In the last module, we made sure to rule out any red flags causing you pain.
In this module, we discuss some of the basic anatomy associated with our cervical spine and neck. We will discuss the intervertebral disc, some important muscles involved in neck pain, and how posture affects our anatomy and leads to injuries.
Your neck is relatively flexible so it relies on muscles and ligaments for support. "Sprains" and "strains" are the result of these tissues being stretched too hard or too far, much like a rope that frays when it is stretched beyond its normal capacity.
The term, "sprain" means that the tough, durable ligaments that hold your bones together have been damaged, while "strain" means that your muscles or tendons that move your neck have been partially torn.
An extremely common diagnosis for neck pain is a herniated disc, but what exactly does that mean?
Throughout our spine, we have little shock absorbers that connect the individual vertebrae together. These are called intervertebral discs. A disc is made up of a fibrous outer ring and a gel-like center.
Here's where a jelly donut analogy may help. You know when you squeeze a jelly donut and all the jelly comes out? That's kind of what they disc in your back are like.
When we suffer disc-related injuries, the outer fibres can be damaged, and the inner gel will squeeze out.
Upper Crossed Syndrome is less of a syndrome and more of a pattern of muscular imbalances that we commonly see in patients with neck pain.
Upper Crossed Syndrome is largely a result of current societal habits and the amount of time that we spend staring at screens. When we are working at a desk, looking at a phone, or watching TV, we are often held in the same posture for extended periods of time. In fact, if you work in an office you may be in that posture for over eight hours a day!
When the body is in a sustained posture the muscles will adapt. Therefore, muscles that aren’t activated to sustain that posture become very weak, while the muscles that are held under a lengthened position will conversely become overactive, tight and irritable. This is called a “crossed” syndrome because the pattern of weak/tight creates an “X” in the upper body.
A = The Tight Line
- Staring at screens or phones cause muscle imbalance patterns to develop. This results in the muscles lifting around your shoulders, pulling your head forward.
B = The Weak Line
- Line B muscles react to changes in the neck, head and shoulders and the body compensates by inhibiting the muscles.
The muscles in this area all play a role in distorting and compression the body's bony framework which can lead to pain-spams-pain cycles.
Restoring the original balance and symmetry requires a therapist to manually lengthen the tight muscles and tonify the weak, inhabited tissues.
- The suboccipital muscles: These muscles are at the base of your skull and the top of your neck. They are often very tight due to the posture of your head while you look at a computer. When these muscles get tight, they become very tender and can be a leading cause of cervicogenic headaches (headaches stemming from your neck).
- The levator scapulae: This is a muscle that attaches to the top of your shoulder blade and extends into the neck. It is often very tight in upper cross syndrome and can be a common neck pain generator.
- The upper trapezius: The trapezius is an interesting muscle because it has 3 parts. The upper trapezius is typically overactive and apart of the “tight” group in Upper Crossed Syndrome, while the lower trapezius will be weak and inhibited. The middle is often unaffected in this syndrome.
- Pectoralis major/minor: Pec major and minor tend to also become facilitated when someone is dealing with upper crossed syndrome. This is a result of sitting with your head forward and your shoulders rounded.
- The deep neck flexors: The deep neck flexors are a group of muscles that sit behind your trachea and esophagus. They play an important role in flexion of your upper cervical spine. With the common forward head posture we see in today’s society, these muscles seldomly have to work hard and as a result become very weak. Strengthening these muscles serve a very important role in the treatment of neck pain associated with Upper Crossed Syndrome.
- The lower trapezius: As discussed above, the trapezius is made up of lower, middle, and upper sections. While the upper trap is often a very tight, shortened muscle, the lower trapezius is often weak and overpowered by the tighter muscles above it. As a result, we develop poor control over our scapula (shoulder blade) which can ultimately lead to imbalances in the both the shoulders and the neck.
Neck pain patients that presents with any of these patterns will be treated in our office using manual therapy to help release these chronically tight muscles and strengthening exercises to help retrain the muscles that are weak.
This is a very effective treatment not only to reduce symptoms but eliminate recurrences of pain.