Unconventional Methods To Relieve Neck Pain || EP 51

This is another episode that I have done in the past that I think a lot of people got a lot of value from. So, I wanted to just put this one back on just in case you haven't been following me last year.

In this episode, I discuss three neck pain relief strategies that generally don't work long term, and what I teach my clients in the Pain Free Academy instead. I've learned these 3 unconventional methods through diving into the research and from personal experience as a person who struggled with years of persistent neck pain.

If you have neck pain that sidelines you from activities you love or from family activities, and you struggle with stiffness in your neck getting out of bed and going to work, this is the episode for you.

I also speak later in this episode about a specific foam roll that I keep in my office at all times to prevent neck pain, and it's called the intelliroll. It has specific grooves that align with your neck and back. You can go to www.flexwithdoctorjay.online/intelliroll and use code DRJAY for a 15% discount.

Please support by subscribing to my channel, leave a ranking or review, and sharing this episode on your social media platforms and tag @flexwithdoctorjay. 

Transcript

0:03

Welcome to the Won Body Won Life podcast. Hi, I'm your host, Dr. Jason Won lifestyle physical therapist. I talk about everything health and wellness related. So you too can have a more resilient body and a more fulfilling life. If you haven't yet, please support the channel by hitting that subscribe or follow button. So you never miss out on another podcast episode. Also, if you could please leave a review or ranking before leaving this episode. That way, more people will be able to benefit from the content of this podcast. Today, I'll be covering three unconventional ways to relieve neck pain. Now, neck pain is one of the most common muscle or joint complaints and continues to rise with more. work from home and more computer bound folks than ever before. Neck pain has an annual prevalence rate of 30 percent among all adults in the United States and 50 percent of those individuals will experience some degree of chronic neck pain or frequent recurrence. Neck pain has also been shown to cause or stem from headaches, temporal mandibular dysfunction, shoulder tightness, poor upper back mobility, breathing dysfunction, and much, much more. Lastly, causative factors for neck pain include stress, lack of social support, anxiety, depression, poor ergonomic setup. Poor perception of self assessed health, obesity, and past history of neck injury and or low back pain, which is very interesting to find. So as you can see, neck pain is not just as simple as you have poor posture or you simply have poor ergonomic setup. It is a culmination of many different factors, including our general perception of our health, the way that we carry ourselves in our own beliefs about our own health and much, much more I wanted to share three quick tips that are unconventional, meaning they either go against normal standard care or something that does not confirm to standard beliefs. So number one is a pretty big one and good posture doesn't matter as much as you think. Now this goes against so many practitioners and you think This might be some sort of crazy talk and you might want to just stop this episode now, but hear me out. Posture is not just a position and we've been told good posture is shoulders back. It's chin tucked. It's sitting. Our back is basically As straight as an arrow. And that's simply not the case. So epidemiological studies actually suggest that 99 percent of active military have normative perfect posture. And Google it, you want to go to image. google. com and simply tell me what you see when you type in military or army or sergeants or generals or soldiers. You usually. We'll see. You usually will see somebody that is sitting up very tall or standing very tall, very upright, chin tucked and long shoulders back. And yet the studies have shown that 44 percent of active military today claim they have persistent chronic pain. So when you go into a doctor's office. Specifically an orthopedic doctor or a physical therapist or even a chiropractor, you'll often see on one of two sides that one side is a person sitting at a side view and that person has absolute perfect posture. There's a big green check mark above that person's head and then you'll see a really big red X on the right side and you'll see that's poor posture and the head's coming forward, the shoulders are drooped, the person's entire back is like a C shape, and that's perceived as poor posture. So I personally have experienced this in the past where I've been told that poor posture. I actually had a lot of chronic neck issues for over four years and I was told that I had poor posture and that's something that I needed to fix. I was told that I needed my spine realigned. I was given x rays that said that I had early stage arthritis and spondylosis. So again, when we go back to those risk factors of. Poor perception of general health, or when we think that something is extremely wrong with us, that automatically creates