One of the tests that physical therapists routinely use to evaluate patients with neck pain is a postural analysis. It’s performed by using a visual “plumb line,” a straight line from the ears to the ankles, looking at the position of certain bony landmarks to determine deviations from this neutral path. Our advantage is that we see your body from the side; a view you most likely don’t see.
You tend to look at yourself in the mirror often — for grooming, dressing, or possibly while working out in the gym, but the view is usually from the front. The head looks OK on the shoulders from the front view, but looking at the head from the side it most often is leading the way. Instead of being relaxed on a strong balanced lower body, it’s forging forward with little support or crunched because the deep muscles that stabilize the trunk of the body aren’t active. Watching people work out on the elliptical machine or an elevated treadmill has brought me to a new awareness. Both are great exercises for cardiovascular fitness and boosters for metabolism, but poor posture on these machines might be stressing your neck.
Neutral posture, or “good” posture, positions the ears directly over the shoulders, the shoulders directly over the outside of the hips and the hips to the outside of the ankles, all in a lovely straight line. In most cases, especially for those experiencing neck and back pain, the line deviates forward and back, and the most common faulty neck position is a forward head posture.
It’s difficult to change posture. The body has muscle memory, meaning that muscles are lengthened or shortened in positions they remember.
If your neck is chronically held forward, it will easily settle there in all activities, whether you’re on the computer or walking on the treadmill. To prevent neck pain and stiffness a new muscle memory must be integrated.
The goal is to give the superficial muscles in your neck a break and prevent them from working so hard by engaging stronger deeper core muscles. Physical therapists call the core muscles spinal stabilizers. We have two girdles in our bodies — the shoulder girdle and the pelvic girdle. Core muscles attach to these bony girdles and to the spine and dictate the path posture will take. The postural muscles around the shoulder girdle are the muscles that draw shoulders down and back. The muscles around the pelvic girdle bring neutrality in the lower back and provide a solid base for the upper body.
Let me share some simple changes you can make to draw in the core and reduce stress on the neck.
• The neck should never be forward in any prolonged activity. Muscles have memory; if you keep them in the same position for prolonged periods of time that’s their new habit. Shortened superficial muscles in the neck become over stressed and stay that way and the core muscles or stabilizers become inactive, resulting in neck, lower back and shoulder pain.
• While driving or sitting, position your knees and hips at a 90-degree angle. Positioning the knees above the hips, which decreases the 90-degree angle, can promote a forward head posture along with a humped mid back and sluggish abdominals. The 90-degree position is ordered for patients after hip replacements but not often for patients suffering with neck pain.
• Lighten your touch on the steering wheel; it’s amazing how a tight, non-necessary grip can activate superficial neck muscles. Lighten your grip on the treadmill, especially when it’s elevated. I see many people hanging on to the treadmill as they exercise, bringing tension up through the arms to the neck.
• If you use your arms on the elliptical machine, don’t push. There’s no tension on the upper body from the machine, so you’re causing your upper body tension. Stand tall and enjoy the rotation in your lower body that you get from decreasing the arm tension. Also feel your core muscles as the muscles between your shoulder blades become active and the abdominals become engaged. The core muscles can be strengthened in any activity but only if you keep them engaged.
• Walk into a room with your whole body leading. The neck doesn’t have the endurance or strength to carry the body forward, Take a deep breath, lengthen your neck, leading from your back. Keep shoulder blades down and your back deep trunk muscles activated. You’ll discover you have a back body and the more you use it, the stronger it will get. The forward posture will soon begin to feel uncomfortable.
With these simple changes, your “plumb line” will be in better shape. The added bonus is you’ll look taller and years younger.
Denise Plastiras is a physical therapist at Maximum Performance in Greenport.