The cervical spine or more commonly referred to as the neck, is made up of seven vertebrae labeled C1 to C7. The cervical spine consists of 6 motions: flexion, extension, right and left rotation, and right and left lateral flexion. The majority of motion occurs in the upper cervical spine, with 50% of rotation at the first two vertebrae (C1-C2). However, it is common for the middle of the neck to contribute too much motion and in turn it is common to see more age related changes on the C4, C5, and C6 vertebrae on X-rays. While you may see these changes on an X-ray they are just a process of normal aging, and not truly the source of the problem. Things such as degenerative joint disease (DJD) is a natural process of aging, and as Dr. Stuart McGill, the leading expert in lumbar spine, says “diagnosing someone with DJD is like telling your mother in law that she has degenerative face disease”.

Structural issues may contribute to the complaint, but usually complaints are from a functional issue rather than solely a structural problem. Yes you may see these structural changes but they can be a byproduct of the underlying functional issue. Such as having limited motion in the upper cervical and excessive motion in the mid-cervical region, excessive range of motion in mid-cervical is the functional problem leading to more structural changes. Therefore, by correcting the functional issues you can establish proper joint mechanics and improve pain free range of motion.

Overactive muscles of the neck such as sub-occipitals, traps, sternocleidomastoid, and scalenes are another culprit of neck complaints. These muscles are typically overactive due to our activities of daily living such as looking down at our phones, sitting at work/poor posture, and surprisingly breathing. Just as overactive muscle contribute to the complaint underactive muscles do so as well. Deep neck flexors lie on the cervical spine and are commonly found to be inhibited in most of the population.

The goals for the cervical spine are to achieve proper joint motion, establishing more motion in the upper cervical spine, and stabilize the mid-cervical spine. As well as activate the deep neck flexors and calm down the overactive neck musculature. While you cannot change the structure, you can improve the function and help to actually get to the source of the problem.

In our weekly video we went over some exercises for mobility and stability in the neck. The chin retractions are a great exercise to activate the deep neck flexors adding stability to the mid-cervical and break up our poor posture pattern. The other exercise called the missile lift (lying on your stomach lifting up and rotating your head) is a good exercise to help activate the postural muscles in the mid back and turn off the over active muscles in the neck, while helping to work rotation in the neck. Other beneficial exercises are the star drill and re-training breathing. Watch the video here (insert link).

Neck complaints also respond really well to manual therapies and adjustments. At TROSS Spine & Sports Performance we provide these services and more. If you have any question about the cervical spine or would like a free consultation contact our office today! TROSS proudly serves the Cottleville, St. Peters, St. Charles, and O’Fallon communities!

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