Neck and Shoulder Pain: A muscle problem, an exercise solution.
If you have ongoing neck pain from working at the computer, what would be the simplest, effective treatment that would stop the pain and keep it from coming back?
The problem is that, even though there’s clearly nothing seriously wrong with your neck, it’s so tense and tight and keeps getting tighter as the day goes on, that it makes sitting at your desk to do your work a burdensome activity. It’s also a problem that this aggravation often crosses the line into your personal life as well, making it harder to enjoy the evening and to sleep comfortably at night.
Since you know your neck is not injured and you have no reason to believe it needs an invasive treatment, like surgery…you’re at a bit of a loss for what to do about the situation. Massage helps for awhile and even muscle relaxers help, but it keeps coming back, so something needs to change, but what?
Many people think about changing their work station. This can help you feel comfortable and keep your neck balanced in a way that requires less effort. But, while it does help, it doesn’t seem like it solves the problem. Which leads us to the uncomfortable conclusion that sitting at our desk is damaging our health, but we can’t see a way around it. Not to mention, there are plenty of people who seem to get away with sloppy posture, so why is it that you can’t?
This idea that we’re pretty well hosed if we have a job that involves sitting at the computer many hours out of the day isn’t helpful (I don’t favor anything that fatalistic), and interestingly, there is compelling evidence to the contrary.
The Dutch Ministry of Social Affairs and Employment funded a 15 year study to see if occupational sitting was associated with arm pain (as well as a few other things). There were 1,500 people in the study and they were examined at 5 year intervals.
Sitting while working was not associated with any of the health problems studied, and it was not associated with upper extremity (meaning the arm and shoulder) pain. In fact people who sat more tended to have less pain in that area.
There were similar surprising results that studied neck pain in teenagers from texting…the texting position was not linked to neck pain.
Why some things affect some people more than others is one of those great mysteries of life that one could happily contemplate for many a year (and I’ll probably have to say more about it later). But let’s just jump to doing something about it that’s going to help the situation.
When you have pain in muscles and associated tissues that keeps coming back, you have a movement problem. Or rather a lack of movement problem.
When the body is held in a position, so that there is tension in the muscle, this leads to pain. That pain is coming from a lack of movement in that specific area.
The book Muscle Pain by Mense and Simons (I wouldn’t recommend it for casual reading) tells us that sustaining a contraction at even 30% of our maximum effort leads to decreased circulation in the contracting muscle. And that a muscle that’s contracting with it’s circulation impaired only takes a minute to become painful.
Pain like that, upper shoulder pain that tends to be in one area, but moves around a bit and is hard to pinpoint exactly, that ranges from mild to severe, and that tends to show up and get worse with particular activities, is coming from a lack of movement.
I wonder how many people with upper shoulder and neck pain would self identify as having a sustained contraction in those muscles? I would guess quite a few, though I know that in general, folks don’t tend to notice just how tight their shoulders are, until it’s pointed out to them.
The key word here is “sustain” a contraction, which is very different from activating and relaxing a muscle over and over again.
Mense and Simons also say that you can sustain a contraction at 10% of maximal effort for up to an hour, without any pain. Which might help explain why our peers can slouch all over the place and not have pain.
So, if the pain is coming from a sustained contraction (read – a lack of movement) then the way to treat the pain is to move the part that isn’t moving.
I want to unpack that deceptively simple sentence a tad.
First, I said “treat the pain”, because the pain is the problem. We are not looking for some underlying structural issue to nail this on. Chances are very good (particularly if you’re on the younger side) that there is no underlying structural problem. And even if there were, it wouldn’t necessarily be painful.
Second, you might think that what a sustained contraction wants most as treatment would be relaxation. To simply stop contracting. Well, anyone who’s tried knows that it’s not so simple to “simply” stop contracting. And besides that, you’ll get more fluid movement if you contract and relax repeatedly, which is what’s wanted since the pain comes from a lack of circulation. There’s (so much!) more to say about this, but I’ll leave it for now.
And thirdly, that part about “move the part that isn’t moving”. What this means is that if you go for a walk, or even do a sequence of yoga asanas, you are moving, but you are not moving the part that isn’t moving. To do that, you have to be a bit deliberate about it. For instance, one of the common painful muscles with upper shoulder/neck pain is the upper trapezius. It goes from your neck to your shoulder and is a prime mover when you shrug your shoulders. Knowing that, if you want to move your trapezius, shrug your shoulders.
And if you want to move more of your trapezius, then make it work to shrug your shoulders by adding resistance (weights in your hand or an elastic band). Since it’s easy for a muscle to make a motion with no resistance it only has to use a small percentage of its fibres. When you add resistance you make the muscle use more of its fibres, so you really are adding more movement.
In fact, this is one of the 5 exercises used in a series of Danish studies that had fabulous effectiveness in treating shoulder/neck pain.
If you have the sort of pain that I’ve been talking about then I would urge you to try Shrugs as well as the other 4 exercises, which are the Lateral Raise, the Front Raise, the Upright Row and Reverse Flies. There are heaps of youtube videos to get you started, so I won’t describe them in detail here.
In the next couple of months I plan on releasing a program where we can all learn and practice these together. It would be great to hear if you were interested in being a part of that.
I haven’t explained all the details yet, so watch out for my upcoming articles that will help you understand and utilize the difference between specific exercise and general exercise, as well as an exploration into what else is going on when we move the body deliberately (enhancing our impulse toward life, creating rapport and better communication in our system…cool stuff. :))