Causes of Stiff Neck:
- Looking down for a long period while reading, writing, or using your phone;
- Excessive or vigorous movement of the neck;
- Sleeping in the wrong position, which exerts too much pressure on the neck
- Clenching the jaw;
- High stress levels;
- Medical conditions such as osteoarthritis and spinal disorders
- Trauma to the neck or back due to injuries, a hunched posture, or picking heavy weights; and
- Sudden movement of the head due to whiplash, which can pull your neck muscles and also can give rise to other serious symptoms.
- Feel along the suboccipital ridge all the way along, both sides, to see if they feel even.
- The area that feels painful, is not the area of complaint.
- Gently tuck your chin down and feel around the back of the lower part of your skull (the top 3 survival muscles) and feel around the lateral joints.
- Feel with two fingers and do some cross-fiber work .
- Keep your shoulders down so you do not activate the trapezius muscles.
- Once you find the tight ridge, palpate and see if you can feel into the area where the ribs are.
- Feel for the upper trapezius and duck anteriorly to it, then press your fingers down into that tight space.
- Palpate around the other side to see if it’s the same or different.
- Drop your ear down to give a little bit of softness to the tissue of the lateral neck which will allow you to really sink deeper into the muscle.
- Press and depress onto that region of the lower neck, it is the area that feels like it would be accessing your first rib, by doing this movement we are also making small changes to the restrictions or tightness over the second rib.
- Laterally flex away from the area and give yourself a little active stretch while sinking down a little deeper.
- As you work along your neck, press towards it and then gently glide away.
- Repeat the process one more time this time moving a little more medially. Come closer to the neck dropping down and in.
- Start to pull away and take the chin away, then try to access those fibers for posterior scalene, dropping down and back then coming along and forward.
- Palpate and see if that made a difference. The scalene should be feeling less taught and bandy, and you should feel better through the range.
- Finger-to-wrist stretching, rotation of the hand, joint and finger rotation
- When doing shiatsu, use the pad of the thumb of the finger, not the tip.
- Extend the thumb when using it; don't flex it.
- Apply gradual pressure to the area between the thumb and the point of the finger.
- There are three pressure points that must be applied to each in between the fingers of the hand.
- After applying pressure on the points in between the fingers, the phalanges are addressed next. Every joint of the fingers has points that need to be pressured on by pressing them from front to back and on the sides too.
View the entire Ask-Me-Anything event with Leisa below:1 - Self-care | Public Health | Royal College of Nursing (rcn.org.uk) 2 - Effectiveness of Hand Self-Shiatsu to Promote Sleep in Young People with Chronic Pain: a Case Series Design (nih.gov)
What are the suboccipital muscles?The suboccipital muscles are a set of four paired muscles in the back of the neck. The suboccipital muscles attach to the atlas (C1), axis (C2) and occipital bone, connecting the atlas to the axis and the two vertebrae to the base of the skull. They are deep to the trapezius, splenius and semispinalis muscles and superficial to the atlanto-occipital and atlanto-axial joints. The suboccipital muscles commonly become tense and tender due to factors such as eye strain, wearing new eyeglasses, poor ergonomics at your home office computer setup, grinding the teeth, slouching posture, and trauma (such as a whiplash injury).
Suboccipital muscle pains symptomsHowever, when the suboccipital muscles become tight, any of these symptoms may occur. These could include:
- Stiff neck
- Neck pain
- Headaches with a band of pain on the side of the head that extends from the back of the head to the eye. This type of pain feels deeper in the head.
Suboccipital pains treatmentsMost treat them with one or a combination of things like neuromuscular techniques, muscle energy techniques, glides, joint capsule mobilizing, but here’s something that's a little bit more global, and something that I've found in the clinic that has got a little bit more lasting results with my clients’ and patients’. In this video, I started with assessing my patients upper cervical range of motion.
- Pushing the chin forward to see the quality and quantity of range she had (this is the extension of the upper cervical spine)
- As she pulls the head back we are testing her flexion
- Neck we looked at the quality and range of seated forward flexion of the spine, we need to look at the bigger picture when we are treating focused on the large myofascial lines (this assesses your thoracic spine)
- Observing any stiffness within her lumbar region
- Next, we assess passive ranges of upper cervical flexion and extension. We rule out any joint or inert tissue with this. If the head moves further through range, I know it is mostly muscular/soft tissue, if it is still heavily restricted I am erring towards the joints of the cervical spine. Active assisted would be getting them to try to get a double chin into the head back maneuver.
- Then, bending her knees and putting her feet flat, we get her to do some bridging actions. Get those big power driver buttocks muscles to bring her hips and pelvis off the ground. Always ask to move up into the bridge slowly so that the gluteal muscles are the primary target, quick moves can push the pelvis into an anterior tilt and cause the hamstrings to contract. We want the glutes to be the driver in this technique.
- Applying the traction to the suboccipital ridge when she’s elevating and relaxing off your pressure to the skull as she lowers herself. We increase the drag along the whole paravertebral erector spinae group with every move. Getting up into that position requires squeezing those glutes.
- Rolling down bone by bone, starting with a thoracic and then going down to lumbar vertebra is great because it forces the buttocks to stay in control of the move.
- As you do this technique take the pressure off the skull traction but try to find more of a chin flexed position between each hold. We are focused on lengthening the full paravertebral muscles.
- Each hold is for the count of 5.
