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Upper Back and Neck Pain

Now more than ever, with gyms being closed from the pandemic and millions of jobs becoming remote, people are spending an excessive amount of time sitting. As you might expect, we at Ground to Overhead Physical Therapy have begun to see a massive spike in patients reporting upper back and neck pain. If you are someone who spends the majority of their day at a desk, has neck/upper back stiffness or pain, and has tried everything under the sun to feel better – this month’s blog post is for you.

It goes without saying that the most obvious treatment for those who spend 8-10 hours sitting each day is to get them to stand more. Standing desks have gained popularity in recent years and are a great tool to start providing immediate and long-term relief. The problem with sitting is that we can assume poor positions for hours on end with our shoulders internally rotated and our head and necks forward. Standing not only requires that you keep the head, neck, and shoulders more properly aligned with the rest of the body, but it also allows you to make small, subtle movements whenever you begin to feel uncomfortable. You’ll notice that if you stand for any length of time, whether at your standing desk or in line at the grocery store, you’re constantly shifting your weight and getting out of uncomfortable positions. If you are thinking “there’s no way I’m going to go from sitting to standing 8-10 hours a day overnight”, that’s completely reasonable and understandable. Start by standing just 5-10 minutes on the hour and slowly increase your standing volume over the course of several weeks. Take more walks on your lunch break and get up frequently to grab some water. Remember that no amount of treatment or exercise is going to correct an imbalance that is being perpetuated by poor lifestyle habits that constitute the majority of your day.

After years of sitting, many people often develop severe stiffness in the neck, upper back, and shoulders that needs to be slowly reversed through targeted soft tissue work and exercise. The key with rehabbing from a painful neck and upper back is consistency and making small changes over the course of several weeks and months. Many of the muscles of the upper back and shoulder also attach at the cervical spine, which explains why so many people with neck pain also suffer from concomitant upper back and shoulder pain. For the initial phase of recovery, we need to “unglue” some of the anterior musculature that has adaptively shortened overtime and is preventing you from being able to get the shoulders back into a more optimal position. Begin with the following soft tissue mobilizations that can be done with just a lacrosse ball and some very light dumbbells/weights:

2 minutes of Lacrosse ball to Trap Mobilization

2 minutes of Lacrosse ball to Pec Mobilization

3 x 30 seconds of Prayer Stretch

2 x 15 of Supine Snow Angels on each arm

Now that you’ve begun to free-up some of the tight and restricted tissues, the next phase of rehab is to eliminate neck stiffness and regain full range of motion. Test yourself by seeing if you’re able to bring your chin to your chest, look up straight at the ceiling, and turn your head about 80-90 degrees in each direction. Most likely, you’re going to find that if you’re suffering from neck and upper back pain, these movements are going to be tight, stiff, and painful. Cycle through the following exercises for 3 sets of 15 reps, most days of the week to begin to regain neck mobility and work your way out of pain:

3 sets of 15 reps - Supine Banded Chin Tucks

3 sets of 15 each direction - Cervical SNAGs

3 sets of 15 reps - Banded Neck and Thoracic Extensions

For the final phase of rehab, we want to focus on strengthening the muscles of the upper back so that we help keep the shoulders retracted and upright. A major point with these exercises is to maintain a neutral head posture while completing these exercises. Often times people have a tendency to push the head forward when pressing overhead or rowing the arms into the sides. Make sure to keep the chin tucked (much like you learned to do in the first exercise on this list) and shoulder blades pulled back and down while completing the following exercises:

3 sets of 12 - Banded Pull Apart

3 sets of 12 - Wall Slides

3 sets of 12 - Prone Snow Angels

That completes this month’s blog post on how you can finally resolve that neck/upper back pain and get back to feeling 100% both at work and in your training. Consistency and proper loading are the names of the game when it comes to overcoming chronic pain. If you have questions on how to execute the exercise properly, optimal frequency/loading, or would like to set up an appointment to get evaluated, don’t hesitate to reach out to either myself or Dr. Tancini. Coming from two guys who spent A LOT of time sitting throughout graduate school, we’ve both dealt with neck and back pain and know how debilitating it can be. Hope everyone has a great month of training!


Dr. Brett Rolison

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