the pain experience in itself. So I was starting to perceive I'm only 20 years of age. I have a lot of issues and where am I going to be in 50, 60 years from now? That was a very huge concern for me. It was very fearful and that experience made it very negative. So that negative experience led to a culmination of different factors that led to more persistent chronic neck issues. Like I said, I have had I've tried to fix my posture, I've tried to sit up tall, in fact, sitting up tall for over, I think, six months straight while I was in grad school and everything, that was actually making my pain worse. And then I look at people like my old roommates who had extremely poor posture, they would read in bed, they would be in these weird, awkward positions, and yet they never complained of any chronic neck issues whatsoever. What I'm trying to tell you is that Good posture. There's no such thing as good posture. There's also no such thing as perfect posture. And I will definitely say that. a lot of people perceive that there's also no such thing as poor posture. But I think there is a such thing as poor posture, but I think it's not the same definition as you might think. So part of posture is also perceived as what I said again is the shoulders droop forward, the back is super rounded, the head's coming forward. People say that when your head's forward that your neck becomes increasingly heavy and that causes neck strain. And that's Really not the case. It's a very generalized, simplified definition. And I want to tell you what poor posture in my definition really means. So I perceive that poor posture is a poor capacity or coping with physical stress or inadequate tolerance to postural challenges. And what this means in a nutshell is you could have Myself come into a room, sit at a computer, and I can sit at a computer in any position I want. I can be slumped, I can be sitting up tall, and I can have no pain the entire day. The entire, let's say, 8 hours a day, 40 hours a week. I can be perfectly fine. Maybe it's because I have less stress in my life, maybe because... That version of me is not a dad or a mom and you're not lacking sleep. That version of me can also be working out five days per week and be very social and have a very good life. So that person, all those different factors would say, I don't have any pain. Another person that's exactly like me that walks into the room can assume the same exact postures and have pain after 10 minutes of just slumping. Now what's the difference? That person might have poor coping skills. They might not tolerate stress very much. They not. They may not tolerate being screamed at for project deadlines. They may have a lot of financial and familial responsibilities. Maybe they have to take care of their entire family. Maybe they're a dad of two kids and they're lacking sleep. Or maybe they just got into a fight with their wife or with their husband. See, there's a lot of factors that play into this. And that's why I always say that good posture and perfect posture, it really doesn't exist. Poor posture. But by the same token, you may just have an inadequate tolerance to those certain positions. So you may have inadequate tolerance to sitting up tall or even slumping forward. However, what I always say is that if people simply change positions, every 30 to 60 minutes that can generally change the position of your body and can either decrease stress to a certain area or increase stress to another area. Either way, you're not keeping the same exact stress in the same exact areas. At the same time, I always encourage people to Breathe more at work to be able to learn better stress management skills and to even change up the ergonomics. So I currently right now, I have a Jarvis Fully. It's a desk that goes up and down. I was gifted to me by my family back in 2019 and it's been a game changer. I no longer have to sit for 8 to 10 hours. So I'm able to stretch out my legs. And when I stand up, I generally will assume a different posture. And that's a great way that I curb any persistent neck issues. Alright, so let's go on to number two, because number one was already a huge one, and hopefully let me know what you think about them. Number two is actually to stop stretching. And if not stop stretching, but at least put stretching on the back burner. Don't make it as much of a priority. And you're probably wondering, but... The first exercises I got Dr. Jay was that was given in PT or from a trainer was to stretch my upper traps, stretch my levator, stretch my scalene, stretch my pectorals, stretch my lats stretch. And now there is. not a plethora of research out there saying stretching is not helpful, but there is evidence to show that passive stretching has not been shown to decrease pain long term. It has not been shown to prevent injury or strain. And in fact, excessive passive stretching can actually be harmful and increase your risk of injury. So they actually did this on. patients that stretch out their hip flexors and stretched out their hamstrings. And they did that consistently. They stretched for 60 to 90 seconds before they did a sport. And that actually increased their chances of