive forces of gravity, combined with joint instability, make it difficult for the muscles to sequence properly for pain-free joint movement. Some of the table stretches are not done seated due to the unavoidable compression that occurs in this position.

Lying Down:

Working against gravity accomplishes everything you would like for your healing without any of the potential problems that can arise when you are sitting or standing.

In this position, every stretch is equal to one repetition of strengthening as well. With the average head weighing in at about 15 lbs., it will not take long to develop true stability in your neck. Working against gravity gives your muscles the neurological stimulus they require to function differently by creating appropriate sequencing for smooth joint movement and retraining proprioception. With compressive forces reduced, you can safely apply this work to disc conditions.

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1. Sit with your arms at your sides. 2. Turn your head to your R. 3. Drop your chin towards your R shoulder. 4. Keeping your chin tucked, slowly follow your collar bone to

your breast bone and then up your other collar bone, making a “smiley face” with the movement of your chin.

5. Keep your chin tucked as you return to the starting position.

Repetitions: 10 times.

Body Mechanics:

Keep your breastbone up towards the ceiling.

Do not let your chest collapse during the movement.

Keep your shoulder blades down and back.

Keep your spine straight.

Helpful Hints:

Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are flexing your neck too far. You may need to keep your finger on your chin as reminder.

If you are leaning forward, you are moving too far, keep your back straight.

Keep your shoulder blades against the chair.

Neck Semi-Circles; Seated Area Stretched: Entire Neck

Muscles Emphasized: General warm up for all muscles, ligaments and discs.

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1. Sit with your arms at your sides. 2. Place both hands over the top of your head with your

elbows pointing towards your chest. 3. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 4. Bring your nose towards your breastbone. 5. When you cannot move farther on your own, assist

yourself gently with your hands. 6. Hold for 2 seconds. 7. Keep your chin tucked as you return to the starting

position.

Repetitions: Two Sets of 8-10

Body Mechanics:





Neck Flexion 1; Seated Area Stretched: Back of Neck

Muscles Emphasized: Neck Erectors

Helpful Hints:


If you are leaning forward, you are moving too far.


Precautions: This stretch may be contraindicated if you have a posterior disc bulge.

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1. Sit with your arms at your sides. 2. Turn your head halfway or 45 degrees to your L. 3. Place your L hand over the top of your head with your

elbow pointing towards the center of your L breast. 4. Gently draw your chin back, lengthening up through the top

of your head, and keep it tucked. 5. Bring your nose to the center of your L breast and reach

your R hand towards the floor. 6. When you cannot move farther on your own, assist yourself

gently with your L hand. 7. Hold for 2 seconds. 8. Keep your chin tucked as you return to the starting

position.


Body Mechanics:





Neck Flexion 2; Seated Area Stretched: Back of Neck

Muscle Emphasized: Levator Scapula

Helpful Hints:


If you are leaning forward, you are moving too far.



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1. Sit with your arms at your sides. 2. Turn your head halfway or 45 degrees to your R. 3. Place your L hand over the top of your head above your

R ear. 4. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 5. Bring your L ear to the center of your L breast and

reach your R hand towards the floor. 6. When you cannot move farther on your own, assist

yourself gently with your L hand. 7. Hold for 2 seconds 8. Keep your chin tucked as you return to the starting

position.


Body Mechanics:





Neck Flexion 3; Seated Area Stretched: Back of Neck Muscle Emphasized: Trapezius

Helpful Hints:

Focus on an object or point straight ahead of you.

Do not lean your torso forward, backward or sideways.



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Body Mechanics:





Neck Lateral Flexion; Seated Area Stretched: Side of Neck

Muscles Emphasized: Trapezius, Levator Scapula, and Scalenes

Helpful Hints:

Focus on an object or point straight ahead of you.

Do not lean your torso forward, backward or sideways.


Precautions: This stretch may be contraindicated if you have a lateral disc bulge.

Mr. Stretchy:

Remember to bring your ear to your shoulder, not your shoulder to your ear!

