Latest / The Driven Athlete / Neck Pain, Headaches, & Steps to Get Relief | Ep 43

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Neck Pain, Headaches, & Steps to Get Relief | Ep 43 · The Driven Athlete

• 0:00
  Speaker 1: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what this podcast is for you.
• 0:07
  Speaker 1: This is the Driven Athlete Podcast.
• 0:10
  Speaker 1: What's up y'all?
• 0:13
  Speaker 1: It's your man, dr Kyle.
• 0:13
  Speaker 1: Welcome back to the Driven Athlete Podcast Topic today neck range of motion and neck mobility.
• 0:19
  Speaker 1: As it relates to pain, stiffness, tightness and the classic upper trap tightness or levator scap tightness, pain down my shoulder blade or tightness down the middle part of my shoulder blade towards my spine, those are all classic signs and symptoms that usually we first think as clinicians.
• 0:36
  Speaker 1: We got to roll up the neck.
• 0:37
  Speaker 1: Usually neck is involved, all right.
• 0:39
  Speaker 1: So the neck plays a huge role with a lot of functional activities rotation, turning your head side to side, but also turning your body side to side and keeping your neck fixed in a fixed place.
• 0:49
  Speaker 1: As an example, golf swing or tennis swing or baseball.
• 0:54
  Speaker 1: You have to keep your eye on the ball right and golf imagine golfing or tennis.
• 0:58
  Speaker 1: You have to wind up right, the back turn for golf, but you have to keep your eye on the ball the whole time.
• 1:03
  Speaker 1: And if somebody is limited in the ability to rotate backwards and they're stuck because they lose their eye on the ball.
• 1:09
  Speaker 1: That's not a thoracic spine or rotation or hip problem, that's actually a neck problem because your neck range of motion relative to the rest of your body is limited and not allowing you to rotate back as far as you can in your turn, as an example.
• 1:21
  Speaker 1: So, with that being said, we can't neglect or not investigate the role that the neck is playing with limitations and stuff.
• 1:29
  Speaker 1: So how do we go about that?
• 1:30
  Speaker 1: Right?
• 1:30
  Speaker 1: What do we investigate?
• 1:31
  Speaker 1: It seems like a lot of the classic neck limitations, especially for rotation, is limited at the first two cervical vertebrae.
• 1:40
  Speaker 1: Okay, a little anatomy your cervical spine, your neck has seven vertebrae called the cervical spine, the seven cervical vertebrae.
• 1:45
  Speaker 1: Okay, a little anatomy, your cervical spine, your neck has seven vertebrae called the cervical spine, the seven cervical vertebrae.
• 1:48
  Speaker 1: All right, one, two, three, four, five, six, seven, the top two.
• 1:51
  Speaker 1: Your atlas sits on top of your axis and your axis C2 sits underneath C1 and actually 50% of your cervical, your neck range of motion in rotation comes specifically from C1, c2.
• 2:07
  Speaker 1: So if someone is limited in rotation, man, that's going to be the first joint we check, all right, just being purposeful, precise and accurate, of like, what's the cause of this limitation of mobility and range of motion.
• 2:17
  Speaker 1: We need to purposely investigate, dive into that and then intervene and fix it right.
• 2:20
  Speaker 1: Manual therapy, mobilizations, occasionally manipulations, if it's appropriate, are really going to help to address that into that and then intervene and fix it right.
• 2:24
  Speaker 1: Manual therapy, mobilizations occasionally manipulations if it's appropriate, are really going to help to address that joint restriction and range of motion, specifically for rotation at C1, c2.
• 2:34
  Speaker 1: And then of course, we can clean up soft tissue as it relates to soft tissue restrictions after that.
• 2:39
  Speaker 1: But usually the soft tissue follows suit.
• 2:41
  Speaker 1: Okay, so rotation C1, c2 is definitely the thing and we got to intervene, investigate and see why.
• 2:47
  Speaker 1: Then we can appropriately work on it.
