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Weekly Rehab: Neck Tension

Injury prevention and rehabilitation are major interests of mine  (hence my quest to become a physical therapist) so I’ve decided to have a weekly series addressing common pains and injuries that come with active lifestyles (because what active person wants to be stuck on the couch due to an injury from being active– the thing thats supposed to make us less likely to be sick or injured). In these posts I’ll discuss injuries, the anatomy of these injured areas, possible causes, prevention, and remedies. As a huge disclosure: I’m not a medical professional (yet), please do not follow my advice if it goes against your doctor’s orders or your better judgement.

This week I’m going to focus on the neck.

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There are 2 reasons I’m starting here: 1) Pain in this area affects so many people 2) This area has given me significant trouble lately. I have always had very tense neck and shoulder muscles, and recently, it’s led to tension headaches especially after my upper body workouts (Booooo!).

Some significant contributors to tension in this region include:

  • The scalenes and sternocleidomastoids (SCMs) on the sides and front of the neck

     

  • The large trapezius, the levator scapulae, and lots of other little sub occipital muscles along the back of the neck

     

  • And the pectoralis major and minor in the chest, below the clavicle (collar bone) and attaching to the arm

     

My hypothesis is that a big factor of tension/tightness in the neck is poor posture and, more specifically, a forward head and associated forward-rounded shoulders.

How do we end up in such a posture? Well, 2 major culprits are this:

posture-pictures-bad-posture

and this: bad-posture-620w-from-CBS-News

Despite my best efforts, I’m guilty of both. As you can see in diagram above, the more forward the head is positioned relative to the body, the heavier it pulls on stabilizing structures (i.e. the bones and muscles of the neck). The scalenes and SCMs on the front and sides of the neck spend many hours each day in a shortened state (contributing to the “tightness” we feel there). The sub occipital muscles, levator scapulae, and upper trapezius are constantly overstretched and overworked, which may be why many experience muscle spasms leading to knots and trigger points (and tightened muscles) in those areas.

And, yes, there are other causes of neck pain and tightness including stress, prior trauma, structural conditions in the vertebrae, nerve irritations, etc. but posture is the only one I’m going into now because this is a blog not a book.

Weekly Rehab Fix:  

Firstly, we are going to be mindful of our sitting and phone postures.

Secondly, here is a routine to try 1-3 times each day for the next week. Please, listen to your body as you do these activities. Pain is the body’s signal that something is not right. If you have pain with any of these, modify the range of motion to eliminate the pain or don’t do the exercise.

  1. 1-Arm Doorway Pec Stretch, 3X 30 seconds on each side
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    Start with the arm against the wall, at a 90-degree angle to the body, and lean forward (keeping your head and neck in a neutral position) until a slight stretch is felt in the chest.
  2. Scalene Stretch, 3 X 30 seconds on each side
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    This stretch comes from Kelly Starrett who has a youtube series called “Mobility WOD” (WOD=Workout of the Day). Place one arm behind the back. Tilt the head toward the opposite side, ear toward the shoulder, and from that position rotate the chin slightly toward the ceiling. To increase the stretch, press down gently on the tightened scalene and SCM just above the clavicle (collar bone). Follow this link  to see Kelly’s video demonstration at 2:25. He uses a band to anchor the arm behind the back. Try it that way if a band is available, but you should feel a good stretch even without the band.
  3. Levator Scapulae Stretch, 3 X 30 seconds on each side
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    This is another stretch from Kelly Starrett. Place one arm overhead, bent at the elbow, as if doing the typical triceps stretch. The palm of this hand should be oriented toward the ceiling.
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    Anchor the arm in this position by using a band (recommended by Kelly) or a stationary object (I place the palm of my hand against the underside of my fireplace mantle). Tilt the head toward the opposite shoulder and roll head forward until a slight stretch is felt along the back of the neck. To see Kelly’s video demonstration, click here and watch it at 3:00. Also, stay tuned into my instagram (K8IrelandActive) this week for my demonstration of the stretch. I feel this stretch very intensely, so I don’t need to apply any pressure to my head with my opposite hand. My hand also goes numb quickly in this overhead position so I only hold it for short 30 second intervals. While doing this stretch it is very important to listen to your body’s pain signals and move into and out of the stretch slowly, with caution.
  4. Small ball soft tissue work in the pecs: 1 minute each side of the chest
    safely-improve-your-shoulder-strength-and-mobility_graphics-pec-lacrosse-ball-rollout
    Using any kind of moderately firm small ball (tennis ball, lacrosse ball, softball, racquetball), massage the chest muscles by sandwiching the ball between you and a wall and moving side to side and up and down. Make sure to focus on the area in front of the armpit where the pecs cross to the arm and the area below the clavicle (collar bone). Side Note: I try to do this exercise from the comfort and privacy of my home, especially being female.
  5. Small ball soft tissue work in the traps: 1 minute on each side of the spine
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    Using the same ball as in the previous exercise, sandwich it between your upper back and the wall. Move side to side, up and down pressing against the ball to massage the area. Hug the arms across the chest to work between the scapula (shoulder blades). When you feel big “knots” or bumps in the muscles, move back and forth over them for a little bit.

