Neck Pain

Article

Is Instability the Cause of Your Neck Pain?

Try This Simple Techinque to Find out

Neck pain is a widespread problem, and there are many different causes. Sometimes as a therapist or someone who suffers from neck issues, it can be hard to know what will help. Should we rest or stretch more? Or do we strengthen? The following technique can help, particularly if you have pain during movement caused by instability.

Step 1: What types of neck movements are painful?

If you suffer from neck pain, you are almost certainly aware of what head movements aggravate. But if you don't, first, explore the neck's different movements and make a mental note of when pain occurs:

  1. Take the chin towards the chest
  2. Extend the head back
  3. Bring the right ear towards the right shoulder
  4. Bring the left ear towards the left shoulder
  5. Rotate to the right 
  6. Rotate to the left. 
What did you feel? Was there a particular direction that produced pain? 
Jihva Bandha
Step 2: Press the Tongue Up
Next, I want you to press the tongue to the roof of the mouth. Do this, so the back of the tongue is drawn back slightly, so you can feel it pressing into the throat slightly. At the same time, press the entire tongue upwards. 

In the image, you will see that as I do this, the frenulum, the tissue that connects the tongue's underside to the lower jaw, is lengthed.  This is effectively a technique called Jihva Bandha. However, it is better to modify this by keeping the mouth closed.
As you become familiar with the tongue's position, start to become aware of how you feel around the throat area. This is due to some of the deeper muscles around the front of the neck activating. You should be able to feel this region becoming higher, which you can appreciate if you place your hand gently on the throat.

Step 3: Move Again
When you are ready, press the tongue up and keep it there as you move in the direction or directions you feel pain. What did you find?

In many cases, you can now move without pain or at least less pain. It works well in all directions, though it's not uncommon for it to be less effective and aggravate pain when the head is taken forward. If this is the case, then other techniques are advised.

If neck pain is eliminated with the tongue pressed upwards, you likely have neck instability.

Why it works
Pressing the tongue upwards leads to the contraction of some of the deep neck muscles mentioned earlier. These collectively are known as the deep neck flexors (DNF) or deep cervical flexors (DCF). These are essential stabilisers of the neck and are often weak in those with neck issues. Activating them helps stiffen the neck and can help overcome instability if present.

Let me expand on this. The neck joints are designed to work a certain way and allow specific amounts and types of movement. This movement is controlled partly by the stiffness of tissues, such as the intervertebral disc and ligaments. When these tissues are injured, they lose their ability to correctly guide motion. This faulty movement can lead to pain and other issues. In this situation, the role and activity of muscles become essential: we need them to work much more efficiently and take over some of the work that the ligaments and discs are currently providing.
The Deep Neck Flexors (DNF)
Image: The deep neck flexors (DNF), include the rectus capitus anterior, rectus capitus lateralis, longus capitus and longus coli. (Image by Henry Vandyke Carter).
When to Use
You can use the technique whenever needed in everyday life and asana involving the neck. For example, you may require added stability during upward-facing dog or trikonasana. You can also use it when working with the neck, such as during controlled head movements.

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