Laurence Plant is specialist chiropractor and clinic manager at Henley Practicea multi-discipline sports injury clinic based in HenleyOnThames. The clinic has a diverse team of practitionersensuring they offer the highest standard of evidence-based care to all clients. The clinic covers a wide range of treatments, with a primary focus on swim, bike and running related injuries and performance. 

Physiotherapy Expert

 

Neck Anatomy 

The muscles of the neck are a hot topic within anatomy circles and with more than 100 muscles in your neck, head and face area, it’s vital to keep them all functioning properly. The neck itself plays crucial role in supporting your head and consists of seven vertebra which hold up the skull. Central to the neck is the spinal cord, where nerves exit at each level and travel further down to innervate the rest of the body. The nerves that exit the neck from the side, form the brachial plexus and travel down under the clavicle to your shoulders and arms. 

Anterior to the neck is the collar bone (clavicle), posterior to the neck is the shoulder blade (scapula) and lateral to the neck is the acromion. Anteriorly, the sternocleidomastoid muscles go from behind the ear, diagonally down to the sternum. Posterior to the neck are the upper trapezius muscles, which attaches on the vertebra of the neck, connecting the scapula, clavicle and ribs. Another posterior muscle called levator scapula, goes from the upper and inner corner of the scapula to the top of the neck. On the lateral part of the neck are the scalene muscles. The scalene muscles act as accessory muscles of respiration and perform flexion at the neck. 

Supported and protected by muscles which generally go from the scapula, up to the vertebra in the neck and some attaching onto the back lower area of the skull (occipital). They allow the head and neck to rotate, flex and extend, and also act to prevent excessive movement. The sternocleidomastoid muscles on the anterior of the neck help with flexion and rotation. 

There are also a few large muscles on the posterior compartment of the neck; the trapezius and the semispinalis capitis. The trapezius muscle helps with your posture and is used to help rotate the neck, and also to shrug and steady the shoulders. The scalene muscleslocated in the anterolateral part of the neckextend from the vertebra to the first two ribs. These muscles help with flexion and side flexion of the neck. The longus capitis muscle is a deep anterior muscle that runs in front of the cervical spine, used for stabilisation. 

 Conditions 

Upper Crossed Syndrome 

Upper crossed syndrome is a posture that develops when the muscles in your neck, shoulders and chest become deformed. Typically, this due to an imbalance in the muscle ratios of the upper body. This leads to your shoulders becoming rounded forward (protracted) and the head leaning in a forward positionUpper crossed syndrome is very common in runners who have a tendency to lean forward, rather than maintaining tall posture from the hip up. This places excess strain on the muscles of the upper shoulders, upper trapezius, levator scapulae and surrounding musculature. 

Causes 

  • Poor posture – Constant sitting at desk/car, slouching 
  • Incorrect body alignment 
  • Running on hard surfaces 

Symptoms 

  • Pain/ache in your upper back and shoulders 
  • Pain/ache in the back of the neck 
  • Limited range of motion in your neck and shoulders 

 Management  

  • The best way to treat upper crossed syndrome is through exercise and postural changes. A few simple exercises daily can help relieve stiffness and soreness. 
  • Relieve tension in the levator scapulae by using a lacrosse ball against a wall or on the floor to breakdown the trigger points. #
  • It’s important to stretch the pectorals, allowing the shoulder to be pulled back into better posture (retracted). 
  • A sports massage can be a great aid when aiming to decrease muscle tension. 

Prevention 

  • Postural strength training is key to develop the lower scapular stabilisers and can be done with the use of a Meglio resistance band. 
  • Foam rollers can be used to increase thoracic extension; therefore promoting better upper body posture. 
  • Develop strength in the deep neck flexors so that the posture of the neck is straighter and removes the tendency for the head to be carried in an anterior position. Lay on the floor, place a small block under the back of the head and practice gently tucking your chin towards the floor. When done correctly, you will feel the muscles deep under your chin react and it will feel as though you have developed three chins! 

Resistance Bands Neck Pain

Breathing from your shoulders 

If breathing occurs from the upper shoulder area, it leads to repetitive elevation of the upper shoulder girdle. This in turn creates excessive tension in the upper shoulder musculature and can lead to compression of the brachial plexus. Breathing during running should occur predominantly from the diaphragm and lower ribs and will only result in upper shoulder activation at the extreme effort intervals. 

Causes 

  • Inefficient breathing style 

Symptoms 

  • Pain in the upper shoulderand neck muscles 
  • Pain around the front of the neck to the collar bone (clavicle) 
  • Radiating discomfort that can travel into the arms and as far as the hands (brachial plexus compression) 

Management  

  • Relieve tension in the upper shoulders using self-release massage techniques like a lacrosse ball or foam roller. 
  • Stretch the muscles of the anterior neck 
  • A sports massage can be a great aid when aiming to decrease muscle tension. 

Prevention 

Train to breath from your diaphragm. Lay on the floor and work on drawing your breath into the base of your rib cage and stomach. Place your hands on your stomach, so that you can feel it rise up and down as you inhale and exhale. This can then be practiced in a seated and standing position, before executing while you run. 

 

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