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.
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
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.
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!
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.
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.