Neck pain and Spinal Hinging | Movement Fix Monday | Week 12 | Dr. Ryan DeBell


– I’m Dr. Ryan Debell
from The Movement Fix. This is Movement Fix Monday, and today we’re gonna look at something a little bit more clinical. I’m gonna take a peek at neck pain, and I’m gonna show you one
classification of neck pain, which is the person who is hyper mobile in the middle of their
neck, and a lot of times, what can happen with people is that, I’ll show you an example
here on the spine. So, if this person was sitting here, and I was checking their
neck range of motion, what I want to know for that person is, are all the joints of
their neck contributing to the global range of motion? And so, when I test someone’s
neck range of motion, I have them tilt side to side, look down, look up, rotate both directions. And what happens a lot of
the time for a lot of people, either because of habit or
previous history of injury, is they will develop an area of their neck where they move too much through. And so, when I ask them to
bend their head to the side, or look up or look down,
I’ll find this area where, say in the middle
of their neck right here, they hinge right there,
or they hinge up here, and they don’t have contribution
from all the joints. Because, when we look
at neck range of motion, I’m thinking that, from T4,
which is roughly right here, is sort of functionally
where the neck begins, in terms of looking around. And so, you will see this if you check neck range of motion, is that people, a lot of times will hinge. If they look up, they
may hinge just in the middle of their neck rather
than getting some contribution from the upper back. The consequence of that is,
when someone has one joint or two or three joints where
they primarily move through, and they don’t get
contribution from other joints, they get an overuse injury at those joints that are moving too much. And so, a lot of times for that athlete, they need to learn how to use their neck as a larger functional
unit, getting contribution from multiple joints. And so, I have a little bit
of a case study for you today, and I’m gonna use my wife,
who gave me permission, someone who’s had chronic neck pain, and we’re gonna take a look at what that actually looks like, and the some ways and some
methods that we can look at, to how can we help that person get the load distributed over more joints rather than focusing on just one or two where the hyper mobility occurs and where we can get pain and other issues going on. So, let’s take a look
at what that looks like. So I have Alana here, and
she has volunteered her neck for me to show you some things about what may be going on with her. And one of the things I noticed when checking her neck range of motion, was the way in which she bent to the side. And so, can you show, if I had you bend your head to the right, can you show us how you would do it? Okay, and then, look straight forward. And now tilt your head to the left. Now what you can see in Alana is that, go ahead and relax,
there is a lot of tilting that’s happening from
the middle of her neck. And one of the ways that you can see whether or not that’s the case, is this. I said before that functionally, the neck starts from the fourth
bone, or the fourth joint down in the thoracic spine. And so, if I tell Alana,
I’m gonna put my finger right here, down, basically between the tops of her shoulder blade more or less, and I’m gonna say, “What I want you to do is tilt your head to the
left, but think about letting it relax all
the way from down here. And rather than sort of tilting like this, think about tilting from
all the way down here. Go ahead and do that for me. You can see how different
of a range of motion that appears for her. Now, go the other way, let’s
see what that looks like. Good, okay. Now, do it the way that you
wanted to do it the first time. And so you can see how there’s just so much more contribution
occurring in the middle of the neck versus the way
that I tell her to do it from down lower in the thoracic spine, there’s more contribution from
some of those other joints. What she has to learn to do as an athlete, or even just as a human being with a neck, is that she has to learn how
to make it more of a habit to use the joints that are lower down to help contribute to the
global pattern of neck movement. Sometimes it’s as easy as
literally just practicing bending to the side from
all the way down here. So, go ahead and just
show us a couple of reps. So sometimes is as simple as
just learning how to do it, and then doing it enough
so that it feels normal. Sometimes, though, we have to load it, and we have to create some sort of demand on other areas of the
body, so the neck can learn how to do that when there is
some sort of external load. And so, what we can do for that, is, Alana’s gonna swing around here. We have a band attached to the rack here, and she’s gonna pull it into her chest, and there’s just gonna be a
little bit of tension on it, and she’s gonna push it away from her body about four or five inches. Now, what that does is,
it loads some of the muscles in the trunk,
and once that’s loaded, what we will then do in this position is start trying to bend
the neck from down lower, where we doing it seated,
and doing reps there. So go ahead and just do a couple reps. And it’s really, really
important that the person realize that they can let all
the way down here help in this movement. And go ahead and do the other direction. And so, once we do a
certain amount of reps here, maybe five, ten, fifteen reps, we could switch around so that the band is pulling in the opposite direction. But for demo purposes, I just
want to show you the one side. Now here’s the thing, the
way that you move your body feels normal to you even if
it’s not technically correct, because your habit
feels normal, of course. And so the first time that we did this, and I had Alana move her
neck from lower down, she goes, “This feels
wrong, this feels awkward.” And it does feel awkward
when you learn how to move a different way
if it’s not your habit. And it’s gonna take some retraining, it’s gonna take a lot of
reps because there’s probably been thousands of reps over
time where she’s done that, and that’s her habit. And we have to change that,
and we have to make the new way feel more normal. But what that does is,
it makes some of the range of motion that was happening
in the middle of the neck be distributed over more joints, and so there’s less stress at one or two particular joints within the neck. So, that’s kinda what we’re working on and what we’re looking at. And so, it’s important to
both do it just seated, and sometimes you have to
in that load with the band. Now here’s the thing, neck
pain can be complicated. If you have neck pain, don’t assume that this is necessarily the
reason why you have neck pain. This is one reason a
person can have neck pain. It’s one thing to look at, it’s one thing to add into your exam if
you’re a health care provider, that maybe you haven’t
thought about before, or maybe you’ve never seen implementation of getting some contribution
from the joints lower in the neck or upper back like that. So, if you do have neck pain out there, don’t assume that this is why. Just know that it is
possibly one reason why, but you should always get
evaluated if you have neck pain. So don’t rely on just this
video if you have neck pain. You should go get
evaluated, but realize that this is something that’s out there. There can be these hinge
points in the spine where there’s this big amount of stress rather than being distributed
over the whole load. So that’s Movement Fix
Monday for this week. Hey, if you haven’t already
followed us on Facebook, go to Facebook.com/themovementfix, follow us on Instagram
at The Movement Fix, and the new t-shirt, the
new Movement Fix t-shirt, which I have under here, but I’m not gonna show it to you today, but it’s on the open 15.4 video. It’ll be on the website, ready
for pre sale or pre order on Wednesday at 5:00 p.m.
at Themovementfix.com. I’m only going to presale 100 of them at the special price of $15.00, and then it’ll go up to the regular price once they are actually in stock. So, make sure you’re one of
those first 100 if you want one. They’re awesome, so check it out. See you guys for 15.5 this Thursday, and then we’ll see what we’ve got going on for that last event in the open. Good luck and take care.
See you guys later.

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