1. Sit with your arms at your sides. 2. Reaching your L arm over your head, place your L hand

on top of your head above your R ear. 3. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 4. Bring your L ear to your L shoulder and reach your R

hand towards the floor. 5. When you cannot move farther on your own, assist


position.

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1. Sit with your arms at your sides. 2. Gently draw your chin back, lengthening up through

the top of your head, and keep it tucked. 3. Turn your head to the R. 4. As you turn your head, place your R hand on your L

cheek bone and your L hand behind your head just behind your R ear.

5. When you cannot move farther on your own, assist yourself gently with your both hands.

6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting

position.


Body Mechanics:





Only rotate your head; do not move it forward or backward.

Neck Rotation; Seated Area Stretched: Back and Side of Neck Muscle Emphasized: Sternocleidomastoid

Helpful Hints:

Lead with your eyes, looking as far behind you as possible. Even after your head has stopped, continue to look behind you with your eyes.

Keep your L shoulder down and back.

Hold onto the bottom of the chair to help stabilize your torso.

Keep your torso and shoulders facing forward at all times.


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1. Cross your arms over your chest with your fingertips gently holding your collar bones.

2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Jut your chin forward as you extend your head and neck,

and look up towards the ceiling. 5. Hold for 2 seconds 6. Return to the starting position.


Body Mechanics:

Keep your abdominals tight.

Lean forward the whole time. Do not sit up.



Neck Extension 1; Seated Area Stretched: Front of Neck

Muscles Emphasized: Scalenes and Platysma

Helpful Hints:


Place your tongue on the roof of your mouth to intensify the stretch.

Precautions: This stretch may be contraindicated if you have an anterior disc bulge.

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2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Turn your head halfway or 45 degrees to your L. 5. Bring your L ear up and back towards your L

shoulder blade. 6. Hold for 2 seconds 7. Return to the starting position.


Body Mechanics:

Keep your abdominals tight.

Lean forward the whole time. Do not sit up.



Neck Extension 2; Seated Area Stretched: Front of Neck Muscles Emphasized: Scalenes

Helpful Hints:


Remember to keep your head turned to a 45 degree angle throughout the movement.


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2. Lean forward until your elbows rest on your thighs. 3. Keep your back straight. 4. Turn your head halfway or 45 degrees to your R. 5. Jut your jaw. 6. Look up towards the ceiling, bringing the back of your head

towards your L shoulder blade. 7. Hold for 2 seconds 8. Return to the starting position.


Body Mechanics:


Keep your lower body relaxed.


Neck Extension 3; Seated Area Stretched: Front of Neck and Jaw

Muscle Emphasized: Scalenes and Platysma

Helpful Hints:


Place your tongue on the roof of your mouth to intensify the stretch.

Remember to keep your head turned to a 45 degree angle throughout the movement.


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1. Lie on your back with your arms at your sides. 2. Place both of your hands on the top of your head with

your elbows pointing towards your chest. 3. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 4. Roll your neck, bringing your nose towards your

breastbone, without lifting your shoulder blades off the surface you’re lying on.

5. When you cannot move farther on your own, assist yourself gently with your both hands.

6. Hold for 2 seconds. 7. Keep your chin tucked as you return to the starting

position.


Neck Flexion 1; Table Area Being Stretched: Back of Neck Muscles Emphasized: Neck Erectors

Body Mechanics:

Keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high.

Keep your shoulder blades touching the surface you are lying on. If you feel them come up, you are lifting too high.

Pull your shoulder blades together and press them down into the table.

Keep your body relaxed.

Helpful Hints:

Focus on moving your head only - do not roll your shoulders up.

Be certain to keep your shoulder blades touching the surface you are lying on.

Precautions:

If you have a TMJ disorder, be cautious of tucking your chin aggressively.

Advanced Movement:

As your flexibility improves, reach your hands towards your feet.

Mr. Stretchy: Suffer from headaches?

Cervical flexion can be an excellent stretch for relief of headaches.

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1. Lie on your back with your hands at your sides. 2. Turn your head halfway or 45 degrees to your L. 3. Place your L hand over the top of your head with your

elbow pointing towards the center of your L breast. 4. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 5. Bring your nose to the center of your L breast without

lifting your shoulder blades. 6. When you cannot move farther on your own, assist

yourself gently with your L hand. 7. Hold for 2 seconds. 8. Keep your chin tucked as you return to the starting

position.