Step-by-Step Guide for the Neck and Shoulder Office ExerciseIn this article, I will share with you a few easy exercises to check your range. It is important to see how comfortable you are when you go into flexion, extension, and rotation. These exercises (neck and shoulder office exercises) will help determine whether you feel any restrictions in your movement whatsoever.
For the neck:
- Sit up straight, slowly tilt your head forward, bringing your chin to the chest.
- From this position, slowly tilt your head upward, until you are looking at the ceiling.
- Return to the starting position, looking straight ahead.
- Turn your head gently to the left, then to the right. Return to the starting position.
- Lastly, slowly lower your head to your right shoulder. You should be able to do this at a 45-degree angle without any restrictions. The shoulders should not hitch up, and instead, remain still.
- Return to the starting position, and repeat, slowly tilting towards the left shoulder.
Arm ranges to check with adductions, abductions, and flexions:
- For the starting position, hold your arms out on both sides.
- Raise both hands up overhead. Repeat 5 times. this is to check elevation.
- Return to starting position. Then slowly swing your arms forward to check horizontal flexion. Repeat 5 times.
- Return to starting position, then stretch them backward to check extension. Pull your shoulders back as far you can. Repeat 5 times.
- Lastly, do figure of 8 movements.
For the elbows:
- Hold out your arms in front of you, palms up.
- Bend your elbows up towards you. Repeat this 5 times, then return to the starting position.
- Twist your arms outward gently. This is to test internal and external rotation.
- Lastly, try to do the figure of 8s movement with your elbows.
For the wrists and hands:
- You will start with the same starting position as the one from elbows. Bend your wrists upward five times.
- Then, move them from side to side.
- Lastly, do figure of 8 movements.
- Go back to starting position, then flip your hand over so that your palms are facing down.
- Bend your fingers 5 times.
- Then stretch them out, holding them apart from each other. Repeat this five times
- Lastly, try making piano movements with your fingers.
Another tip for your neck and shoulder office exercisesAfter these neck and shoulder office exercises, make them go through the neck ranges again, to see if they get any changes. Another tip I have today is to tuck the chin back into your neck. I always use the analogy of pretending that someone you really don’t like is coming up to you and is trying to give you a great big kiss on the chin. Naturally, you would be recoiling your head back.
- Tuck the chin in. This is the starting position.
- Hold your arms out to your sides, and then pull your shoulders back, like step 4 for the arm movements. hold for 10 seconds.
- Repeat it 5 more times.
Many therapists miss out on getting the best outcomes because they overlook this little muscle. In fact, did you know that a lot of neck-related pain can be traced to the platysma? As therapists, 75% of people entering our clinic complain of either neck or lower back pain! If you are focusing your techniques at the back, which is quite often joint-related or soft tissue around the traps, splenius, etc, then can I ask you to try this simple technique on your next neck pain client?
I could go as far as to say unless we address the tightness in the platysma. We won't get full neck movement.
Your First Moves
First, you must assess your client’s neck range. From a relaxed, sitting position, have your client lookup or go into full neck extension. Watch and be vigilant on the lift to note any tightness of the anterior neck esp the flat band of the platysma. Have your clients return to neutral or as neutral as they can. This video will show you step by step how I teach the muscle and surrounding soft tissue via way of an active glide. This way both of you are working together. Plus, they are increasing their afferent and efferent nervous system. They will also increase their agonists and antagonists, and myofascial trains.
For therapists out there, when we do active movements, it means that both you and your client or patients are actually actively involved in the process.
1. Stand on the treating side, in this case, stand on the right and have the client turn their head to the right, as far as they can go comfortably. 2. Place two fingers or knuckles. If you have OA issues just above their right clavicle at the midline closest to the supraclavicular notch and sink into the tissues. The fingers will be facing out towards the AC joint on the superior line of the clavicle so that you can take up the tissue along with its attachments. 3. Have your client slowly rotate their head back towards the left as far as they can go comfortably. 4. As they move their head allow your fingers to glide along with their muscle. Work with a pace that mimics the speed of the rotation and at the tension of the hypertonic muscle/fascia. 5. I always apply any technique three times before I re-assess. NB* make sure you DO re-assess! 6. Repeat the same process on the other side.
As you’re doing this, it should feel “tight” and “stretchy” or “burny” to your clients – all signs of fascia, muscle, and/or tendon. Have your clients test their range again, by moving their heads up, down, and side to side. The results can be astronomical in pain management, posture, and range. You should be able to see the tissues are not as taut as this time around.
The beauty of this work is that you can offer it to clients as homecare. This is an attempt to release any ongoing restrictions felt in the neck. This is another cool technique that adds value along with the other ways to assist in neck pain that we've discussed in earlier videos.Have fun and hope this helps you and your clients in the future!
Our Jaws in the Modern DayMoving forward 500 million years where we live in a world of ongoing stress, increased hyper-vigilance, high acid systems we see more and more people you clench or grind their teeth. These habits may have varying reasons, like stress, anxiety, or different types of arthritis. Too much jaw clenching may result in cracking of teeth, TMJ dysfunctions, headaches, tension and pain in the neck and head, and farther afield including the paraspinal muscles and muscles of the lower back. It is surprising how stress and/or chronic jaw clenching can have such a significant impact on our glutes, but that is the truth of it. There is an easy way to test this, but you must first have someone else around to help you.
- Lie down completely relaxed, and bend your right knee up, with your foot planted firmly on the floor.
- Have your friend attempt to lift up your right foot, while you use your glutes to resist.
- Now, clench your jaw, and have your friend attempt to lift your foot once again. Try to resist.