Understanding Your Shoulder & Neck Pain
Four Muscles You Should Be Stretching To Avoid Neck Pain
The most common area that I treat has to be the neck. Why does this happen so often? I believe that there are several reasons as to why, including poor posture, bad bio-mechanics and inactivity.
Many of us now work in offices with nine-to-five jobs. A lot of these offices have people working at desks, with their computers in front of them, with improperly placed screens, keyboards, mice, and chairs that are not suited for the task of sitting all day long, do not give proper support or are improperly adjusted. The head falls forward quite often due to the fact that the centre of gravity for the head and neck is just above the ear, and very slightly towards the face. Many people also sit with a rounded-over shoulders posture due to fatigue and their own postural ignorance.
One of the things that I most often prescribe for homecare is a series of self stretches to the sternocleideomastoid (SCM), to the scalenes, to the levator scapulae, and to the upper trapezius.
1.I’d like to first talk about the SCM. The SCM starts from just in below your ear, off your jaw line, and reaches down to both your clavicle or collarbone, and your sternum or your breastbone. You can feel this muscle if you put your hand on the side of your neck, and look over your opposite shoulder. You can stretch this muscle from a seated position by tilting your head back gently, and reaching over with your opposite hand and putting it on top of your head. Gently pull your head and hold it for about 30 seconds. You should feel the stretch from your ear down into just above your chest. Make sure to stretch both sides, and that there is no bounce. If there is pain or discomfort, back off. If you wanted to increase the stretch, try sitting on your hand.
Another thing that you can do to help yourself with this muscle is to self massage it. Make sure that you have your head turned to the same side to slacken off the tissue. Take your thumb and first two fingers, and start massaging the muscle up by the ear. Use a little bit of pressure, but not too much. Make sure it’s tolerable. It may be a bit uncomfortable, but this is normal. If you feel like you’re starting to get a headache from any sort of massage to this area, this is normal as well, especially if you feel any sort of patterns like this:
The X’s on the diagrams represent common areas of where the muscle may be feeling tight or sore. The red areas show where you may or may not have pain referring. It may not even be the part of the pattern shown here, but this is where the average person may or may not be feeling any sort of sensation or referral.
2. Next are the scalenes. They come off all but the first cervical vertebrae and either attach into the clavicle or into the first rib. They can cause a number of problems when they’re overused or over-tight, including impinging upon the brachial plexus. This means that if people could potentially have numbness, tingling, or achy feelings going all the way down the arm and into the hand, with nothing actually wrong with the hand or arm itself. Of course, because nothing is ever simple, you can have anatomic variations from person to person, as seen in the picture immediately below. This means one person can have a nerve impinged upon, but have slightly different patterns of numbness or tingling down the arm than another.
You can find the three major scalene muscles and the smaller scalenus minimus just to the outside of the SCM. Please, go easy in this area as it’s right below the carotid artery, and has the brachial plexus running right through the middle of the muscle belly. To find these muscles turn your head to the opposite side to get the SCM out of the way. Put your fingers just above your clavicle, and just outside of the SCM (the side closest to your shoulder). Breathe in. You’re now on anterior scalene. If you wanted to find the middle scalene, it’s just a bit further out towards the shoulder (laterally).
To find the posterior scalene, you have to find middle scalene and the levator scapulae (which I will describe shortly). Gently put your finger pads in between these two muscles. Take a deep breath to further expose the muscle belly. You can tell the difference between the levator scapulae and the posterior scalene by doing tiny little up-and-down shoulder shrugs. The one that doesn’t move around is the posterior scalene.
I wouldn’t recommend doing any sort of self massage to the scalene group because they are so close to the brachial plexus; it could make your problem a lot worse. Self-stretching is an excellent idea instead because your fingers are not poking anything that could cause any problems. As with SCM stretching, stay seated. You can bring your neck away from the side you’re trying to stretch, but just keep your head and neck moving in such a way that you’re trying to bring your ear into the top of your shoulder. No rotation is needed. You can bring your hand across your head as a way to increase your stretch.
3.I’d now like to talk about the levator scapulae. It comes off the outside, or lateral parts of the first four cervical vertebrae, and down to the inside, or medial corner of the shoulder blade, or scapula. The muscle is used to elevate the shoulder, especially if reaching overhead or if you are shrugging your shoulders.
When people assume the typical working position at a desk, their shoulders are hunched and rounded over. What this does is shorten up the muscle, making it tight, and causing tension and pain. Self stretching can help this by lengthening the muscle back out. While you’re seated, try bringing your chin to your chest, and then by bringing your ear into your shoulder, then looking down at your armpit. You should look like you’re trying to smell your armpit. You can use your arm to pull your head across if you like, and if you want to stretch further, you can bring your arm up almost like you’re stretching your triceps, but I prefer to just sit on my hand. It makes it easier to remember. I’m going to recommend that you not massage the levator scapulae because of the fact that it is so close to the brachial plexus and because there are so many vulnerable structures in your neck.
- Now we need to talk about the upper trapezius. It comes off right from the base of the skull, off of the inion, and the nuchal line. We can feel these as the rather large bump at the back of the skull, and the ridge just below that respectively. The muscle then comes down and out across the shoulder to the lateral third of the clavicle, to the top of the shoulder to just before it meets the humerus, and into the ridge that you can feel on your shoulder blade, called the scapular spine. This is the primary muscle that gets cranky when dealing with the rounded over shoulders posture that was discussed earlier. You can stretch this out by tilting your head forward gently, then by tilting your head to the side. It’s almost as if you’re trying to touch your ear to the front of your shoulder. You can increase the stretch by putting your hand on your head again, and gently pulling.
You can use something like a TheraCane (which, we coincidentally have in store!) or two tennis balls stuffed in a sock to do some self massage on the upper trapezius if you like.
As we can see from the black, red, and white picture above, if pressure is put on the approximate area of the X, you may get referral patterns in a sort of question mark pattern, with the terminus around the outside corner of the eye. Referral can also be felt at the angle of the jaw.
I myself love using deep moist heat on these muscles because it helps improve blood flow, which improves tissue extensibility as well as bringing nutrients to the area. It doesn’t feel too bad either!
If you have any questions or comments, please don’t hesitate to let me know! I’d love to hear feedback on what you think about these, or if you have any ideas for future topics!
I can be reached at 250-298-4484, or at [email protected]. I’m currently available for clients on Saturdays from 9:30 to 6, or for later appointments upon request. Roxanne is also available for appointments throughout the week. Appointments can be booked easily and conveniently online here.
I look forward to hearing from you!
Until Next Time,
Kirsten
DISCLAIMER: This information is not a substitute for professional advice or therapy. Please check with your physician or health care provider before trying this out to confirm it is appropriate for your condition. Always stay within your comfort zone and if something does not feel right, refrain from doing the activity.
