In part one of my articles about neck pain I discussed the various causes of neck pain and why it is so important that you DO NOT rely solely on stretching and massage to relieve your pain. In many cases these very strategies are making your problem worse, especially if you have a depressed shoulder accompanied with weakness and poor movement. This is not to say that all stretching and massage is useless, you just need to know what stretches to use, and how to combine your mobility work with strengthening exercises. If you missed part one you can go back and read it again by clicking here. While it is important to strengthen various muscles it is foolish to rush into this process for you will almost certainly make matters worse. You need a plan of trying to reduce inflammation and trigger points to weaken over-working tonic muscles stealing work from weakened phasic stabilizer muscles. This is a delicate process to do this with this area of the body as there is so many nerves and things to contend with. Even your thoughts and emotions can play a role in creating tension in muscles around the neck so this is something you need to consider. To help you out I have put together a plan that outlines the various exercises to use as assessment tools to find out where to start.

How to Strengthen Your Neck

Now before you rush out and start trying to find a stack of exercises to strengthen your neck you need to start with the basics. The worst thing you can do is copy exercises from someone else for you may end up using an exercise that makes your neck pain worse. You will also come across some very strange exercises that are very useful for wrestlers, MMA fighters, and even racing car drivers who require abnormal amount of strength in their neck to handle the demands of their sport.

However, for most of us who do not participate in these activities these exercises may be a bit too aggressive for what you need. This is why it is never wise to copy people as you may do more harm than good if you do not know what the purpose of the exercises are.

As there are so many things to address with strengthening of the neck I have broken this process into several parts starting with simple mobility and stability exercises that evolve into the more integrated strengthening exercises.

It is not just one single exercise that will help you here but the combination of many.

The tricky part is finding out where to start and knowing when to progress. You must progress to the end as this is where you make the biggest and most permanent change so your problem does not return. However, it is important you do not rush to get to this point as you will cause more problems than you solve.

Okay, let's get stuck into the exercises you need to test and assess yourself with to find out what is behind the cause of your neck pain.

1: Assess Your Breathing

This part is critical and you can find if your trigger is stress or anxiety your breathing will be behind the neck pain. There may be no dysfunction with your scapula or shoulder, or any of the muscles in the upper body, the problem is you are breathing incorrectly.

I regularly find 95% of all neck pain people are poor breathers! They often adopt a method of breathing similar to an asthmatic having an asthma attack by using their shoulders and neck to create respiration. They are often mouth breathers or at best heavy chest breathers, and very poor diaphragm (belly) breathers. There is no point in doing any stretches, exercises or getting massage or chiropractic treatment while your breathing is dysfunctional. You are going to take on average 20-25,000 breaths per day so getting it right is critical.

Learning to breathe through the nose and how to effectively use your diaphragm prevents you from using your shoulder and neck muscles to breathe. This instantly prevents tension going into your neck. Yoga, meditation and Tai Chi are great methods to use here.

For such a simple tip it is so powerful. I cannot tell you how many people have resolved their problem from learning to do this alone!

You can read more about breathing in this article - Do you know how to breathe correctly?

2: Trigger Point Release

Once I have eliminated breathing as a factor I turn my attention to finding and releasing trigger points and mobility restrictions that affect the neck from achieving optimal stability. This part is very important in the beginning as it can provide some short term relief from the tension and pain. IT DOES NOT FIX the problem though so you must not fall into the trap of thinking the job is done.

So where do you look?

Usually the area around the upper thoracic region along the border of the scapula and also around the lats. There is often very nasty trigger points hiding in these areas creating all types of dysfunction and weakness creating a stack of problems for the neck and shoulder. Always remember if you have a shoulder problem you are very likely to have a neck problem as the same muscles that move your arm also move your head.

The video below show you how to do this.

Shortly you will see the other trigger point release I like to use in combination with the wall slides drill.

3: Mobilize C7/T1

This area of the body is often very stiff and very painful to touch for a person with neck problems. If someone has a significant forward head posture this joint takes a beating as it is at this point that they hinge their neck forward. This can be extremely difficult to mobilize and this is where a Chiropractor or Osteopath skilled in manipulation can be very useful in helping you to free this joint up.

