The Importance Of Neck Strengthening In Patients With Neck Pain
Neck pain is a common source of musculoskeletal pain with up to 70% of Americans experiencing neck pain at some point in their lives. In the early or acute phases of pain, hands on treatment including spinal manipulation and joint mobilization have been shown to reduce pain and disability due to neck symptoms. If left untreated, neck pain begins to create muscles imbalances including weakness and tightness of the upper quarter muscles. Specifically, research has shown poor performance of the deep neck muscles along the front of the spine. The deep neck flexors provide strength and stability to the skull on the spine as well as the spinal vertebrae. Normally these muscles have a feed forward response where they fire before bigger movements of the neck, but in patients with neck pain these muscles fire late or may not fire perpetuating muscle imbalances and movement impairments at the neck. A new systematic review highlights the importance of the deep neck flexors for patients with neck pain.
Blomgren and colleagues examined the available evidence behind the utilization of deep neck flexor strengthening in patients with neck pain (BMC Musculoskeletal Disorders. 2018). Authors included 12 randomized controlled trials in their final analysis to determine the impact of these exercises on aspects of muscle performance including strength, endurance, coordination, and function. They reported strong evidence was found for the effectiveness of these exercises on coordination, but smaller effects were found for deep cervical strengthening on strength or endurance measurements. In addition, deep cervical flexor strengthening exercises were found to improve neck and head posture.
In our physical therapy practice in Boulder we commonly start with these exercises before rapidly progressing patients toward a higher level strength training program. In our practice experience, higher level strength training of the neck and shoulders is the most effective way to restore function and prevent recurrence in patients with neck pain.