A lot of injuries and complaints I see at Apple Creek are back and neck pain. Often I prescribe exercises at the beginning of my treatment plan to complement the manual work I perform on the patient. Exercises are vital in the rehabilitation process as I am able to unlock joints, loosen muscles and make corrections, in order to maintain these benefits the patient needs to do their home exercise program religiously. It’s nice that the pain goes away for a day or two but then the patient will fall into the same postures and patterns that got their back or neck all gummed up. In order to reap the rewards of manual therapy, exercise is key. When seeing a patient on a follow up appointment I will always ask how the exercise program is going to ensure that they are doing it, and this gives them a chance to ask any questions (if they are doing it right, if they are feeling it in the right areas etc.). The usual reason I get from a patient who is not compliant “I don’t have time”. Which is fine, I get that, BUT in my profession we have to be problem solvers, so here are my efficient exercises to help reduce neck and back pain while driving.
- Chin Tucks: Neck pain comes from many areas; an exercise that I prescribe in the early stages of treatment for almost all causes of neck pain is Chin tucks. Due to technology along with other reasons, all patients with neck pain have rounded shoulders (which we will get to with our next exercises). This cause the neck to go into extension causing our deep beck flexors to lengthen and our neck extensors to shorten. This poor posture is a big reason for recurrent neck pain. Chin tucks is an exercises to strengthen our neck flexors and lengthen our neck extensors.
How to perform the proper chink tuck:
- 2 Hands on the wheel and eyes on the road;
- Take your chin and bring it down as if you are nodding to say yes – this can also be thought of as creating a “double chin”;
- Now your head should be in extension with your neck pressed back against the head rest of your drivers chair-slowly in this position press the back of your head into the head rest hold for 3 seconds then relax;
- BUT DON’T GO BACK TO THE POOR POSTURE: Although this is an over exaggerated exercise this is the position we want to maintain throughout the day.
Scapular setting: As mentioned previously, neck pain is usually accompanied by rounded or rolled in shoulders so other than stretching out our chest muscles (which I highly recommend), we need to strengthen the muscles that keep us in good posture. These are the muscles between the shoulder blades (also known as the scapula).
To do this we must perform proper SCAP Set:
- Two (2) hands on the wheel and eyes on the road;
- Straight arms, now Imagine there is a pencil in the middle of your back and the only way you can hold it is by squeezing your shoulder blades together. This movement should come from your back muscles and you should have some slight shoulder movement towards the back rest of your driver’s seat, no elbow flexion should occur.
- Now for those of you reading this you are squeezing as hard as you can which is good, but we need to contract the right muscles so we don’t want to bring our shoulder blades up and cause more neck tension we want do the opposite. Some cues I use for this when teaching my patients in the clinic is to bring your shoulder blades “down and back” imagine putting your elbows into your back pocket – without bending your elbows of course (yes you read that correctly);
- Hold this position for 10 – 15 seconds but again DON’T GO BACK TO POOR POSTURE THIS IS A POSITION YOU WANT TO BE IN ALL DAY EVERY DAY (seems impossible but with hard work and long work commutes you can do it);
Lastly to help with Back Pain….
Abdominal Hollows: Many times back pain can be caused by having a weak core. How? You ask. Well imagine being in a room with 6 walls on the top is your diaphragm a very big strong muscles, the back being held by a spine and ribs, the sides by ribs and what you are standing on is the pelvic floor which is extremely strong group of muscles bones and ligaments. Now we look to the front of the room where all we see is a few layers of muscles and some fat (ever wonder why people get big belly’s?). When there is increased pressure it will follow the path of least resistance in humans that is the area we consider to be the stomach. When we have weak core we cannot maintain thoracic pressure, which means when you bare down and hold your breathe to lift something or twist and turn your body cannot maintain optimal pressure levels and you guessed it the stomach “gives out” when you lose that pressure the spine now loses stability and BAM back pain begins. I see this a lot. So now you need to strengthen your core but you have no time to do a 6 pack abs workout – well great because I would never recommend that (unless you just want to look good) so in comes our basic but effective abdominal hollow.
How to perform the abdominal hollow:
- While sitting in your car 2 hands on the wheel and eyes on the road;
- Take a deep breathe in and blow out your stomach (trying to replicate a pregnant belly);
- Take a deep breathe out and now suck your stomach in as much as you can (as if you were taking a picture on the beach);
- Now hold the sucking in or hollow position while breathing but try to keep your stomach and core stable (don’t let it move);
- Hold this for 30 seconds, this one you can relax but try to maintain your core stability you can do this by holding that hollow contraction throughout the day BUT at around 30% of strength (don’t suck in as far, just cause the muscle to contract);
I would do these set of exercises on your commute to and from work as many times as you can; each day, or week increase how long you hold each exercise for. Remember you are strengthening postural muscles AKA muscles that have to fire all day long – so doing 5 to 10 reps for a muscle that is needed almost 16 hours a day will give you very small improvements. Train the muscle the way you use the muscle. Too easy? You can also do all of these exercises at the same time. Whether you are on the train, bus, at work, in your car etc. these exercises are specific for those of you on the go, NOW GO! Try them.
–Nicholas Halkidis CAT(C) RMT