I find the two exercises shown in this video are another great way to combat this by yourself to ensure you prevent the joint from stiffening back up. Once again I must stress these exercises are not enough to address the reason for the stiffness, but in the beginning they enable you to get your full range of motion back so you can move your head and neck again.

Watch the video below to see how this works.

Next thing to look at is thoracic mobility and the first one I like to use is the Feldenkrais exercise.

4: Feldenkrais Shoulder/Spine Integrator

This exercise is not a neck stretch. It is actually a great way to mobilize the thoracic spine to allow you to easily rotate your neck. We have all experienced that awful feeling when you can hardly turn your head to look behind you, and this exercise is great for carefully helping your body to get this back.

I prefer this in the early stages with neck pain as it is so gentle. The whole point of this is to be able to move your head with the least amount of effort as the rest of the body moves to allow your head to fall into position. This is usually a favourite exercise for many neck pain sufferers in the early stages as it feels so relieving.

Watch the video to see how this exercise works.

The Feldenkrais method is remarkable and highly encourage you to read the works of Moshe Feldenkrais or take part in some of the courses that run all over the world as it is fascinating stuff.

5: Thoracic Mobility

I won't spend too much time here as I have covered this in great detail recently in the article 10 ways to improve thoracic mobility.

Thoracic mobility is always very tough for the neck pain person to work with for they often have compressed the spine so much that it has lost a great deal of its mobility with extension and rotation. Until this is addressed you will never be able to stabilize the head and neck to prevent the ongoing tension and stiffness in the muscles of the neck.

It is important to understand that the mobility of the thoracic spine is vital for the lumbar spine and the shoulder joint to achieve stability. Both of these joints are regularly exposed to injury when the thoracic region becomes stiff and rigid.

The video below while similar to the Feldenkrais drill is a much harder version to use. I prefer to use this as a test as it tells me a lot about where the restriction is hiding exactly. This is also an example of where the test is also a great corrective exercise in its own right.

6: Stretch the Pecs & the Latissimus Dorsi

While you are not trying to stretch the neck muscles, you are definitely going to be stretching the pecs and the lats. These muscles are very prone to shortening and tightening which greatly inhibits muscles like serratus anterior and lower trapezius from firing. Using stretches to weaken these overworking muscles will give you every chance of succeeding with the upcoming stability and strength exercises to come.

Here is a video showing you 3 ways to release the pecs. And to see a video about how to release the lats click here

I suggest to read the article - How to identify mobility restrictions affecting how you move to see more on this and several other examples for releasing the pecs and lats.

Finally we are up to the point where we try to stabilize and strengthen muscles supporting the neck. This is where the long term solution is going to be found, but it is also where you can potentially aggravate things so you have to be careful. If you do not attempt to move forward in this phase you will never get rid of your neck problems and have a lifetime of stiffness to deal with.

7: Serratus Anterior Wall Slides

Once you are at this point you are now going to make some serious changes for you are going to be able to address the hidden weaknesses causing all of your trouble. This is such a great exercise to use for the neck pain person as it teaches them how to lift their arms correctly without the need to shrug into their neck, but more important it begins to free up the scapula with its correct motion and get the serratus anterior activated.

The downside of this exercise is it can be very difficult to learn. The scapula is the key here and it is very unique in that it needs lots of mobility but not too much, as the scapula also needs stability too but again not too much! The secret to restoring optimal mobility and stability at the right time to the right muscles is to teach movement mechanics, and very specifically with POSTERIOR TILT and UPWARD ROTATION of the scapula. This is the purpose of the wall slides exercise and it does an amazing job of restoring these movements.

I have two versions I like to use with the preferred version being the standing one shown below.

However, sometimes this may be too difficult to do especially with the person who has shoulder pain and cannot extend their arms so I will take the person down to the floor and complete this same drill lying down.

This exercise provides them with more control and helps them to feel the scapula wrapping around the rib cage which is so important for the strengthening exercises in the next phase. The video below shows how this works and also shows the other trigger point exercise I like to use at this point.

I also suggest to read the detailed article about the serratus anterior wall slides to see more about this exercise and why it is rated so highly for shoulder and neck pain.
Click here to read the article.

8: Neck Isolation Strengthening Exercises

Most of us know all about the tight muscles at the back and sides of the neck, but very rarely do people pay attention to the weak muscles under the chin that are responsible for holding the head in an upright position.

