Dr. Gangemi: Hey, this is Dr. Gangemi. In this Sock Doc video, I want to talk about some common neck injuries and some neckaches and ailments that many people get. Helping out today is Dr. Melissa Weinberger from New York. Welcome to the studio.
Dr. Weinberger: Thanks.
Dr. Gangemi: Also known as my treatment room. I want to discuss the neck today. A lot of people get whiplash accidents, or something traumatic done to their neck, or maybe they wake up with a good old crick in the neck as we like to say down here in the South. You can’t turn your neck comfortably one way or the other. Or, you had an accident, and next thing you know, you’re having some muscular dysfunction in the neck, or you had to wear a cervical collar for a while because of the whiplash from a car accident. Many people are stuck with these injuries for a long time. They never have full range of motion again after these accidents, or they have a headache, or some other reoccurring, daily nagging problem ever since they got in that accident, that nobody’s ever been able to fix.
We’re going to talk a little bit about self assessing, or how you can maybe look into some other ways to check out some trigger points in the neck muscles, and where the muscular issues might be coming from. To start with, when you have whiplash, and you have this flexion extension type of injury where your head goes back, especially if you didn’t have your headrest at the right spot if you’re in your car. Then as your head comes back, it snaps forward at the neck flexor muscles, they engage to try to center you back, as a counter reaction to the force of however you fell. A lot of people end up straining the muscles and the tendons and the ligaments in the front of their neck, even though the back of their neck might be where it’s hurting.
Nobody wants to go in and actually check out the trigger points in the front of their neck because they’re afraid of the carotid arteries, and other arteries, and nerves in here, and just hurting someone. Obviously your throat and your esophagus is in there, and choking them. You don’t often see massage therapists or other practitioners, unless they are very skilled, want to go in and actually treat the front of the neck muscles. That’s actually the one thing you often need to do to relieve a lot of these problems and correct them once and for all.
You can put your arms up like this, and then she’s going to lift her head up and turn to one side. Let’s say that was hard for her to do, and so this is her sternocleidomastoid muscle, pretty much your major neck flexor. If that was hard for her to do, we’re going to take a note of that and look into how to relieve some of that pain. Or if she turned to the left, and if the same thing happens. So in other words, if her head is shaking, or if you do this and your head is shaking, and you’re unable to turn comfortable, or this neck muscle is not firing properly, then what you’re going to want to do is assess this neck muscle. I’m going to show you how to treat the trigger points in here. Also, you can just look straight up, and if someone has a problem while they’re lying on their back, looking at their feet, then we’re going to look at these muscles in the front. I’m going to show you how to do that after, but first she’s going to turn over.
Similarly here, you’re going to put your arms up. So this is what you’ll be doing at home. Put your arms up like this. She’s going to look straight up, like looking forward. What you’re going to want to do here is not raise your shoulders too much, so you keep your shoulders down but lift your head up, and then turn it in to one side. If you’re having trouble keeping your neck up here, or if these neck muscles hurt here, we’re going to look at the right posterior side. If she turns to the left, then the left posterior side here in the neck, okay?
Actually, I’m going to start there, and you can put your head down for a second while you’re here. Typically, if you have pain in your neck while you’re lying prone, face down here, and if you lift up and turn to one side like she just did. Although that’s these muscles in the back of your neck here, usually you’re going to find the trigger point somewhere lower down on the back here, usually in the rhomboids or the mid or lower traps, or even the lats. You’re going to look somewhere in this area, again, for these muscles here on the same side.
So, if she lifts her head up and brings her arm back up, and turns to one side, and if it’s hard for her to do that or if it hurts, what you’re going to do is look for trigger points down here. Put your head down. If you have a friend helping you out on this, they can kind of poke around here and look for a trigger point and work them out. Or, if it’s you, then what you can do is you can use a ball or something. Sit up for a second. Or, I’ve been using these massage blocks recently from a guy who makes these cool little devices that help with trigger points, and she would put this down on something flat. Let’s say this was the left back side of her neck here, what if she was having problems with, then she’s going to look for that trigger point somewhere here in the left side of that mid-back… and work out that trigger point there. Just enough for comfort. She can just lay on it and see how it feels. You kind of feel it working the muscle, right? You would just pull the trigger point there, and work out any tight muscle you’re going to feel in your mid to lower back, or her mid thoracic area, I should say, in here for any neck extensor type problems. You’re not going to actually work any of these muscles in here for the type of pain that I’m talking about, but go down here. Again, you can use a tennis ball, you can use a golf ball, or whatever you’d like.
