By Mike Bills, MS PT
A ‘crick in the neck’, neck discomfort, pain in the neck, knots in the neck. Whatever you call it, neck pain is not fun! So why do we get that discomfort in our necks and how can we take care of it?
There are some common causes for neck discomfort. It can stem from stress which causes tight muscles in this part of the body. Neck pain can also occur because of poor posture. When we sit or stand or do anything for that matter with poor posture, this causes tightness in the neck muscles as well as a change in the alignment of the vertebrae in the neck. Another common cause for neck pain is overuse of the shoulders. Overuse of the shoulders might look like lifting heavy boxes or reaching up repetitively to clean you cabinets or even when you’re exercising or playing a sport. The overuse of the shoulder muscles has a ‘trickle up’ effect on the neck and therefore can cause pain.
Neck pain, when not taken care of can progress to other issues as well:
- Arthritic changes in the neck due to poor alignment or chronic tightness in these muscles
- A breakdown of the discs in the neck
- Discs are the cushion that keep vertebra from rubbing against each other, prevent arthritis, keep the space for the nerves that exit out of the spine
What are the common symptoms for neck pain?
- Neck pain will start as stiffness and tightness. This might make turning your head or looking up or down difficult or painful. Usually this stiffness and tightness will last for a few minutes, hours or maybe just a day.
- Sometimes, neck pain will cause you to have headaches if the tightness continues. Keep in mind, headaches are always due to muscle tension.
- This stiffness and tightness can progress to what we all refer to as a “crick in your neck”.
- This is where the alignment of vertebrae is beginning to shift causing increased pressure in between the vertebra.
- This pain will be more intense.
- Sometimes we may wake up with this ‘crick in the neck’ feeling and assume we slept wrong. You did not sleep wrong! What’s happening here is there is still tightness in your neck and a small shifting in that didn’t “shift back”. Overnight, this “kink” builds overnight and thus adds more pressure in the morning and more pain.
- This ‘crick in your neck’ makes turning your head difficult. Many people with neck pain may have trouble turning their head while driving and looking up. It may also cause sharp pains, pulling and overall discomfort
- Neck pain can also progress into radiating pain.
- The nerve that exits out from the space into between the two vertebra is now being pinched on either by the vertebra or the muscles themselves.
- This is generally because the disc is starting to lose some of its shape as well.
How does neck pain impact my day?
- Tightness and stiffness in your neck
- Difficulty turning your head or looking up or down
- “Crick in your neck” feeling
- Problems with sitting for any period of time (work, school, the movies etc)
- Pain – aches, stabbing or shooting pain in the neck, shoulder blades, shoulder, chest, arms etc.
- Tingling into arms or hands
The good news with all of these painful symptoms is that physical therapy is a very effective treatment method for neck pain and discomfort. A physical therapist at Loudoun Sports Therapy Center will determine the real cause of your neck discomfort. Determining the cause is critical to helping handle the pain so we can handle the problem and stop the pain from getting worse. A physical therapist will address any alignment and positioning issues with the bones in your neck. Using manual therapy techniques, we’ll help get the pressure off of the nerve and thus reduce the pain. We will manually and actively stretch the muscles in your neck helping to relieve tension, get rid of headaches and other symptoms. Physical therapy will also help strengthening your neck muscles, shoulder blades and muscles in your upper back. Targeted strengthening will help support the weight of your head and improve your posture. There are many small muscles in your neck that need to be strengthened and we will teach you the right way to do so.
Don’t turn away from your neck problems! Call TODAY at 703-450-4300 so one of our therapists can help address your neck pain and get you back to pain-free living! Not sure if you’re at a point where physical therapy can help you? CLICK HERE and try this self-assessment to see how good your neck range of motion is.
1. Release the painful area
Massaging the area of pain between your shoulder blades will ease the tension going through the muscle.
What do you need? All you really need is some sort of massage ball to do this to yourself.
I recommend using a lacrosse ball for best results as it has the right amount of firmness without being too uncomfortable to use.
- Place the massage ball at the site of pain between the shoulder blades.
- Apply as much of your body weight as required over the ball.
- To increase the release, move your arm in a up/down motion. (see above)
- Target those painful areas!
- The tighter/overactive the muscle is, the more pain there will be. Don’t stop!