I’m going to follow my own advice on this and perform this routine at least once a day for the next week, and I encourage you to give it a try because it only takes 13 minutes. Stay tuned into my instagram, K8IrelandActive, for videos and pictures of my progress, and please let me know if you give it a try!

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January Resolutions

I don’t know about you, but I love resolutions, planning, and goals. I’m truly a goal-oriented person. I love setting goals in all areas of my life as they give me direction, focus, and a sense of purpose. I also think resolutions give us hope that the future will be a little different, a bit better in some way than the present.

Sadly, however, we all know how New Years’ Resolutions tend to go: Jane sets New Years’ Resolutions, Jane tries really hard the first week or month of the year, then by March, Jane has either given up on or forgotten said resolutions, and nothing has changed. So, what can we do to set resolutions that stick? Here are 5 tips that may help.

  1. Turn your goals into systems.
    My dad introduced these concepts to me when he handed me this article by James Clear. What’s the difference between a goal and a system, you ask? To summarize, a goal is the result while the system is the process. If the goal is to write a book this year, the system could be to write 2 pages each day. I don’t know about you, but planning to write 2 pages each day sounds a lot less overwhelming than thinking about sitting down to write a whole book. I’m also a lot more likely to procrastinate a big endeavor like writing a book than the little task of writing a few pages. Lastly, in focusing on the system, every day has the potential to be deemed a success. In focusing on systems, we commit ourselves to a process, not an end result, which  reduces stress over the outcome, produces more chances for success, eliminates the need for immediate gratification,  and enhances our enjoyment of all the moments along the way.
  2. Plan small changes.
    With a new year comes the desire to make a fresh start with drastic lifestyle changes.
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    I like the analogy of a pendulum to describe the effects of big changes. The more change you aim for, the higher the pendulum is raised and the greater the rebound force will be swinging toward the other side (the old habits). Instead of making big changes all at once, make 1-2 small changes every week, 2 weeks, or month. For example, if your goal is to lose weight (or more accurately, fat) through dieting this new year, instead making the drastic change to an immaculately “clean” diet of chicken and asparagus 5 times a day, just make 1-2 small changes in your diet per week that align with the overall goal like this:

    • Week 1: Track your food intake each day
    • Week 2: Track food intake each day + Eat 1 gram of protein per pound of your body weight each day
    • Week 3: Track food intake each day + Eat 1 gram of protein per pound of your body weight each day + Eat 3 servings of vegetables daily
  3. Start now and keep going!
    There is no need to wait until next Monday, the 1st of February, or next January 1st to start working toward a goal. Further, if you mess up, forgive yourself and keep moving toward your goal.
  4. Consistency is Key!
    It doesn’t matter how many times you hit the gym, how many healthy meals you eat, or how many pages of your book you write this week if it’s not sustainable. If you hit the gym 7 days this week and are so exhausted/sore/injured that you don’t go at all next week, what was the point? Set yourself up for success by setting goals/systems you can be consistent with, even if they seem small. Overtime, the progress you make will add up!
  5. Plan to Reassess!
    It is said the definition of insanity is doing the same thing over and over again, expecting different results. I recommend reassessing your progress toward your goals at least once a month and no more than every 2 weeks. Is your diet working? Are you seeing the results you anticipated? Do you constantly find yourself wanting to write more than 2 pages each day? Is going to the gym 5 days each week and working out 2 hours each session too much for your body? When setting a goal, I put my reassessment date on my calendar and then put that idea out of my mind. Until that assessment date, I’m committed 100% to the plan I’ve set.