Neck Flexion 2; Table Area Being Stretched: Back of Neck Muscle Emphasized: Levator Scapula

Body Mechanics:



Keep your body relaxed.

Helpful Hints:

Be sure to keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high.

Precautions:

If you have a TMJ disorder, be cautious of tucking your chin aggressively.

Advanced Movement:


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1. Lie on your back with your hands at your sides. 2. Turn your head halfway or 45 degrees to your R. 3. Place your L hand over the top of your head above your

R ear. 4. Gently draw your chin back, lengthening up through the

top of your head, and keep it tucked. 5. Bring your L ear to the center of your L breast and

reach your R hand towards the floor. 6. When you cannot move farther on your own, assist


position.


Neck Flexion 3; Table Area Being Stretched: Back of Neck

Muscle Emphasized: Trapezius

Body Mechanics:



Helpful Hints:

Be certain to keep your shoulder blades touching the surface you are lying on.

Precautions:

If you have a disc condition use a pillow to help reduce the effort required by your muscles to lift your head,

Advanced Movement:


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1. Lie on your R side with your knees slightly bent for balance. 2. Reaching your L arm over your head, place your L hand on

top of your head above your R ear. 3. Gently draw your chin back, lengthening up through the top

of your head, and keep it tucked. 4. Bring your L ear to your L shoulder, not your shoulder to

your ear. 5. When you cannot move farther on your own, assist yourself

gently with your L hand. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position.


Neck Lateral Flexion; Table Area Being Stretched: Side of Neck

Muscles Emphasized: Trapezius, Levator Scapula, and Scalenes

Body Mechanics:

Lengthen or extend your spine through the top of your head, then bring your ear to your shoulder, not your shoulder to your ear.

Keep your hips stacked. Do not roll your body forward or back.


Helpful Hints:

Keep your chin tucked. If you cannot keep your chin tucked, you are lifting too high.

Focus on an object or spot in front of you.

Placing a pillow between your knees helps provide comfort, balance, and support.

Precautions:

If you are weak, do this exercise lying on your side with your head resting on a pillow.


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1. Lie on your R side with your knees slightly bent for balance. 2. Gently draw your chin back, lengthening up through the top

of your head, and keep it tucked. 3. Turn your head to the L. 4. As you turn your head place your L hand on your L cheek

bone. 5. When you cannot move farther on your own, assist yourself

gently with your L hand. 6. Hold for 2 seconds 7. Keep your chin tucked as you return to the starting position.


Neck Rotation; Table Area Being Stretched: Back and Side of Neck

Muscle Emphasized: Sternocleidomastoid

Body Mechanics:

Lengthen or extend your spine through the top of your head, then rotate your head and neck.

Do not shrug your shoulder.

Only rotate your head and neck.

Do not lift your head up or down.

Keep your hips stacked. Do not roll your body forward or back.


Helpful Hints:

Lead with your eyes. Start by looking down at the floor; then, turn to look behind you as far as possible. When your head cannot turn farther, continue looking with your eyes.

Keep your eyes open throughout the movement.

Hold onto your pants’ leg or reach for your feet with your non-exercising arm to help stabilize your shoulder.

Placing a pillow between your knees helps provide comfort, balance, and support.

Precautions:

If you are weak, do this exercise lying on your side with your head resting on a pillow.


Mr. Stretchy:

When driving can you see your blind spot without turning your torso? If not this stretch is for you!

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1. Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman or stool.

2. Jut your jaw and extend your head and neck looking up towards the ceiling.

3. Hold for 2 seconds 4. Return to the starting position.


Neck Extension 1; Table Area Being Stretched: Front of Neck

Muscles Emphasized: Scalenes and Platsyma

Body Mechanics:

Begin your movement at the bottom of your neck.

Do not shrug your shoulders.


Keep your chest on the table; do not extend your back.

Helpful Hints:

Lead with your eyes, looking up and back. Even after your head has stopped moving, continue looking up with your eyes.