- Continue for 3-5 minutes.
2. Stretch the shoulder blade muscle
Muscles that are over active will tend to be the ones that hurt the most.
By stretching the overactive muscles between the shoulder blades, it will help them relax and result in a reduction in your shoulder blade pain.
- Grab an exercise ball.
- Proceed to wrap your arms around the ball as far as you can.
- Hunch your upper back as much as possible as you push your hands away from you.
- Look down.
- Hold for 30 seconds.
- Repeat 2 times.
Note: Do NOT over stretch this muscle! (This may cause the muscle to become even weaker). Aim to stretch it enough so that there is a reduction in your pain.
4. Shoulder circles
- Place your finger tips on your shoulders.
- Slowly and forcefully draw large circles with your elbows in a backwards direction.
- Make sure your squeeze the muscles between your shoulder blades as firmly as you can.
- Repeat 30 times.
5. Shoulder pumps
- Place both hands (with elbows forward) on the sides of your head. (see Start position)
- Bring your elbows all the back. (see End position)
- Make sure to squeeze the muscles in between your shoulder blades as firmly as you can.
- Hold for 5 seconds.
- Repeat 10 times.
7. Stretch the thoracic spine
If your spine is used to being hunched forwards, your shoulder blade is going to be placed in poor position.
Stretching the thoracic spine into extension will help place these shoulder blade muscles in a better position to function.
- Using a rolled up towel or foam roller, place it in the middle of your thoracic spine (see above).
- Whilst supporting your head with your hands behind your neck, roll your body weight onto the foam roller.
- Arch your thoracic area (upper back) backwards.
- Be sure not to cheat by arching your lower back too much.
- Maintain this position for 1 minute.
*** For more exercises to loosen up the joints your upper back, have a look at this post for thoracic spine exercises.
8. Chest stretch
Tight chest muscles can pull your shoulder blade out of alignment.
- Place both hands high up on a wall in front of you.
- Lean firmly into your hands.
- Squeeze your shoulder blades down.
- You should feel a stretch at the front of your chest.
- Hold for 30 seconds.
- Repeat 1-3 times.
9. Promote shoulder mobility
If you lack full mobility of your shoulder joint, there will be compensatory changes in your posture.
If you lack internal rotation: The shoulder will natural hitch up and cause more strain to the shoulder blade muscles.
To check if you lack internal rotation:
Lie down with your shoulder at 90/90 position (see above).
Drop your hand down to the ground. If your shoulder raises way before your hand hits the ground, you have a lack of true internal rotation.
To increase the internal rotation of the shoulder:
- Place your hand as far up behind your back.
- Pull your shoulders backwards firmly.
- Hold for 60 seconds.
- Repeat 3 times.
- To progress this exercise: Do the same exercise whilst lying on your back.
10. Strengthen your postural muscles
Strengthening the postural muscles that are responsible for optimal shoulder blade placement is vital!
The best exercise for this is the Wall angel.
- Stand with your back to a wall.
- Keep your back and arms pulled backwards as to remain in contact with the wall throughout movements.
- Place your arms in the ‘W’ starting position.
- Transition to ‘I’ end position.
- 10 repetitions.
11. Postural taping
Taping your shoulder position will help you maintain the right posture and prevent you from defaulting back to bad posture.
There are many different methods to tape your posture so you may need to see which one suits you the best. But the main one (and easiest) I use for most of my clients with shoulder blade pain can be seen in the picture above.
- Maintain a good posture by gently pulling your shoulders back into a neutral position.
- On the side of your pain, place the tape starting from collar bone and pull back and down to the middle of your thoracic spine. (as above)
- Make sure you place firm downward pressure when applying the tape.
- If you develop any itchiness, rashes or swelling from the tape, it may mean you are allergic to it.
- If this is the case, remove it as soon as possible.
- Keep it on for 1-2 days.
12. Reduce exposure to aggravating factors
When are you experiencing your pain?
Whatever it may be: Either change it so that it doesn’t make your pain worse, or don’t do it at all!
A common time when people experience pain between the shoulder blades is when they are in front of a computer.
Make sure your workstation is helping you maintain a better posture!
Image from Village Health – Osteopathic clinic.
If you want to know exactly how to do this, head over to this post: FREE E-BOOK: How to set up your workstation for everything that you need.