• 2:50
  Speaker 1: For flexion extension, which is looking up and looking down, 50% of the flexion and extension range of motion in your neck comes from your occipital bone.
• 3:00
  Speaker 1: We call that C0 because it's not your vertebrae.
• 3:03
  Speaker 1: Let's call it C0 on C1.
• 3:05
  Speaker 1: All right, so again, the upper cervical, the upper two vertebrae and your occiput, the base of your skull, as it flex and rolls into flexion extension.
• 3:14
  Speaker 1: 50% of your neck range of motion comes from that.
• 3:16
  Speaker 1: And if it's not, then you're compensating elsewhere.
• 3:20
  Speaker 1: Right, so we'll talk about those compensations, but the 50 of your flexion extension actually comes from c0 to on top of c1.
• 3:28
  Speaker 1: So if somebody's limited or painful with looking down or looking up at the ceiling man c0, c1 or your suboccipital region right on your occiput, we're definitely going to investigate that first because 50 comes from there.
• 3:41
  Speaker 1: So if somebody's limited in both looking up and down and rotation side to side and it's painful and it's stiff, it's very common for those concomitantly to be limited in a joint restriction.
• 3:52
  Speaker 1: We have to address those joint restrictions first and then the soft tissue that's guarded and tense for sure because it's protecting the joint dysfunction.
• 4:01
  Speaker 1: We have to release that too and definitely intervene at those soft tissue restrictions so we can mobilize, manipulate C0, c1 to get that specific segmental joint moving better and then also C1, c2, segmentally that joint to move better as well.
• 4:17
  Speaker 1: The interesting thing is that the C0, c1, the suboccipital region with dysfunction at that joint and the muscles in your suboccipital region that get guarded and tense and protect against can create headaches.
• 4:31
  Speaker 1: We call those cervicogenic headaches.
• 4:33
  Speaker 1: Okay.
• 4:33
  Speaker 1: So something very interesting is somebody has headaches in the back of their head because it wraps around the top of their head, called like ram's horn headache, and it gets worse and more involved with prolonged sitting or prolonged standing.
• 4:46
  Speaker 1: That makes me think C0C1, the suboccipital region, is definitely involved and we have to address that too.
• 4:52
  Speaker 1: So cervicogenic headaches can come with those concomitant joint dysfunctions.
• 4:56
  Speaker 1: It's just very interesting, right.
• 4:58
  Speaker 1: Can come with those concomitant joint dysfunctions.
• 5:00
  Speaker 1: It's just very interesting, right.
• 5:01
  Speaker 1: So the compensation patterns if somebody is limited at C01 with their pure flexion and extension mobility or range of motion, or at C1, c2, rotation range of motion mobility, somebody's limited in those specific joints segmentally then someone's going to make it happen, to make life happen, like turning around to look at the car when you're backing out of the driveway or reverse right, or checking traffic right.
• 5:20
  Speaker 1: Or looking up and down if you're looking at the birds and the clouds right, or looking down at your cell phone, right.
• 5:26
  Speaker 1: Neck posture, desk phone, homework, studying TV, watching TikTok, all that stuff that's poisoning your brain.
• 5:33
  Speaker 1: Think about that.
• 5:34
  Speaker 1: Like those postures, someone's going to compensate, right?
• 5:38
  Speaker 1: No-transcript time.
• 6:06
  Speaker 1: So repetitive movements and prolonged postures develop compensation patterns over time and that ultimately leads to pain, right, and our job is to investigate where.
• 6:15
  Speaker 1: So, specifically for the neck man, the first two things we're going to check out is C01, upper cervical, c12 for rotation.
• 6:21
  Speaker 1: We're definitely going to investigate that and if those aren't moving well, guess what's going to move instead?
• 6:25
  Speaker 1: The middle cervical vertebrae, all right, so let's think about this, right.
• 6:30
  Speaker 1: So like from C4, 5, 6, and 7.
• 6:32
  Speaker 1: Let's say C4, 5, and 6.
