Deep Neck strengthening
 

Hi,
I was wondering if any members here have any tips or advice regarding deep neck strengthening, as in the deep muscles and ligaments of the side, front and back of the neck.

The only exercises I have found are isometrics, but there is considerable debate about how effective they are, and wisdom holds they have to be progressed to 80% of max strength for actual strength to follow. That would activate my superficial muscles too!

Now my neck thanks to whiplash, is pretty weak at specific "segments" on the left side since that's where I fell- at the middle/bottom and right at the top. When I move my neck up and down, it actually "pulls" to the right. I can't rotate my neck to the left/right well because in a sense, that's where its unstable and the brain is directing the musculature to prevent the rotation.

So whats happened is my neck is messed at specific segments - rotation, flexion - probably the ligaments too, left side is very weak - and the right side (scalenes) are overactive to stabilize my neck.

This is what is causing TOS on the right side. On the left side, the lack of stability implies, the pain generators are probably the facet joints and nerves themselves.

So how can I strengthen the neck without activating the superficial muscles? Any ideas welcome.

Tight muscles are weak muscles.

Do a search for "chin tuck exercises".

Hi Eight, thanks - those are deep neck flexor alone exercises, correct?
I am thinking rotators and extensors on left also need a leg up.

Also, how does one do unilateral strengthening? I need to strengthen left more than right.

I frequently wake up with a headache and stiff neck. I could benefit from some exercises too.

Does holding your head back then rotating your head help? It makes a crunching sound.

A crunching sound is usually a sign of some amount of instability or funky stuff going on. It by itself is harmless, and a sign of crepitus and more of an indicator.

Headache could mean overactive SCM and deep neck flexor exercises should help. On my left side where i have damaged deep neck flexors, i get headaches.

It's been crunching since I was a teen so I guess that's normal. :o

FWIW i have read of people strengthening their shoulders especially lower traps, rhomboids and the cracking went away.

Ok, results. I have read people with cervical issues have flare ups, post the exercise if it didn't work out, some 24 hours later and then it worsens or betters or just tapers off.

In my case, I did a lot of strong (in other words, wrong) isometric exercises for my left. I think it was a mixture of impatience and generally "do something" attitude.

So I had a flare up which lasted for 2-3 days. Shoulder pain and worsened symptoms.

After that, I do feel things improved. Not by much, but yes improvement. How I judged this? Movement in a moving vehicle, usually I would find it hard to sit straight - that worked.

Its not a magic cure all, but it does help positively.

Next step, regular isometrics with lower strength.

One big issue I am struggling with is whether to do an exercise program and go for a MRI/xrays to determine cervical instability.

If the exercises are marginally successful, they would bias the test results.

And cloud the diagnosis.

My upper body update.
While x-rays have come back normal. I do believe though that I have cervical instability especially on the left side. However, deep neck muscle strengthening, lower core, and arm strengthening are probably what I need to try first.

Deep neck flexors - IMO - dysfunctional (L especially); still figuring out how t strengthen these.
Tight Pec Minor (R>L)
Tight Lats (R>L) - perhaps stretches for both pec and lats might help

Probably aloe vera to reduce the load of inflammation induced by stretches.

Prolotherapy is probably my last option to fix my posterior ligaments. I suspect lax ligaments allow my neck to translate forward when sitting forcing my pec minor and levator and upper traps to get overactive.

My main issue on my right side is an overactive pec minor. Its dominating all shoulder muscles. Is there a way to strengthen the lower traps and serratus while shutting off the pec minor and levator?

Any ideas welcome.

This site has exercises for lower traps and serratus: http://fixtheneck.com/

I find prone cobras good for the lower traps and push up plus for serratus (I do a lot of these).
Though both put a load on the neck.

I have a concern about "strengthening" neck muscles w/TOS.

If you try to do so and those muscles are already over firing from nerves or spasms it won't do any good and may make things much worse..

I would only attempt to strengthen when all muscles are relaxed and not in spasms.

In the trigger point sticky thread there is more info about it-
If a muscle has trigger points/spasms - you cannot accomplish much until all of those are resolved..
http://neurotalk.psychcentral.com/thread125577.html

Passive stretching that allows the shoulders to relax & drop was very helpful for me - images here-
http://neurotalk.psychcentral.com/album.php?albumid=422

Hiker thanks!! Have the pushups with a plus helped? My wrists are too weak or painful to do them. I end up being on my knuckles and my form sucks.