As an example of these strategies applied (and to keep myself accountable), here are my January Goals:

  • Career Goals
    • Blog: Get it running, gain followers
      • System: Write an article every 2 days. Plan articles for the month on calendar ahead of time. Link on Facebook and Instagram. Make card and hand out to gym friends and clients
      • Reassessment: 1 month, January 31st. Average views? Was it manageable to write a post every 2 days?
    • Training: Start training clients, give educated advice
      • System: Read training research and articles by other trainers I trust 30 minutes daily
      • Reassessment: 4 weeks Feb 1st. Is it manageable reading that much? Could I read more? Am I learning useful information this way? Are my clients satisfied with my coaching and obtaining desired results?
    • Doctorate of Physical Therapy Programs: Get accepted!
      • System: Maintain correspondence with the 20 schools I’ve applied to.
      • Reassessment: April 1st. I should hear back from all the schools I’ve applied to by then.
  • Fitness Goals
    • Diet: Goal is to lose fat
      • System: Track food intake and meet protein goals (wk 1). Hit macro goals daily (wk2-4). Plan and prep meals ahead of time. Measure/Track progress with weight, pics, circumference measurements weekly.
      • Reassessment: 1 month, Feb 1st. Am I losing fat? Am I able to stick with my macros consistently? What can I do better?
    • Workouts: Establish a good base of strength, mobility, and aerobic conditioning so next month I can start learning olympic lifts!
      • System: 4 day lift split (upper body, lower body, full body A, full body B), at least 1 cardio session with high intensity intervals per week, daily mobility/stretching work on areas with issues (more on this later)
      • Reassessment: 1 month, Jan 31st. Change workout to Olympic Lifting progression. Weekly Reassessment for mobility/stretch work: January 11th.

What kind of goals and/or systems are you working on this month?

Protein is King

  Protein

  • Amino Acids are the building blocks of protein. There are 20 different amino acid. To make proteins, they are joined in arrangements of a few dozen to hundreds called polypeptides. Nonessential amino acids are made (synthesized) by the human body and essential amino acids are not made by the body but must be obtained through the diet
    • Essential Amino Acids: Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan, Valine, Histidine*
    • Non-Essential Amino Acids: Alanine, Arginine, Asparagine, Aspartic Acid, Cysteine, Glutamic acid, Glutamine, Glycine, Proline, Serine, Tyrosine
  • Protein quality: How well a protein supplies amino acids proportionate to the body’s needs. High quality proteins supply the body with all 9 essential amino acids. Complementary proteins are lower-quality proteins that can, in combination over the course of the day, supply all 9 essential amino acids.
    • High quality: proteins of animal origin including eggs, meat, fish, poultry, dairy products
    • Complementary Proteins: generally, beans/legumes plus grains for example, beans and rice, corn and beans, corn tortillas and refried beans, and peanut butter and bread
  • 1 gram of protein contains 4 kilocalories (Calories)

Functions

  • Proteins are important structural molecules, enzymes, and antibodies in the body
  • They are essential for muscle repair, muscular hypertrophy (growth), catalyzing biochemical reactions, DNA repair, and so much more
  • Consuming protein helps to maintain muscle mass, especially while at a caloric deficit (dieting).

Recommendations

  • Recommended protein for sedentary, non-active adults: 0.36g/pound of body weight per day. A 150lb person should consume at least 54g of protein daily
  • My recommendation of daily protein intake for an active individual is 1.0g/pound of body weight or up to 1.5g/pound if dieting. A 150lb person should consume around 150g of protein, with at least 65% of the protein coming from high-quality sources
  • The best way to meet protein recommendations: protein should be divided equally across 4-5 meals daily separated by 4-6 hours each. Each meal should contain30-45g of protein and 3-4g of leucine. Consumption of a leucine or amino acid supplement in between meals is recommended as well.
    • this strategy maximizes muscle protein synthesis and anabolism (i.e. muscle growth and recovery)
    • If this strategy doesn’t work for your life, modifying it to meet individual needs is ok! Consistency is what is most important.

References

Lee, Sohee. How to Count Macros Ebook 2. Sohee Lee 2015

Baechle, T.R., Earle, R.W. Essentials of Strength Training and Conditioning, 3rd Edition. NSCA 2008.