• 6:35
  Speaker 1: Those three vertebrae are the most common ones that are going to get dysfunctional and imaging would describe arthritic degenerative changes at those specific joints Disc protrusions, disc herniations, foraminal narrowing, stenotic changes, oncovertebral joint osteophyte development.
• 6:53
  Speaker 1: Right, these are all just like degenerative changes that are noticed on an x-ray image or an MRI.
• 6:59
  Speaker 1: Right, and the most common joints that demonstrate those dysfunctional pathoanatomical images is C5-6, c4-5, and C6-7, in that order.
• 7:11
  Speaker 1: Isn't that crazy?
• 7:12
  Speaker 1: All right, so it makes sense.
• 7:12
  Speaker 1: Okay, so those middle cervical vertebrae, it tells us.
• 7:16
  Speaker 1: Those are compensating for the other ones that aren't moving well enough.
• 7:19
  Speaker 1: So then, where's our treatment going to intervene at right?
• 7:22
  Speaker 1: Take that a little further.
• 7:24
  Speaker 1: Those joints that get dysfunctional and inflamed and irritated.
• 7:27
  Speaker 1: The most classic signs for pain referral from the neck is, like I said earlier, guess where the trap, down the middle part of your scapula, towards your spine, like your rhomboid area, or down your arm.
• 7:39
  Speaker 1: Those classic referral pattern pain pattern sites are C5-6, 6-7, and 4-5.
• 7:46
  Speaker 1: So those are the most common neck referral pattern pain that we see right.
• 7:51
  Speaker 1: So there's a lot of commonalities and repetitive patterns that we're seeing in patients with neck issues is it usually comes from the mid cervical compensating because the upper cervical isn't moving well enough.
• 8:02
  Speaker 1: So, that being said, all the muscles that surround there and connect to those joints are going to be guarded and protected, which causes tightness and stiffness and pain.
• 8:10
  Speaker 1: The nerves that exit those areas are also going to be very lit up and inflamed and irritated and sending signals down your arm, signals down your trap, down the middle part of your scapula and shoulder blade.
• 8:20
  Speaker 1: Those tells us we need to investigate the neck.
• 8:24
  Speaker 1: It's not necessarily like a scapular problem or upper trap tightness problem.
• 8:29
  Speaker 1: It might be that's totally tight right or like a rhomboid strain.
• 8:32
  Speaker 1: That's not hardly.
• 8:34
  Speaker 1: Hardly ever is a rhomboid strain.
• 8:36
  Speaker 1: It's usually referred pain from the neck and that's what we have to investigate, right.
• 8:41
  Speaker 1: So all the muscles that connect there are going to be guarded and tense because of that, that compensation dysfunction.
• 8:44
  Speaker 1: So where do you think we're going to intervene If the mid cervical is hypermobile and chronically overcompensating and the upper cervical isn't moving well enough or recruited well enough?
• 8:52
  Speaker 1: What do you think our manual therapy, joint mobility, segmental intervent, segmental mobility interventions are going to focus C01 and C12, suboccipital and the first two joints, the atlas and axis right.
• 9:06
  Speaker 1: We're going to definitely work and focus on those first right, because that's where the dysfunctional lack of joint restrictions is going to be, and soft tissue restrictions, totally right.
• 9:15
  Speaker 1: Then, following after that, and there's like okay, before I continue, there's a ton of interventions we can do with that.
• 9:19
  Speaker 1: Joint mobility, manipulations as appropriate, mobilizations as appropriate, um, and then also soft, uh, soft tissue restrictions and the limit that can limit motion and create more issues.
• 9:29
  Speaker 1: Stripping, uh, prolonged pressure with like a release, like a suboccipital release.
• 9:34
  Speaker 1: Cupping can be really helpful just to lengthen, help open up soft tissue and break up adhesions and improve muscle guarding and tension restrictions.
• 9:43
  Speaker 1: And also dry needling.
