The Connection Between Posture and Neck Pain
I’ll start by saying that I do not subscribe to the idea that there is one “Perfect Posture”
-Standing perfectly tall, head and shoulders back, is perfect for giving presentations
-Hunching forward may be the right move for late night expense reports
-Somewhere in the middle probably works for the rest of the time
That said, is someone is having neck and/or shoulder pain their posture is definitely something I look at during their evaluation.
When that neck/shoulder pain has been hanging around for a long time, the person often remains in a forward rounded position even when asked to stand tall. They feel that they are upright, but many times are far from it.
I won’t go so far as to say that their posture has caused their pain, but biomechanically, being more upright absolutely reduces strain on their necks, and allows their shoulders to function in a better position.
When this is the case there are three exercises that I usually turn to to begin to address this issue: (Click the links for videos I think have been well done!)
A chest stretch: Doorway pec stretch. Unlike the video, I usually ask people to stretch one side at a time, and have them hold for 30 seconds, 3 times on each side
An upper back strengthening exercise: Shoulder Ys. My goal is for the client to feel “medium resistance” so they can focus on perfect form rather than getting the reps done. I often ask them to repeat the movement 10-15 times per side, and make sure they are feeling the movement in the middle of their backs (rather than in their neck!).
A neck strength and length movement: Chin tucks. This movement seems easy, but is often tricky. I often instruct clients to “tuck their chin towards their throat” an remind them that their ears should stay in the same place while doing the movement. Their heads should stay on the pillow (not lift off of it) and the big muscles in the front of their necks should be relaxed to allow the smaller deep muscles to engage.
Now it should go without saying (but I’m going to say it): Everyone is different! When someone comes to Bespoke Physical Therapy we are treating that individual person. Some people have difficulty standing, so we modify the pec stretch, some people have really strong upper backs so the Shoulder Y will be too easy, but in general the above work as a starting point for many people. In the clinic, we would also typically use a combination of hands-on skilled manual therapy, stretching, and strengthening techniques in order to get our clients get back to pain free as soon as possible.
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