NECK CARE AND SELF HELP EXERCISES

For sufferers of recurrent headache, or long standing intermittent neck pain or ache

PostureA side view of the human body in standing shows S shaped curves with a hollow in both the neck and the lower back (lumbar lordosis).

Keeping a good posture at all times can help prevent neck pain and stiffness (as well as relieve aching in the upper back, shoulders and arms).

Consider the following:

1. Standing

Due to postural neglect, people can often be seen to carry the head in front of their body with the chin poking forward.

Try to “grow tall”, hold your head high and neck straight. Do not poke your chin forwards. Keep your shoulders relaxed, and you may need to gently draw them back.

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2. Sitting

To prevent the development of neck pain, due to prolonged sitting, it is necessary to:

a. Use adequate type of chairsb. Sit correctly (avoid slumping)c. Take regular breaks

Ideally all chairs should provide support for your lower back so that the lordosis naturally present during standing is also maintained whilst sitting. If the chairs you sit on do not give adequate lumbar support, a “lumbar roll” should be used. (Ask your physiotherapist where you can buy one). This is placed in the small of the back to maintain the lordosis and can be used in any chair or car seat. As well as helping to look after your lower back, it immediately encourages your head and neck to be more central and in a better postural position.

Sitting at WorkPeople with office jobs easily develop neck (as well as low back) problems. This also applies to school children and students. All chairs should provide adequate support for the lumbar curve, and be the correct height in relation to the table or desk, so that when sitting (with your stomach against the desk) you do not need to lean forward. A sloping surface for resting the books on, and for use when writing, is also desirable. It is much better to have the work at eye-level with the head up than to be bent over a desk or table.

Ideally the seat should slope down from back to front (alternatively use a foam wedge cushion; ask your physiotherapist where you can buy one) with the feet resting comfortably on the ground. This forward slope encourages the maintenance of the natural curves of the back and neck. Chairs are made which feature this concept. They are call BALANS chairs. Some have no back rests, and are good for shorter spells of desk or table work e.g. in the home.

Sitting at HomeAll easy chairs must have good support for the lower back in order to keep the head upright and a good neck/upper back posture. The seat base should be firm and of the correct depth for the individual, (i.e. your bottom should be touching the back of the chair). Not uncommonly, seats are too deep, encouraging “slumping”. This makes the head and chin poke forwards and causes strains on the neck muscles. The feet should reach the ground comfortably. It is also desirable that the seat back be tall to rest the head on. You can try a small cushion or roll to support your neck.

When sitting for prolonged periods, take regular breaks to prevent the onset of pain. Stand up and with your hands in the hollow of your back for support, bend backwards a few times. Then walk about for a few minutes, keeping your head up and neck straight. While sitting try to exercise for 5 minutes every hour i.e. roll the shoulders backwards and turn the head from side to side several times to prevent muscular tension.

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3. Sleeping and Resting

Try lying on your back with one pillow; however if your upper back is more rounded, try two pillows tiered, that is, have the lower one partly under your shoulders.

Keep the hollow of your neck supported, without the head being bent forward too much by:

a. Tying your pillow gently in the middle e.g. with an old stocking or a thin scarf, or:b. Try a supportive roll made of foam (about 3” diameter and 18 inches long) or a rolled up towel placed

inside the pillowcase.c. Buying a neck shaped orthopaedic pillow.

If you lie on your side, try two pillows.

If you need to sleep in a raised position e.g. because of a heart, chest, hernia or dizziness problem, use plenty of pillows to support upwards from the waist, with the tied pillow at the top.

Once you are adult, try not to sleep on your front; it can cause a neck strain.

If you regularly wake in the morning with a stiff and painful neck, do also consider your bed. Your mattress should not sag. The mattress itself should not be too hard, but it should be placed on a firm support.

4. General Work and Leisure

Avoid prolonged head bending, stretching back, and awkward working positions.

At leisure, when reading, hold your paper or book well up with your arms supported; similarly when knitting support you arms and try and rest your head on the chair-back.

Sit facing your television set, or the people you are talking to. Check your posture if you wear bifocal glasses, you may be constantly ‘poking your chin’.

When bathing do not lie in the bath too long, it is impossible to keep your head in a good position.

Avoid carrying anything heavy e.g. shopping bags.

AVOID LOOKING UP IF THIS CAUSES DIZZINESS.

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5. Effects of poor posture

Poor posture results in what we call mechanical pain, due to the stretching of the soft tissues, that is, the muscles, and the ligaments. This disturbs and irritates the nerves. When poor posture becomes a habit, all the tasks of everyday life are being performed in strained postural positions, causing the soft tissues to be overstretched and damaged. They may then heal with scar tissue forming, and if not exercised the muscles begin to tighten. Because these strains are often repeated, the neck movements continue to stiffen. Also our necks stiffen very easily with mental stress and tension. Use relaxation techniques to ease tension.

ExercisesHere are some simple, important exercises, to be practised daily, to help first to loosen your neck, and then to maintain good movement and posture. Use heat before exercising to reduce stiffness. If you feel dizzy whilst exercising stop.

Retractions

Start by lying with one pillow:

Gently press your head into the pillow with the chin tucked in, and feel your neck flatten into the pillow (as if you are making a double chin). Repeat this about five times at first. You should feel stretching in your neck.

As soon as possible, progress to doing this exercise in sitting, in an upright firm chair with the low back well supported. Make sure you keep your head horizontal, and do not poke your chin out. Hold the retraction a few seconds before gently releasing. You can benefit from repeating this exercise, little and often, during the day.

Extensions

Only progress to this when you have become proficient at retraction. In sitting, perform retraction, and while keeping the neck back start to gently let your upper back, neck and head move backwards, as far as is comfortable, then return to the starting position, keeping your chin down and in a good position all the time.

Retractions and extensions are the most important exercises to practise regularly.

Other important movements which need to be regularly exercised are:

a. Turning the head to look over your shoulderb. Bending the head sideways, taking your ear towards your

shoulder.

Always start with, and hold, retraction while doing these movements.

a.

b.

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