• 9:44
  Speaker 1: Dry needling in the cervical spine and the neck is really helpful.
• 9:47
  Speaker 1: We have a lot of really good effects and responses to that.
• 9:52
  Speaker 1: So not everyone's appropriate for dry needling, and this is all case by case, right, we're not going to like throw needles on everybody all the time, right, but it can be really helpful and if you're on board and think it's and we communicate the risk benefit ratio and why we're doing it in the first place and what soft tissue structures we're going to hit purposefully right.
• 10:09
  Speaker 1: It's very purposeful of like, exactly what we're hitting and why, and there's a rationale behind it.
• 10:14
  Speaker 1: That's what we'll explain.
• 10:16
  Speaker 1: If you're on board, then we would do that right.
• 10:17
  Speaker 1: If not, then we'll move on.
• 10:18
  Speaker 1: There's other things we can do to help, for sure, but all those soft tissue modalities is really just to help with improving soft tissue restrictions and muscle guarding, hypertonicity, intense muscles.
• 10:29
  Speaker 1: And then also there's a neurovascular, neuromuscular response that we can't neglect also plays a role too, right, and that's what we want to also target.
• 10:36
  Speaker 1: We totally want to target that In a previous podcast we talked about.
• 10:39
  Speaker 1: We can't separate the mind from the body and the deep, intricate neural matrix that innervates everything.
• 10:45
  Speaker 1: For sure we can neglect that and we can actually leverage the nervous system on purpose to help improve, get improvements.
• 10:57
  Speaker 1: But anyway, so with that, then, after improving the joint restrictions, first the primary function and joint mobility, segmentally throughout the spine, soft tissue restrictions, all those modalities we described with the purpose, then we have to strengthen and stabilize the anterior cervical stability muscles are right in the front, right underneath the Adam's apple, right in the middle, underneath the throat.
• 11:12
  Speaker 1: Those are the muscles we would target where other ones are going to be overly guarded, tense, tight, strong and very over-recruited and that's going to help feed more of a compensation pattern and issue.
• 11:23
  Speaker 1: But in order to get those guys to turn off, we also have to get other things to turn on, and less is more specific purposeful activation of those muscles to get things more stable, and we will call that, like postural endurance and postural stability, all right, and that's the stuff we would work on to help with the upper cervical joint restrictions and soft tissue restrictions and then also stability and strengthening stuff, because that plays a role we can't neglect.
• 11:48
  Speaker 1: Prolonged posture, as I mentioned, totally plays a role and it's just being mindful, you know.
• 11:58
  Speaker 1: But getting some of the muscles that are going to be the main anterior cervical stabilizers for those your neck is really a big target and that's going to be a huge game changer to focus on.
• 12:04
  Speaker 1: So if you have any questions with neck issues and stuff that definitely reach out, we treat neck all the time.
• 12:08
  Speaker 1: It's very common, so don't feel like you're alone and there is a solution, I promise.
• 12:12
  Speaker 1: It's just a matter of deep diving into what's the issue and if we're not the providers, we'll refer you out right, that's what we're going to do.
• 12:19
  Speaker 1: We're out of humility and we have a lot of good referral sources we work with and that seems to be the best collaborative approach and we're never going to say that we're going to cure all everything, but we're, we have regarded optimism and confident and optimistic that we can help you.
• 12:33
  Speaker 1: If it's non-traumatic or traumatic doesn't really matter, but we can really help, intervene and get people feeling better, improve their quality of life, thinking they couldn't otherwise, but anyway, so don't hesitate to reach out.
• 12:44
  Speaker 1: We'd love to chat with you and if you have any questions, comments, concerns, conflicting opinions, for podcast ideas, I'm always open to ideas and suggestions, so don't hesitate to reach out.
• 12:52
  Speaker 1: The best way to reach us is our email at team at athleterccom, or our phone number, 561-899-8725.
• 13:01
  Speaker 1: We'd love to help, so don't hesitate to reach out and we'll catch y'all next time.