The Ascent #2

What to do with a stiff neck:

Waking up in the morning and not being able to turn your head can be pretty concerning and impactful. I occasionally notice that after I’ve gone camping or slept in a hotel bed I’ll wake up with this stiff neck. For me, this means, when I turn a specific direction I have a sharp/specific pain in a certain spot on my neck that often radiates into my shoulder blade region. It usually doesn’t last too long, a few days maybe, and then it’s back to normal. However, these few days with this stiff neck can really impact life. Every time I check my blind spot while driving, move my head quickly to look at who is talking to me, or work at the computer for longer than 10 minutes, I’ll notice that discomfort. From this, the question arises of what, if anything, can be done to speed the recovery process along? Here is my approach to managing these symptoms without treatment. Of course, I can’t guarantee this would be appropriate for everyone as each condition can be different. A quick self assessment obviously isn’t a substitute for a professional evaluation to ensure the appropriate treatment is being applied. With that said, here’s what I’d do:

1. Check for a reproducible sign

- Find the specific movement that provokes the symptom every time you do it

2. Apply the cervical self mobilization technique outlined in the prior post

- Points of performance-

a. Symptoms should be better with the towel not worse.  If symptoms are worse, slide the towel slightly up or down your neck until you find the location that improves the symptoms with the movement.

b. Complete 3 sets of 10 repetitions, checking in-between sets to see if the reproducible sign(painful movement) occurs

c. Make sure your chest is up, shoulders are back and that your shoulders don’t rotate when turning your head

d. Symptoms should be improving and eventually resolve following the application of the technique

3. Recheck the reproducible sign

- If symptoms are gone, complete the technique every 3-4 hours throughout the next 2 days

- If symptoms are not gone, other techniques can be applied

4. Other Techniques:

• Foam roll thoracic spine- Horizontal thoracic foam roll rolling up and down the spine

• Trigger point release with racquet ball, tennis ball or lacrosse ball

• Scapular strengthening- Rows, shoulder extensions, pulling exercises

• Chin tucks- leaning against a wall, sliding the back of the head up the wall

5. If none of this works, and time doesn’t resolve the symptoms, the next best move would be to seek evaluation and treatment.

My treatment philosophy for this condition is associated with the theory that a joint or a few joints in the neck get “stuck” by being in one, less than optimal, position for an extended period of time. When the joints in the neck get stuck it causes the muscles around those joints to work to protect those joints which is in effect a muscle spasm. The idea with treatment is to help the joints that are stiff to move better and to help the muscles reset out of a spasm state.

Please let me know if you have questions or if there's any way for me to help!

nicsiewert@physicalitypt.com or text to (541)510-3622