In Part 1 we looked at some of the biomechanics of neck problems and especially how to eliminate unnecessary tension in our neck when weight-bearing on our hands. In yoga asanas we commonly take our head back, extending our head and neck. Students are often cautious and hold back with this movement, concerned that it may hurt their neck. However, our necks are perfectly designed that we can gaze at the stars with wonder and delight!
As a Chiropractor I am trained in both radiography (taking x-rays) and radiology (the interpretation of x-rays). In the case of suspected gross instability in the cervical spine after a traumatic injury I might order a set of ‘stress x-rays’. Here the radiologist takes a set of x-rays with the patient in both full neck flexion and full neck extension. We are looking for any disruption in the flow of the posterior line of the vertebral bodies one on top of the next. When setting up the patient’s neck position, specific instructions are given on how to extend the neck. The patient must first poke their chin out and then take their head back. Poking the chin out causes activation at the very base of the neck with the last cervical vertebrae initiating the movement. This creates a smooth even backward curve in the neck, distributing the arc over the whole neck with each vertebra involved in the movement. Failure to lead with the chin will cause the neck to instead mainly hinge at the fifth cervical vertebra (C5). The following video explains further.
The neck is the most common place in the spine for degenerative arthritis and C5 is the most common level in the neck for degeneration and disc disruptions. Leading with our chin when taking our head back in ekam (first vinyasa in Surya Namaskara A), the warrior postures and backbends creates an even, stress-free mobilisation of all the cervical vertebrae into extension.
There are multiple layers of muscles at the back of the neck that perform cervical spine extension. The one that interests me most is the splenius muscle. The splenius in the neck is akin to the quadratus lumborum in the low back in that when both sides are working they produce extension of their domain on the spine. The splenius has two portions: capitus and cervicus. Between these two portions it has attachments to the cranium at the mastoid processes and occiput and to the cervical and upper thoracic vertebrae as low down as T6 between the shoulder blades! The splenius does in fact extend the upper thoracic vertebrae as it extends the neck.
With their firm attachment to the upper ribs the upper thoracic vertebrae (especially T1-T3) tend toward problems of fixation and stiffness. To keep these vertebrae and their rib attachments (costovertebral joints) healthy and freely mobile it is necessary to depress the shoulder blades when performing neck extension. As the chin initiates the neck moving into extension, lift your sternum in front and at the same time depress the scapulae on your back. Working your upper back in this way tractions the upper thoracic and cervical vertebrae and allows for problem-free neck extension. Additionally, this traction in the upper thoracic spine inhibits formation of the postural deformity known as a Dowager’s hump.
Taking the head back beautifully stretches all the muscles and tissues on the front of the neck. For most of us these muscles are habitually shortened from our chronic computer head posture! Take your head back with confidence and ease and enjoy its benefits, including the celestial view that adorns the sky above us!
In Part 3 we’ll look at some of the other musculature of the neck, the therapy we can do to keep our neck happy and some rehabilitation exercises in the case of neck problems.
Always with you on the mat…