6 QUICKFIXES FORNECK ANDSHOULDERPAIN

Proven methods

from a Doctor of

Movement to

improve pain

and return you

to everyday

function

Naples Premier Physical Therapy

www.naplespremierpt.com | 239-595-7833

Dr. Shane Smith, DPT

Naples Premier Physical Therapy

Page 02

COMMONCAUSES OF NECKPAIN

Neck and shoulder pain are some of themost common complaints I see frompatients on a regular basis. Some of thoseindividuals have been dealing with pain formost of their lives – others have justexperienced symptoms only a few weeksago. Regardless of when this issue arose, thereare techniques to improve these problems.

Other causative factors are functionalsuch as poor posture, soft tissuerestrictions, overuse injuries or poormovement habits. The helpful hints listed below are toinform you of ways to help improve yourpain, return you to normal-life activities,and promote the permanent relief youwant and need. I hope my knowledge onthis issue can be of great benefit to you.

There are many reasons someone mayexperience neck or shoulder pain. Some reasons are structural causes such asdegenerative conditions which includeOsteoarthritis, disc degeneration, discherniation, spinal stenosis, and Rotator Cuffinjuries. 

Statistics show that two thirdsof the population willexperience neck andshoulder pain at some point intheir lives, and ten percent ofthese people will continue toexperience symptomschronically (years to decades).

RELIEF IS IN SIGHT

Dr. Shane Smith, DPT

Naples Premier Physical Therapy

Page 03

1. ICE VS. HEAT

One of the most common questions I getasked is, “When do I use ice for an injuryand when should I use heat?” The answer to that question is related towhat was the cause of injury. If the injury tothe neck or shoulder was recent and haswarmth, redness or swelling present, aswell as a potential throbbing pain, thecause is most likely inflammatory,therefore ice Is the better choice for theinjured area. Ice will help an inflammatory condition byreducing the flow of fluid, which can causeswelling and cooling to the surroundingtissue around nerve endings that areresponsible for signaling pain. The time forice use should be limited to 10-15 minutes.If ice is applied for too long (greater than30 minutes) skin damage may occur.

Heat is best used for chronic conditionsand those that are a result of joint ormuscle stiffness. This is usually someone who feelssymptoms worse in the morning or aftersitting at a desk for a prolonged period oftime. Heat works by increasing circulationto an injured area which then increasestissue flexibility and range of motion. Heat should be applied to the affectedarea for no longer than 30 minutes andthe temperature should be comfortablenot hot.

If you are lying down on heat make sureto have a physical barrier between yourskin and the heating element. If you havesensation deficits, do not lie on the heatdue to the inability to feel if the heat isgetting too hot for your skin.

THE GOAL IS TO BEPAIN-FREE

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2. COMFORTABLEACTIVE RANGE OFMOTION

The ability to restore comfortable range ofmotion in an injured area is alwaysparamount for speedy recoveries. When beginning with range of motiontraining, you must keep the motion in atolerable pain range. It is KEY to not moveinto sharp pain otherwise you will continueto irritate the injured tissue. Another negative to moving into areas oftoo much discomfort is it will cause yourbrain to become hypersensitive to the painin that region of your body. Doing this willmake you think and feel that painconstantly and prevent you from focusingon other things in your life. When range of motion exercises areperformed in a tolerable discomfort range,the joints and muscles can getreacclimatized to movement. Make surethe discomfort level does not causemuscle guarding or tensing withmovement. For neck pain, start lying down on yourback with comfortable neck support (towelrolled up, or a small pillow) and begin withleft and right rotation followed by gentlechin tucks. You can do a combination ofthe two movements, chin tucks with neckrotations, left and right in a tolerable painrange.

Shoulder movements should begin lyingon your back with a light stick or golfclub in both of your hands, or you canjust hold your injured arm with your non-injured hand at the wrist to assist withoverhead rang of motion. You will slowly bring both arms up andforward overhead in tolerable painrange, also work your arm out to the sidekeeping the arm resting on the floor orbed. Finally position yourself on your sidewith your non-injured arm and place asmall towel under your injured shoulderand begin with rotating your injuredshoulder away from your body. All range of motion exercises aredisplayed in table 1 on page 9.

GET BACK TOFEELING BETTER

Two very effective stretches for the neck are

both performed sitting in a chair where the

injured side’s arm can hold the bottom of the

seat to keep that shoulder down while the head

is held with the non-injured side hand at the

back base of the skull and gently pulled down

and away from the injured side of the neck.

The second stretch is held with the non-injured

arm's hand near the side of the injured side and

gently pulled out to the side (ear to shoulder)

away from the injured side.

For the Latissamus Doris muscle —standing or sitting — hold the injured wristwith the non-injured hand and bent thetrunk and pull the injured arm overheadtowards the non-injured side and slightlyforward. All shoulder and neck stretches should beperformed 2-3 times a day for 30-45seconds each in a comfortable pain range. No stretch should be performed to thepoint of severe pain or result in lingeringpain. See Table 2 on page 9 for images ofall the stretches described above.

