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[Muscle Monday]  I Have a Core In My Neck Too??  Introducing the Deep Neck Flexors

6/7/2020

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Every time someone talks about 'core strengthening', your mind probably goes straight to "Abs! Abs! Abs!"  and "Planks for days!"  What if I told you that there is another often-neglected core in your body that is equally as important?  Welcome to the fourth installment of our Posture Series. Allow me to introduce the Deep Neck Flexors (DNF) - Longus Colli and Longus Capitis.
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Image Credit: www.kenhub.com
While small in stature, these two muscles work together, similar to your abdominal muscles, to stabilize the neck and keep your head balanced on your spine.  With the human head weighing about 10-11 lbs (admit it.... some of your heads are bigger than others), balancing on top of a small flexible peg (ie. your spine), perfect balance is necessary in order to minimize stress on the spine and allow your muscles to work at their best abilities.  
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Both of these muscles sit right up against your cervical spine and they work together to flex the spine to a small degree.  When working together in a balanced manner in conjunction with the ALL of the muscles around your neck, including our friends the upper trapezius and suboccipitals which we discussed in previous posts, they help stabilize the head and neck through micro adjustments as you move.
Neck pain and its effects on muscle activation of these muscles have been widely studied over the last few decades.  Studies have found that up to 70% of  patients with chronic neck pain actually have decreased muscle activation of the deep neck flexors and sternocleidomastoid (Source).  In the same study, subjects with chronic neck pain who underwent a deep neck flexor strengthening program showed significant decreases in overall reported neck pain 
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If you've read my last few blog entries, you are likely now familiar with our poor-postured friend.  With poor posture, the DNF complex  (the upper/front portion of the cross) gets stretched/elongated which, in turn, results in the muscles becoming inherently weaker and less able to perform the job it was tasked with.
This is also significant for people who have experienced whiplash injuries such as being involved in a car crash.  In the beginning of the whiplash motion,   the head is flung backwards during the hyperextension phase (in the picture below), which strains the anterior neck muscles such as the DNF and sternocleidomastoid muscles (to be discussed in a future post).  However on the rebound the head is flung forward, putting increased strain on the upper trapezius/levator scapulae muscles.  Depending on the severity and velocity of impact, ligaments supporting the cervical spine may also become sprained.
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So you have a scenario of what came first?  The chicken or the egg?  Did neck pain develop which caused the DNF and supporting muscles to become weaker?  Or did the DNF get weak because of poor posture, which resulted in neck pain?  

This muscle is particularly important for musicians who are violinists or wind players.  With the majority of mankind typically sitting in some kind of slouched posture you can end up relying on those stronger/tighter muscles that we previously discussed (upper trapezius much?) to support the instrument or bring our heads to the instrument to play.  Instead, I challenge you to add in a bit of DNF strengthening into your warmup routine.  

Next week will be our final installment of the Posture series, where we spend a little more time with our poor postured friend and link some of these muscles together.  While they are not the ONLY ones affected by posture, it's important to start to think about how they all affect each other and give you a better understanding of how they work.

Until next time,
​Stay happy and healthy!
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[Muscle Monday] My PT Told Me That My Neck Felt Like a Rock!!

4/13/2020

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When I was in college, there was a wellness fair with a massage station tucked away in the corner of the cafeteria.  I waited patiently for my turn and when it came, the therapist introduced herself to me and asked me if there were any areas I wanted her to work on.  I had never received a professional massage before, so I just shrugged and told her to focus on wherever she thought was the best.  She smiled and had me sit and put my face in the hole in the massage chair.  When she felt my shoulders, she recoiled in horror and called her colleague over to feel my muscles as well.  "WHAT are you doing to yourself??!" they asked.   The fact is, is that I was on the computer, playing the violin and piano and texting for hours upon hours during the day.  I had build up so much tension, but I didn't even realize it.
Allow me to introduce you to our friend, the Upper Trapezius:
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This broad muscle attaches from the base of your skull, extending down the spine and out through the upper border of your shoulder blade.  It's part of It's responsible for controlling your head and neck.  What's more important, is that it's a common muscle to exhibit tightness as a result in poor posture, stress or anxiety.
The upper traps can also contribute to neck pain, headaches or pain in the shoulder blade.  These tender areas are commonly referred to as "trigger points", which we will discuss in a future post.
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Simons, D. G., Simons, L. S., & Travell, J. G. (1999). Travell & Simons' myofascial pain and dysfunction: The trigger point manual. Baltimore: Williams & Wilkins.
Here are 3 things that you can do to help improve the tightness of these muscles. 
  • Make sure that your workstation or instrument is set up to allow you to be in a good posture while you are using it.  
  • Take frequent rest breaks when you are working or practicing - take a break to stretch or stand up every 45-60 minutes
  • Try these stretches (make sure to avoid any pain or numbness)
If you have any pain that persists or not sure how to stretch, make sure you seek help from a physical therapist or medical professional for the best guidance.

​Until next time, stay happy and healthy!
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    Author

    Dr. Janice Ying is a Los Angeles-based Physical Therapist.  She is board-certified Orthopedic Physical Therapy Specialist and is regarded as a leading expert in the field of Performing Arts Medicine and the development of cutting edge injury prevention and rehabilitation programs for musicians.

    Disclaimer

    The information on this website is intended for educational purposes and should NOT be construed as medical advice.  If you have or think you have a health-related issue which needs to be addressed, please seek the help from your local licensed medical professional.

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