So then, for the front of neck muscles. When she was laying on her back and she had her head up, and it was the big, more meaty, head rotation type muscles, if that’s what’s straining you as you’re lifting your head up and turning to one side, then what you’re going to do is look for the trigger points here in these muscles. All the way down to where it attaches to your sternum and your collarbone. One thing you can do is actually just pinch the muscle like this, and look for any tender spots. If I’m doing that on myself, that shouldn’t be tender at all, and if it is then you just hold it. If you’re doing it to someone else, be careful, or have them do it themselves. Just like that. Really, none of them should be too tender. You could do them both together, and see how they feel. If you’re on the muscle, there’s no problem, just be careful that you don’t dig in too much. You could hit one of your carotid arteries and get a little woozy.
The other things you can do, even though you’ve got to be really careful, you could just come down in a broader sense on these neck flexors on either side. Especially just the inside of that sternocleidomastoid, again, SCM, and see if there’s any tender spots in here. Again, on the same side that you had a problem with as you were lifting and turning your head. So you’re turning your head to one side, and it’s that opposite front neck muscle, okay?
A couple of other things to mention. With neck problems, a lot of people have shoulder girdle instability. I talk all about this in the shoulder video, and look for subscapularis type injuries. That’s that muscle underneath and in the front of your scapula, your shoulderblade here, sort of your armpit. If you go in and poke in there, it’ll a lot of times relieve a lot of scapula pain that might be throwing this whole area off, actually causing you to have neck pain. So that’s in the shoulder video, on how to assess your subscapularis muscle. Again, maybe referring pain to your neck.
The last muscle I want to address is the one called your laveta scapula, which goes from the back of your neck here, to the top of your shoulderblade, and actually does this type of motion, like that. A lot of people think they’re getting upper trap pain, like tenderness and tightness from maybe sitting at the computer too long, but it’s actually their laveta scapula muscle. Where you want to correct that, if you want to stand up and turn around, is you would have somebody, or you can kind of get yourself. You bring your fingers to the top of your scapula there, and look for tender points here, or, on the back side of your neck here. That’s if you just have pain moving your scapula, your shoulderblade, like that, up and down, like shrugging your shoulder. Come here and poke in your neck. Do you want to show them how you would do that, like for a trigger point? So there, on the top of the scapula, or here in the neck. Any tenderness in there, and sort of just rub it out. That would be more like you have a sore neck. So more so there for that scapula, rather than if your head’s back. Again, that’s going to be more in the mid back.
The other thing, really quick, for people who, like I said when I started. If you ever wake up with neck pain, or you wake up and you can’t turn your neck, you think you slept wrong. A lot of people think they woke up and they slept wrong for whatever reason. It’s usually, as long as you slept in your same bed and not on someone’s couch or on the floor in a weird position. Typically if you wake up with neck pain, it’s actually from something you did the night before, usually what you ate the night before. So think about what you ate, maybe you went out to eat, if you drank too much alcohol, if you had some fried foods, a lot of processed foods, sugar, that sort of stuff. That’s the number one reason why someone wakes up with a stiff neck in the morning. It’s how that food is now affecting your digestive tract, it puts a lot of stress on the spine from the weight in the belly, and actually unfortunately tracks the cervical spine downward and puts a lot of tension on those tendons and ligaments of the spine. So you end up with a stiff neck in the morning.
So, that’s how you check it out and treat it, and hope it helps. Thanks for helping out.
Dr. Weinberger: Sure.
Got a crick in your neck? Chronic and acute neck pain, whether from a traumatic injury (whiplash or fall), general muscle tension, or waking up “having slept wrong” is a common ailment many people suffer with. Some people have chronic headaches as a result of an injury to the neck or from sitting at a desk all day long. Neck pain can hinder athletic performance in every sport, and more so if you’re a swimmer, cyclist, or athlete playing any sport involving precision and accuracy.
In this Sock Doc video I discuss some easy ways you can assess where you neck pain may be coming from and how to safely treat it. I also discuss what it often means when you wake up with a stiff neck, unable to move your head much without significant pain.
Please check out the Trigger Point Therapy article and video if you need more information regarding this subject.
Also please read the Sock Doc First Aid For Injuries series to understand why it is often disadvantageous to ice, heat, stretch, or take NSAIDs for this, or any, injury.