3. STRETCHING

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If neck and shoulder range of motionexercises are tolerable, you can begin withstretches to the muscles in this region. The most common muscle that get tightand restrict normal motion in the neck arethe upper trapezius muscle, the levatorscapula muscle and the scalene musclesthat attach from your neck and head downto your collar bone and shoulder blade.

The shoulder muscles that are mostaffected are the pectoralis muscles whichare positioned on your ribs in the front ofyour body as well as your lattissimusmuscle that is on your back. Both of theses muscles attach to yourarm right around the shoulder joint andwhen they are tight they will causemovement dysfunction that will lead toshoulder injuries. Pectoralis muscle stretching can beperformed standing in a doorway withyour arms at your side shoulder heightwith your elbows on either side of thedoorway. Once in this position simply stepthough the doorframe to add stretch tothe front of the shoulders. An alternative position for this stretch canbe performed lying on your back in bedwith the injured arm near the side of thebed and simply stretch your arm out tothe side until a comfortable stretch is feltacross the chest.

3. STRETCHING

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4. SLEEP ANDPILLOWS

It cannot be stressed enough how vitalsleep is to injury recovery. A lot of tissuehealing occurs when we sleep, therefore ifyou are not getting good sleep at night, itis recommended to take a short napduring the day if permissible. Naps only need to be 20-45 minutes tohave positive health benefits. For adults,evening sleep should be between 6-8hours. The pillow you sleep on is critical toachieving the correct amount of sleep toheal from an injury. If your pillow is a few years old and seemsto be losing some of its support, it may betime to get a new one – or if you arewaking in the middle of the night with neckpain, the amount or type of support youare sleeping on might be the root cause ofyour problems.

Memory foam and dense foam pillowswork for some people and others dobetter with a cotton or feather pillow thatwill support the neck while sleeping. Making sure your neck is supported andheld in a neutral position are the mostimportant aspects of your pillow. I recommend to avoid sleeping on yourinjured shoulder unless necessary orsleeping on your stomach with neck pain.

SLEEP IS VITAL TOINJURY RECOVERY

The perfect pillow is different for eachperson's neck. Finding the perfect pillowshould mean you maintain a neutral spinewhile you lie in your sleeping position. The term neutral spine refers to your necknot bending left or right if you are a sidesleeper or too far forward if you are a backsleeper.

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5. POSTURE

Posture corrections and supportiveexercises are always a great idea forissues affecting the neck and shoulderregion. Many common shoulder and neck issuesare fixed entirely from correcting postureand performing supportive exercises tomaintain strength in your postural muscles. If your neck or shoulder problems areworst in a prolonged position there is avery strong chance the prolongedpositioning is the problem. There is goodnews to this problem that is it is easy tocorrect. Shoulder blade squeezes are a greatposture exercise to start with. I alsorecommend chin tucks and spinallengthening movements.

Table 3 below on page 9 will show youimages of the exercises described. Remember, it takes two thousandvolitional attempts at something before itbecomes habit, and once you havestored these as habitual, you willautomatically continue to do them.

IMPROVE YOURCURRENT STATE

The best way to describe spinallengthening exercises are to think about astring attached to the top of your head andsomeone is putting tension on it,lengthening your spine as you sit or stand. These three easy posture exercises canhelp correct poor posture and also startstrengthening the muscles that havegotten weak and allowed your body to getin a position that has resulted in injury.

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6. CONSULT AMEDICALPROFESSIONAL If some of the simple fixes given above arenot getting you back entirely to where youwant to be to live a pain-free life, then itmay be best to speak to a medicalprofessional to assist you on your road torecovery. There are many medical professionals thatcan assist you along your rehabilitationpath. Physical therapists treat musculoskeletalinjures on a daily basis and try todetermine the factors that cause an injury.From there, they facilitate the correctmovement patterns to rehab the bodyafter the injury, and teach preventativemovements or exercises to keep the injuryfrom reoccurring. Some conditions are more severe andneed to be treated surgically. The best professionals for surgery areneurosurgeons or orthopedic surgeons. Ifthe injury is due to a spinal mal-alignmentthen a chiropractor may be a very helpfulresource. Chiropractors are experts at jointmobilizations and maintain correct spinalpositioning. If the injury is due to a sore muscle thenmassage therapy might be a helpfulresource.

LIVE A PAIN-FREE LIFE

Naples Premier Physical Therapy (NPPT) wasdesigned to change the way physical therapy care isgiven. To be patient centered and to always provideone-on-one care with a Doctor of Physical Therapy. Feelings of helplessness without options for painrelief and dysfunction are over. The main focusat NPPT is to deliver the most outstanding care thatis designed to get you back to your normal life again,and to help you better understand what causedyour problem and the solutions available. Treatments at NPPT Therapy take place in a fullyequipped gym and private treatment rooms for allmanual and massage therapy. Call us to learn moreabout our services at 239-595-7833.

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AT- HOMEEXERCISES 

Table 1: Range of motion exercises (cervical and shoulder)

Table 2: Stretches for neck & shoulder

Table 3: Posture exercises