Neck and schouder problems

After low back problems, neck and shoulder issues are the most common injuries in the physiotherapy clinic. Sometimes the problems are acute, but more often problems to the neck and shoulder are chronic.

Because we spend too much of our time sitting, often in a sub-optimal position, our body adapts to this position. A rounded upper back, shoulders forward and down, head and chin forward.

In this position, some muscles are continuously shortened, while other muscles are continuously in a stretched position. Both a shortened and a stretched state causes an increased internal pressure in the tissue. This increased pressure impairs blood flow and circulation. When circulation is impaired, tissues do not get enough oxygen and nutrients, causing fibrosis and cramping.

Long days in this not optimal working position combined with a lot of repetitive movements and a (too) high of a workload, causes a lot of tension in the neck and shoulder muscles and can lead to pain and injury in this region.

These problems can be local, but can also radiate down your arm and / or towards your head.

Anatomy

Your neck is made up of 7 cervical vertebrae, facet joints, intervertebral discs, connective tissue, muscles and nerves. The nerves from your neck innervate your shoulder, arm and hand.

In physilanguage, we often talk about the shoulder complex or shoulder girdle instead of the shoulder joint. The shoulder joint consists only of your shoulder blade (scapula) and upper arm (humerus) while the shoulder complex consists of; your scapula, collarbone (clavicle), sternum and your humerus. Between your sternum and your collarbone is your SC joint, and between your clavicle and scapula is the AC joint.

Together, these bones and joints create a big movement potential in the shoulder girdle. A big movement potential also means lots of things can go wrong.

Because the neck and shoulder are positioned close together and muscles run from the shoulder to the neck and vice versa, they influence each other’s movements and compensate when needed. These compensations can lead to pain and injury.

Common injuries

to the neck

 

Neck problems can be divided into acute neck problems and chronic neck problems.

An acute neck issue we hear a lot about in the clinic is when people wake up and can’t move their neck. Or your neck locks up with a “wrong” movement. When that happens, even the smallest movements can be extremely painful.

Clients often mention that they have just had a busy and / or stressful period with little sleep, etc., and suddenly their neck locked up.

When people are stressed, busy and / or tired, muscle tension increases. When the internal tension reaches a certain threshold, even small movements can set things off and cause everything to cramp up.

This acute pain can be very intense, but often pass quickly with dosed exercises combined with relaxation like stretching and breathing exercises.

In most cases, our treatment can quickly provide relief for these types of problems.

Chronic neck problems are characterized by long-term pain or stiffness in the neck. The problems can be located on the front of your neck, but also on the back of your neck, in the trapeziusregion. Sometimes the complaints come and go, sometimes they are continuously present and are aggravated by standing or sitting in the same position for a long time. Problems often decrease in the weekends or holidays.

A common symptom with neck complaints is that people feel that their head is too heavy for their neck. This could be a sign that you need to strengthen your neck and shoulder muscles.

Especially with chronic neck problems, there is often also a nerve entrapment between the neck muscles. This might sound alarming, but is surprisingly common and can often be resolved within a few sessions.

Common shoulder issues

Shoulder issues can occur in different ways. Shoulder problems can start acutely during a movement, or have a more gradual onset and grow worse over time. The problem can be located on the front, side, back or top of your shoulder. Sometimes symptoms are local, but sometimes they also radiate towards your neck, elbow or even your hand.

Acute shoulder injuries often start during a singular event like a fall, crash, lift or movement.

Shoulder problems with a more gradual onset without apparent reason are often caused by a something else. Sometimes you are literally carrying “the weight of the world on your shoulders” A non-optimal working posture can also cause the muscles in and around your shoulder to stiffen up and start hurting.

A common diagnosis is tendonitis or bursitis. This involves a compression of the supraspinatus tendon and / or bursa under the roof of the shoulder. While this diagnosis may be (partly) true, this is just the tip of the iceberg. The cause of the compression can be caused by several things. When upper back cannot extend and rotate enough, when your wrist is stuck, when a nerve is entrepped in the neck or when your elbow does not rotate sufficiently. Even a 10-year-old injury to your big toe can cause this compression under the roof of the shoulder.

What is the best thing you can do when you have problems with your neck or shoulder?

 

  1. Move your neck and shoulder in all directions, within the pain threshold.
  2. Move the surrounding joints and areas through their full pain free range of motion. That means your shoulder blades, elbows, upper back, your opposite shoulder.
  3. Relax! Breathing exercises, stretching and a walking in nature can help you to relax.

Especially when you have acute problems with your neck and / or shoulder, it is more about THAT you move instead of HOW you move. Moving within the pain free ranges relieves pain and accelerates the recovery process, so move!

Our treatment

Physiotherapy can create quick relief for your neck and shoulder pain. Our treatment improves the way the muscles and joints in your neck and shoulder can move and reduce your pain quickly. We also give you specific exercises you can do to improve your strenght and awareness.

When you experience acute neck pain, book your appointment with Dong, our manual therapist! For all other neck pain or shoulder complaints, all of our therapists are ready help you!

If you have any questions about your neck or shoulder complaints, please contact one of our therapists. Often we can already give you useful tips that immediately reduce your complaints.

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