Keep your tongue on the roof of your mouth to intensify the stretch

Remember to exhale as you lift your head.

Place a pillow under your hips and ankles for extra comfort.

Precautions:

This movement may be contraindicated if you have an anterior disc bulge.

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1 Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman or stool.

2. Turn your head halfway or 45 degrees to your L. 3. Bring your L ear towards your L shoulder blade, looking

over your shoulder with your eyes. 4. Hold for 2 seconds 5. Return to the starting position.


Neck Extension 2; Table Area Being Stretched: Front of Neck

Muscles Emphasized: Scalenes

Body Mechanics:


Keep your head turned to a 45 degree angle.




Helpful Hints:




Precautions:


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1. Lie on your stomach with your head and arms hanging over the edge of a bed or perhaps an ottoman.

2. Turn your head halfway or 45 degrees to your L. 3. Jut your jaw. 4. Look up towards the ceiling, bringing the back of your

head towards your R shoulder blade. 5. Hold for 2 seconds 6. Return to the starting position.


Neck Extension 3; Table Area Being Stretched: Front of Neck and Jaw Muscles Emphasized: Scalenes and Platysma

Body Mechanics:


Keep your head turned to a 45 degree angle.




Helpful Hints:




Precautions:


Mr. Stretchy:

Cervical extensions are the most important stretch for reducing forward head posture.

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1. Lie on your stomach on the floor or on a firm bed. 2. Pull your shoulder blades together. 3. Reach your hands down towards your feet. 4. Lift your torso towards the ceiling, keeping your bottom

ribs touching the floor or bed and your legs and feet relaxed.

5. Hold for 2 seconds 6. Return to the starting position.


Thoracic Extension; Table Area Being Stretched: Front of Torso and Ribs

Muscles Emphasized: Abdominals and Intercostals

Body Mechanics:

Begin your movement at the “bra line” or mid back.

Do not extend your lower back.

Keep your hips and legs relaxed.

Helpful Hints:

Lead with your eyes, looking up to the ceiling. Even after your head has stopped moving, continue looking up with your eyes.


Turning your feet outward will help keep your hips and lower back relaxed.

Place a pillow under your ankles for extra comfort.

Precautions:

If you have lower back muscle pain, spasms or a disc condition, use caution when doing this exercise. Keep your lower back relaxed.

Mr. Stretchy:

Thoracic extension is a key player in reversing an exaggerated kyphosis.

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Key for Protocols of the Neck -

Name of Stretch Muscles Stretched

Seated

Neck Semi-Circles; Seated 1 general neck warm up

Neck Flexion; Seated 1-3 Cervical Erectors

Neck Lateral Flexion; Seated 1 Trapezius, Levator Scapula, Scalenes

Neck Rotation; Seated 1 Sternoclidomastoid, Trapezius, Levator Scapula,

Neck Extension; Seated 1-3 Sternoclidomastoid, Scalenes, Platysma

Table

Neck Flexion; Table 1-3 Cervical Erectors, Sub-occipitals

Neck Lateral Flexion; Table 1 Trapezius, Levator Scapula, Scalenes

Neck Rotation; Table 1 Sternoclidomastoid, Scalenes Trapezius, Levator Scapula

Neck Extension; Table 1-3 Sternoclidomastoid, Scalenes, Platysma

Thoracic Extension; Table 1 Abdominals, Intercostals

Shoulder Horizontal Abduction; Standing 1-5 Pectorals, Biceps, Deltooid

Shoulder Extension; Standing 1-6 Biceps

Shoulder External Rotation; Standing 1 Rotator Cuff

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Complete Neck Protocol - If time allows, complete the entire cervical routine for

table and chair.

You can expect the entire seated protocol to take about 15-20 minutes.

Seated Page

Neck Semi-Circles; Seated N6

Neck Flexion; Seated 1-3 N7-N9

Neck Lateral Flexion; Seated N10

Neck Rotation; Seated N11

Neck Extension; Seated 1-3 N12-N14

You can expect the entire table protocol to take about 15-20 minutes.