getting a hamstring train or a certain injury to their hip or their knee. And it's the same thing goes and it translates very well to neck now. If you don't believe me and you're saying hamstrings and neck, they're very different. Let me actually put you in a certain scenario. Have you ever fallen asleep on a train or an airplane window? And it's not falling asleep on the window. You know what I mean? But it's falling asleep on a seat and your head will simply droop to the right or droop to the left, depending on where the window is. And when you wake up after, let's say an hour or two hours or how longer, however long you've been sleeping. You feel a strain in your neck. It's hard to bring your head back to the center and you're feeling a lot of tension in your neck. And when you try to do any little movements, sit to stand, or try to grab your suitcase out of the different compartments, it's very hard to do that. And the reason being is because when you stretch something for a long period of time, It often leads to temporary weakness. And this goes into different scientific principles like myosin crosslinks and sarcomeres where muscles, they contract. They actually, there are certain fibers that grab onto each other and contract the muscle. But when you overstretch, let's say an upper trap or any other muscle, the sarcomere and the crosslinks, they're not actually not able to link together. So you feel not just a lot of pain, but you also Exhibit a certain amount of weakness. So in that case, if you strain your neck, getting out of bed or you fall asleep in a train or an airplane, and you're trying to stretch it out more, doesn't that actually make the situation worse? So now that kind of hit on that point. And I often tell people is that you can stretch your upper traps. Even if you just had persistent neck pain, it wasn't as much acute. So you had more persistent chronic neck issues. I often say that. Passive stretching is just a means to an end. You can do it. There's no, not a lot of harm to it, but it's not going to get you better long term. So what I tell my clients all the time is to either perform isometrics or shorten the tissues instead. So isometrics in a nutshell, isometrics is a certain muscle contraction. There's concentric. Contractions, there's eccentric contractions, and then there's something called isometrics. And when you break down the Latin ISO means constant and metric means length. So it's constant length. And what that means is the muscles aren't really stretching or shortening, but they're simply maintaining a certain position and it is under tension. So what I mean by that is what you can do right now, unless you're driving, of course, be safe, is to try to put your hand on the side of your neck. That hurts. It could be the right side. It could be the left side, or it can be even the back of your neck. So if you have a lot of pain in the back of your neck, simply put both hands behind your neck, interlace your fingers. Or if you have pain on your right side, try to put your palm on the right side of your temple. What I want you to do is simply Push your hand into your head and your head will meet the pressure of your hands. Try holding that for 20 to 60 seconds. Do it anywhere between one to three repetitions. I want you to grade the amount of stress that you put into your hand or head. So this could be a hundred percent contraction where you're trying to knock over your hand with your head, or it could be as little as 20%. We're not really doing a whole lot there. Once you hold that contraction, see how you feel after. Once you hold that contraction, you'll start to realize that isometrics, they actually might improve your range of motion going that direction, or it reduces your pain. I'm not saying that it's going to be a promise that your pain is going to be completely relieved with just one set. But it should give you a sense of, oh, my motion feels better that direction, or my pain feels less. This has been shown in a plethora of research from studies been done on the shoulder doing shoulder isometrics or to the patellar tendon doing knee isometrics, and they're holding a squat, or they're holding certain positions, or even Achilles tendonitis, where they hold their heels up against gravity and then they contract their calf. So same thing goes with the neck, is that when you hold a certain contraction, like an isometric for a long. for a long period of time, that can actually reduce your pain significantly. And that is what we call an analgesic. An analgesic is a pain reducing type of property or exercise. So the other thing besides isometrics, now that you've learned either push towards the area of pain. By doing an isometric is also to shorten the tissues and by shortening the tissues. What I tell people is when you shorten the tissues, you're approximating the joints. That means you're bringing joints closer to each other. They feel less strained. They feel more comforted and you can actually potentially improve your range of motion. Now, the second thing that I'm going to tell you on this podcast. Is I want you to first test out to see how you feel with maybe stretching the tissues. So