Neck, Shoulder and Arm Pain Part 2: Strengthen Long Muscles

This is the second part of the tutorial on how to keep the shoulder girdle balanced to prevent pain in the arms, back and neck. In this segment we will focus on strengthening. We will begin with a tutorial on what it means to stabilize a winged Scapula, this is what will help us understand if we are in good form (or bad) Winged=BAD. 

How to Identify and Correct a Winged Scapula

Now we will cover three versions of Scapular Push-ups (to strengthen the shoulder girdle). You should perform 2 sets of 10 reps each per exercise, only doing the version your body is ready for. If you find it difficult to hold good form in a version of the Scapular Push-up (if your scapula are winging or poking out), stick with the previous version until you are strong enough to perform the next version of exercise with good form. However, you should continue to perform all versions, even when you are strong enough to successfully complete the most challenging version. Remember, the emphasis here is on proper form and muscular balance- so if you push ahead before your body is ready, you are setting yourself up for imbalance. 

Basic Scapular Push-up

Moderate Scapular Push-up

Intermediate Scapular Push-up

*to advance you may come up off of the knees into full push- up position when you are ready.

Now for our final exercise in the series: Breast Stroke, which will strengthen the back extensors and challenge the shoulder girdle to move properly. This exercise must be performed with the head neutral (ears should not drop below the level of the shoulders- imagine you are swimming and your head and shoulders are both above water, do NOT look out at the horizon, DO look down at the water below you. Start out with 3 sets of 5 reps, move up to two sets of 10, and then 3 sets of 10.

Breast Stroke

Finally- What is that Occipital Ridge I keep mentioning, and why is it so important? Well, for starters, it is a bony landmark on the back of the scull, that indicates the very top of the spine (where the spine and the head meet). This junction is crucial for shoulder health. Our heads are very large and very heavy, and they are held up by a very long and thin neck. Ideally the head stays positioned over the shoulder girdle, where it can balance with very little help from the neck. This allows the muscles of the neck to do their REAL job, which is to move the head around. Unfortunately, we often let our head drift out in front of us, which makes our neck muscles have to carry the load of the head constantly (and the head weighs more the further forward it is). This prevents the neck from doing its REAL job effectively, and soon turns into neck pain, imbalanced neck muscles, shoulder pain, and then finally arm, elbow, wrist pain. It trickles down, just like that. So, that is why I'm always talking  about that Occipital Ridge. I like to use it to check in, making sure our head is balanced with our shoulders properly, whether sitting, standing, lying on our back or tummy- we always need to check in on this balance.

Occipital Ridge

 

Your body may be working overtime (even if you aren't)

Fridays are my work from home day, the day I take to do admin duties; write checks, review my Pilates schedule, pay bills, and when I find time- my day to post to Pilates Geek. On the days that I work from home I sit more than usual. I notice that for a couple of days following my WFH days I get a bit sore in my right shoulder and feel the need to adjust my neck regularly. Sometimes I even notice soreness in my jaw. On days like these I find myself wondering- how does the average person do this on a regular basis?

I understand that tech geeks and desk jockeys love their jobs, just as much as this Pilates Geek loves hers, but I cannot imagine what it would be like to work like this day in and day out without a good understanding of how to better adapt to the physical demands of sitting, typing, mousing, repeat...

So today's post is dedicated to the die-hard geeks (of any trade) who are held hostage to a desk all day (and, who most likely, love every minute of it).

In my last several posts we have discussed how to sit in good posture while working and how to breathe properly in order to relieve tension. We went over techniques to release and strengthen tight shoulders, and learned some simple exercises to do from just about anywhere. Today we are going to tackle a more subtle problem that can undermine the best of our efforts when it comes to posture and endurance at the desk- CLENCHING!

That's right, clenching. That nail biting, gum chewing, white knuckled, teeth grinding arm crossing aggressive habit that goes hand in hand with hard work and extreme focus. In fact, if you look around your office right now, you may be able to observe some of these behaviors first hand. See that guy over there with the little muscle above his jaw bouncing around like a little rabbit, or how about your boss over there snacking on his finger nails, ooh, or maybe him, that guy next to you on the phone without a headset squeezing his phone between his ear and his shoulder while he hammers away at his keyboard. It may be surprising how many examples you can pick out in just one sweep of the office. The simple fact is, these behaviors are so common we hardly notice them anymore, in others or in ourselves.

Unfortunately these unconscious and unnoticed habits create long term tension in the muscles, tendons and ligaments of the jaw, neck and shoulders. Over time the accumulation of tension causes muscles to spasm and inflammation to occur. When this happens regularly nerves become compressed, leading to pain, tingling and numbness in the arms, hands and fingers.

The first obstacle in correcting these habits is that they are usually unconscious. So you are going to have to use your habit radar and start seeking out some indicators that these things are happening in the first place. Once you pinpoint one or two of them, well, then the real work begins...

Here are a few things to be on the lookout for, and what to do to correct them once recognized:

Phone cradling- this one is pretty simple, make an effort to use your headset and avoid holding the phone to your ear. Even holding the phone with your hand for more than several minutes causes poor elbow mechanics and clenching. If you know you are going to be on longer than a minute or two, use your headset!

Gum chewing- skip it, or do it very minimally, for a very short amount of time. Repetitive chewing mimics jaw clenching and teeth grinding which produces major tension in the jaw, neck and shoulders.

Jaw clenching- this is a bit trickier because it is less noticeable. For starters it is helpful to realize that unless you are chewing up your food, you should always have space between your teeth (all of them). The lips can be closed, but the top and bottom teeth should have space between them at all times. It may help to use a rest break software that can help to remind you to relax and release your jaw.

Nail biting- this could, by far be the most difficult to tackle. I'd recommend designating two 5 min nail biting times during the day- say 11 am and 3pm. Outside of those times do not bite- and when you catch yourself biting stop and remind yourself of your biting time. Set an alert to notify you it's time and bite away. Over time you may find that you no longer have the desire to bite.
If this doesn't work I would recommend doing some research, and possibly looking into some cognitive behavioral therapies for suggestions on how to break this habit. Nail biting also has a negative impact on jaw, neck and shoulder tension, because, like gum chewing and jaw clenching you repetitively engage and stress these muscles.

Shallow breathing- this clenches the muscles between your ribs and compresses all of the soft tissues of the torso. Learn to take full deep breaths (see previous post on breathing techniques).

Aside from these detailed tips, here are some general recommendations to keep your body happier:

• Seek out stress reducing activities that you enjoy like Pilates, Yoga, Meditation, or maybe running.
• Take breaks regularly. I've mentioned there are software options that will remind you when a break is needed http://www.workrave.org/
• Make time for physical activity, don't "try and find it", because it will not magically appear, you have to make it happen
• Take a walk around the block, or try taking the stairs
• If you have difficulty staying motivated, schedule regular workouts with a trainer. If you have it on the books and are accountable to someone else, you are more likely to actually follow through.