Table Page

Neck Flexion; Table 1-3 N15-N17

Neck Lateral Flexion; Table N18

Neck Rotation; Table N19

Neck Extension; Table 1-3 N20-N22

Thoracic Extension; Table N23

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Protocols for the Neck –

Forward Head Posture, Thoracic Outlet, Dowager’s Hump and “Military Neck” – The timing below considers both sides.

Primary Purpose - Reverse the exaggerated hump that sometimes forms in your upper back and lower neck.

Common Challenges - Being very tight in the front muscles of your shoulders and torso is a common challenge. Often, however, weakness in the muscles of the back, neck and shoulder muscles is the overriding cause.

Long Term Goals - Stretch and strengthen all of the neck and shoulder muscles, with emphasis placed on strengthening the postural or “anti-gravity” muscles.

If time is not a consideration, it is more efficient to simply do the complete neck protocol and then move on to the complete shoulder protocol. The below suggestions are taking time into account.

Stretch 15 30 Page

Neck Extension: Table 1-3 N20-N22

Thoracic Extension: Table 1 N23

Shoulder Horizontal Abduction; Standing 1-4 S6-S10

Shoulder Extension; Standing 1-6 S11-S13

Shoulder External Rotation; Standing 1 S15

Neck Lateral Flexion; Table 1 N18

Neck Rotation; Table 1 N19

Neck Flexion; Table 1-3 N15-N17

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Nerve Impingement - Nerve impingement follows the same protocols as above.

Typically the impingement comes from pressure on the nerves due to overly tight muscles constantly pressing upon the joint and eventually the nerve.

Spurring - Spurring may or may not be helped with manual treatment. The body has the

potential to reabsorb the calcium it has laid down provided a healthy environment can be created. This requires not only stretching but a lot of strengthening. The body requires stability in order to feel confident enough to disintegrate the spur.

Be careful when rotating your neck; there is increased potential for the muscles to be torn by the spur. X-rays and good communication with your doctor will usually give you the feedback you need to understand which movements are safe and which are not.

In order to have the highest chance for success, it is vital that each movement is done precisely. Be very diligent to avoiding compensatory movements. Remember that most likely repetitive movements and poor posture created the conditions that have led to spurring.

For example, when rotating your head, do not allow your head to tilt forward or backward. Keep your head in a neutral position in relation to your atlas and axis (the first two cervical vertebrae). Do not allow your neck to move away from neutral.

Disc Conditions - In general cervical disc conditions are addressed in the same manner

as described above. The tendency is for the neck to move forward and the head to tilt backwards due to forward posturing. This posture; is typically created by poor body mechanics and the accumulative effects of gravity. This often leads to a disc condition, especially after trauma such as whiplash. There is no predetermined direction a disc will bulge, herniate or rupture. It is vital to know which direction the disc is protruding in order to take best care for yourself. Be sure to discuss x-rays or MRI results and communicate with your physician before beginning any of these exercises.

When working with a disc condition, it is advisable to avoid chair stretches and go right into the table protocols. This allows for building strength and flexibility at the same time. One of the biggest roadblocks to success with these conditions can be stability. Without stability the body continues the cycle of spasms.

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You will usually find the muscles on the side of the bulge to be in spasm. The body adjusts to this condition by tightening muscles in order to protect the disc from further harm. Unfortunately the same tension the body uses to try to keep further pressure from aggravating the disc creates an environment of constant stress on the disc. Without any help to get out of this cycle, more and more pressure is put on your disc as your muscles begin to weaken. Under these circumstances, work very slowly and gently to avoid triggering the stretch reflex and possible muscle spasms.

In order to create a more favorable environment for bringing the disc back into its appropriate position, it is important to emphasize movement in the direction of the bulge. For example, if the disc is bulging to the front, it is advisable to begin with flexion and end with flexion. You are likely to be very sensitive to this movement as some pressure will be placed on the disc. Move very slowly and gently. Listen to your body and be very careful of working into painful movements. Pain is a reminder to pay attention to what your injured body needs to heal. Be mindful of the movements you are doing and remain present to the work being done.

self neck ready · however, it is not always possible, that is why there are the seated and/or...

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