Jomar I tried trp therapy once I guess I need to restart. It's done relatively little for me as my dominant muscles overpower the weak ones causing all the pain. I am trying to kick start the ones which are weak. Trp could be a usefull adjunct...even dry needling had some limited use.

the one thing that did help though was a kneading type massage vs the relatively painful - find a muscle and fix its trp stuff. on a trip to asia, i had a massage for 15 mins and wow, almost a weeks worth of pain was wiped out.

the reason this board is amazing is all the experiences shared. my efforts to stretch out on a foam roll were a flop and then i realized hiker mentioning his nerve pain in lower back being aggravated was the same as mine. i probably have a disc issue in the lower back as well while had a previous injury as well.

so yeah, i guess you have a point and i should find a trp therapist.

anyone tried accupuncture? i was told to try that by 2 PTs.

Is there a ratio which you apply between serratus and lower trap exercises? They are antagonists apparently in terms of location and attachment to shoulder blade.

Let me rephrase - aim is to strengthen the deep neck muscles to take the load off the superficial ones. They are the ones which compress nerves etc. Also, since they are always on, the weaker ones are inhibited. That's part 1.

Part2 is to strengthen the weak back muscles so they dont pull on the neck.

Easier said than done since i am still trying to figure out methods for both of above. For instance, flexion of neck - of any kind, causes me pain. I suspect this is becaue my left side cervical stabilizers are so injured, that the disc bulge presses on nerves and the facet joints also grind together, causing shoulder and arm symptoms plus neck pain.

Since my TOS was caused by trauma, I think this is what happened. Entire sections of my muscles were switched off due to either injury (and CNS recruiting their not so exact replacements). Basically wry neck. One side "loose and floppy - left with deep muscles off' whereas right is completely overactive.

Problem i've run into is stretching doesn't work because its either temporary or causes a stretch reflex. The muscle contracts even more strongly.

Third possibility is deep ligaments etc are damaged hence muscles will always remain in protective spasm. That can only be resolved with surgery or prolotherapy. But even as I run around for diagnostics to confirm the above, I want to give strengthening a chance.

Reason being, I perceive that if you go with a lot of weak stuff and the MRI shows x damage, its easy to say x is the cause of the pain. However, what if strengthening y, which pulls on or stresses x allows pain to go down or gets you to some ok level? Then there is no need for any measures

Hard to tell. They did help strengthen the serratus anterior.
But I think part of my problem was that it (and the lower traps) was not activating to stabilize the scapula when I was moving my arms around and neck muscles were doing all the job.
Here is what I was doing to address this.
1. First learn to activate the muscle in isolation. I found it difficult to do for the serratus. I don't know the proper technique for that I was simply lying on my back trying to pull the scapula to the rib cage and feeling with my hand what gets activated. fixtheneck site shows how to do it with a mirror, but I think you have to be very skinny to see the weak muscles activate.
2. Then train the SA to activate when you raise an arm. Every time you raise an arm you make an effort to activate the serratus and lower traps. After a while this becomes automatic.

No, no ratio.
Yes they are antagonists. Lower trap pulls the scapula down and medially and SA's lower fibers pull it down and laterally. But working together they stabilize the scapula and keep it from winging.

A new member was asking about Edgelow protocol , while searching I also found some videos on top rib , so posted them on that thread, but they might be helpful for this topic also.. if top rib is a problem, you have to address/fix that before working any muscles..
http://neurotalk.psychcentral.com/thread231333.html

Very interesting!! How did you do this? Has it worked to reduce pain?

If I relax the scalenes wont ribs pop back into place?

I just made an effort to always think about the muscles when using arms. First engage the muscles then raise an arm.
I could not use my arms much due to pain so it was not that hard.

Don't think it had any direct effect on pain, but over time I was able to use my arms more. In my case the upper traps were doing all the work which lead to neck spasms.
A year ago I was not able to raise an arm above shoulder level without triggering bad pain. This is not a problem anymore. I still have neck pains, but no disabling pain which I had last year.

mine didn't, they were stuck from all the spasms..

Well, I just remembered after i checked my notes. I managed to find a broom handle and force my first rib down - it felt somewhat good, but no significant improvement, worth another try sometime i guess. Looks like I best get off my lazy butt and start doing the Edgelow stuff.

Its mindset, i am finding it very hard to consistently do the BP cuff thing & breathing. Perhaps I need to trick my mind calling it an exercise. That does the trick sometimes.

Hiker, how many reps of the push ups and prone cobras do you do/day?

Also the neck exercises with the cuff and the neck rolls?

I do them for 1-2 minutes each along with other exercises. 3-5 times a day.
I usually combine neck rolls with the foamroll stretch. 5 minutes at the end of the exercise routine.
I no longer do the cuff exercise as it doesn't seem to do much for me. Per Edgelow it is 30 reps with 5-10 second hold 2 times per day.

Brilliant.. i just figured out i have palsy/very weak serratus on one side.. and lower traps on the other side.. all thanks to a whiplash injury.

Now I have to figure out how to rehab both muscles. Any ideas welcome.