you're going to put your hands down by your side and you're going to try to reach for the floor. Try to elongate your arms as much as possible. You might feel a little bit of a strain either in your neck, your collarbone. Your shoulder. Sometimes you feel a little bit tension, even in your fingers or farms, try to really lengthen your arms as much as you can. And when you lengthen your arms, I want you to try to bring your right ear towards your right shoulder. And then your left ear towards your left shoulder and see how that feels. And I also want you to rotate your neck to the left. And also to the right as far as you can and simply see how those four motions feel side bend to the left, then to the right and also rotation to the left and then rotation to the right. And what you might find is that it feels a little bit strained. It feels a little bit tight. It feels like it's the classic version of a stretch and you might not be able to bring your neck as far to certain directions. Now, scenario B, I want you now to bring your shoulders as high as you can. Bring them up towards the ceiling or up towards your ears and maintain that position. Now I want you to do the same four motions. Try to side bend to the right, side bend to the left. I want you to try to rotate to your left. And rotate to your right. And I think that majority of people, especially if you're watching this and you're hearing this right now, is that you should get more range of motion with scenario B. Instead of stretching the tissues, you actually gain more range of motion by shortening the tissues. You brought joints closer to each other and there's much less strain and there's much less threat going towards certain directions. I know plenty of people and plenty of my clients that have said, I'm a little bit hesitant to bring my neck too far because then I might throw out my neck. It might feel really strained. I might be out of commission for the rest of the day. And I totally understand that. But when you shorten the tissues, a lot of them say that they have a lot more confidence to move in those directions. And this doesn't mean to live your life. By keeping your shoulders shrugged and keeping your shoulders towards your ears. I'm not saying that at all. I'm simply saying that when you perform isometrics, which is shortening the tissues and is contracting the tissues, or if you bring your shoulders towards your ears and you perform range of motion, that is telling you that stretching might not be as effective as you think. And instead, you should be shortening or contracting or even strengthening the tissues. We strengthen our quads to, we strengthen our quads to get rid of knee pain. We strengthen our calves in order to get rid of heel pain. We strengthen our rotator cuff in order to get rid of shoulder pain. Should our neck be any different? Should we not strengthen our levator? Strengthen our scalenes, strengthen our upper traps, strengthen our pecs. Shouldn't we strengthen these muscles more in order to relieve pain if we perceive that for other areas of the body? And that's what I'm trying to get across to you guys. Okay. So lastly, number three is to address the thoracic spine. If you're not sure about what the thoracic spine is, the thoracic spine is the area right below the base of your neck. So we have seven vertebrae that encompass our neck. And if you look towards where your shoulders, your basically your upper traps, they come together. And at the base of your neck, and you may either have a hump there, or you might have a different kind of flattening that is where the thoracic spine starts and it goes all the way down. It's 12 vertebrae deep and it translates and it attaches to your ribs as well. And this is a really important. Part of your spine because it encompasses the thoracic cavity. It protects your organs. It's improved. It's important for breathing. A lot of people with stiff thoracic spines tend to have breathing dysfunctions. So there's a lot of different reasons. Outside of this podcast, I can do an entire podcast episode on just the role of the thoracic spine, but ultimately I need you guys to address the thoracic spine. Because if you don't, if you do everything that I said, the past two tips that I gave to you, but you don't address the thoracic spine, I would argue that you would still have some persistence of chronic neck issues. So I'm going to share with you a study. A study by Lee et al, 2015, it took 46 patients with chronic neck pain and split them into three groups. Group A received thoracic manipulations and neck endurance training, and group B received neck endurance training only, and group C received general active self exercise. So this is likely a plethora of just different upper body exercises, nothing in particular that specifically addresses the neck or even the upper back. Now, After 35 minutes per day, three times a week for 10 weeks straight, group A showed the most significant decrease in neck pain, an increase in muscle strength, endurance increases in pain relief, a decrease in the score of the neck disability index and increase in neck range of motion. Group B and C yielded very similar results, and were not very different from each other. The general conclusion here is to not neglect your thoracic spine, and in fact, there are a number of ways to mobilize or even crack or manipulate your own spine at home, and it's perfectly safe to do. Other conclusions that you can take from the study is that you should not just manipulate your back in isolation. If you either know how to crack your back at home, Or you're going to a Cairo or a physical therapist that cracked your back, but doesn't put as lot as much emphasis towards teaching you exercises or combining the two together. So manipulation plus exercise, then they are doing you a huge disservice. And also understand just that. Even when doing chin tucks, as much as people the ever famous chin tucks, if you just chin tucked all day and it, and you're not addressing, mobilizing your thoracic spine, again, that is a means to an end. It is not going to change your issues permanently. So the cervical spine does attach to the rest of your spine, including your thoracic spine, which is the middle of your back. And it's also continuous with your lower back. So as a result of Nick's neck stiffness, the rest of the spine gets stiff as well. So if you, for example, had a very stressful day and your upper back was very stiff and your neck started to get stiff, and then you're putting heat packs or you're trying to do chin tucks and you're trying to stretch your neck, but you don't address the area right below it, which is the thoracic spine. You're not going to get the relief that you want. You might feel better temporarily, but you're not going to get that that lasting ever changing relief that you want. So this is actually why multiple times a day I mobilize my thoracic spine. I constantly have different rules and I have foam rolls all across the house. I probably have, I think four to five foam rolls in different rooms that I'm regularly in. And even after I end this podcast episode, or I'm after I end being on patient calls or seeing patients, I oftentimes will sneak in a little bit of thoracic spine mobility, and I think it's that important, and I do it probably five, even sometimes as much as 10 times per day. My foam roll that I currently have is actually called the IntelliRoll and the reason why I like the IntelliRoll specifically and I'll link you guys in the show notes is that it actually has two bumped grooves that directly align with the muscles, which we call the paraspinals that line your upper back. So it's very different from the regular foam rolls in which it will distribute the stress towards different parts of your back that you don't want. So if you want relief specifically. At your thoracic spine, it actually have two grooves that vary in density that you can use. And I think it's great because it also has other grooves so that if I wanted to address other areas of my body, like my shoulder, my neck, my calves, et cetera, it has various grooves across the foam roll. That makes it one of the most versatile form rules that I've ever come across. And I also have regular form rules. So I have small form rules for vacation. I also still have the stereotypical, the stare, the foam type of form rule, but those aren't, those don't seemingly aren't as effective. They're still effective. There's still better than doing nothing, but I specifically liked the IntelliRoll for that purpose. So if you're interested. You can go to https://www.flexwithdoctorjay.online/intelliroll. And when you purchase either one of different densities, you can simply put in the code D, R, J, A, Y that's Dr. Jay and you will get 15% off your order. So just to recap, number one, good posture doesn't matter. Instead, focus on improving your overall fitness, decreasing stress, getting good sleep, and improving your perception of health. And I can't stress that enough. Your perception of your health. actually matters whether you think it's good or bad. Number two, put stretching of your neck and your back on the back burner. Instead, either isometrically load your neck or shorten the tissues to improve mobility of your neck. And lastly, number three is to address your thoracic spine. Don't just fall in love with the chin tucks or depend on manipulations or adjustments in isolation. Combine them with a good regimented set of exercises that address both neck And upper back. So that's what I got for you guys today. If you enjoyed this episode, definitely hit that subscribe or follow button. I release new episodes every morning on Wednesday. And I'd love if you can leave a rating in your podcast app. So my content will reach more people who could benefit from the tips that I put out. And if there's any feedback at all about the content I'm putting out good or bad, or if there's specific things you want me to cover in future episodes, send a quick text to 415 965 6580. Again, that's 415. 965 6580 or email me at jason@flexwithdoctorjay.com I reply to all my messages and I will ensure that I take your input into account. And I'll always leave you always with these last best words of advice. We only have one body, one life. Make every action you take be one that makes you a better version of you. Take care.