These muscles are known as the suprahyoid and infrahyoid muscles.

You can feel them contract if you place your fingers on your throat and swallow your saliva. These are prone to weakness and when this happens the muscles known for overworking and tightness will begin to work harder and develop trigger points and eventually pain.
There are a few exercises I like to use to help people develop strength with these muscles without the complexity of coordination and other muscles becoming a factor. The 2 exercises shown in the video below are great ways to activate and strengthen these muscles.

9: Single Cable Push & Pull Exercises

With almost every shoulder and neck injury you will find there is a significant weakness with serratus anterior. This muscle along with the lower traps are such important muscles to healthy shoulder function because they are what helps to keep the scapula attached to the thorax and in optimal alignment. The problem many people face is finding a way to strengthen the serratus anterior for it is very difficult to do. Often the dominating pecs, in particular pec minor steal the workload further exacerbating the shoulder dysfunction. The greater the imbalance becomes the worse the injury gets.

Always remember this quote from the last newsletter and why this part is so important for addressing the real cause of your neck pain.

"Almost all neck pain and headaches I treat are primarily due to poor shoulder blade (scapula) function regardless of the structural diagnosis involved."– By Rick Olderman

The single cable press is one of the best exercises to develop the strength with the serratus anterior and help to restore scapula stability for several reasons.

1. It allows full protraction of the shoulder which is the key in activating this muscle.
2. It demands good thoracic mobility with rotation. Thoracic stiffness is a known problem with instability of the scapula and shoulder.
3. It demands perfect core control.

The video below shows you how to execute perfect form with this exercise but I highly suggest to read the article - Single Cable Push is much more than a strength exercise to see more about this movement.

I would also spend some time developing strength with the single cable pull although this is not as likely to change things as much as the push. Click here to see a video of the single cable pull.

10: Push-ups

When it comes to trying to strengthen serratus anterior and lift the rib cage there is not many better exercises to do this than the push-up. I avoid using this first as it can aggravate the pecs too much which is why I prefer the single cable push first. Once you have cable push down it is time to move to this one and if you can become great at push-ups there is a good chance your neck pain is nearly gone for good.

While a bulk of the workload is performed by the chest, shoulders and triceps, the exercise cannot be done correctly without almost every muscle in the body participating. Even the abdominal muscles must work hard to stabilize your torso and prevent your hips from sagging.

The push-up in theory is a very simple exercise, however, many people with postural imbalances struggle to do this correctly and it may take some time to get this right. When you eventually develop the correct form your scapular will be able to move fluently and wrap around the rib cage with ease.

And when this happens you will build incredible strength into the serratus anterior. Watch the video below to see how this works for improving scapula stability.

11: Upper Trapezius Strengthening Isolated

We are finally up to the point where we begin to strengthen the upper trapezius and the muscles commonly associated with weakness. It is hard to believe that I needed to use 10 steps before getting to this point, but make no mistake about it if you skip any of the previous steps or rush through them too quickly you can quickly cause a lot of trouble to your neck.

I like to think of strengthening the upper traps and overhead movements being similar to the bending action for back pain.

"The very thing that is going to get rid of your problems for good is the very thing that can make it worse!"

Before rushing to integrated overhead pushing exercises I like to use these two strange looking exercises to build some foundation strength first. If something goes wrong at this point it is not catastrophic as the loads are so small and the movements very subtle. The best part of both of these exercises is that they provide great scapula stability by using strange body positions to give you better leverage.

The first one I use is a modified shrug as seen in the video below.

The second isolated exercise is a modified overhead pushing movement. This is very similar to the Turkish Get-up exercise with the body leaning to the side to assist in keeping the body vertical. This is great for two reasons.

Firstly, it allows full upward rotation of the scapula.

Secondly, it avoids placing huge loads through the shoulder itself as the body takes most of the force and compression.

This is an excellent way to progress to overhead movements by minimizing the risk associated with it. This can build incredible confidence to get to the next step.

You will find the article how to strengthen your upper trapezius provides even more detail about these exercises and overhead movement.

12: Integrated Overhead Movement

Now I am finally ready to push big loads overhead. This is where I will use integrated movements that allow my legs to assist the shoulders with the load. Not only is this much more efficient it avoids excessive load being forced into one area and gives my body more freedom to move and a chance to adapt and strengthen without stiffness.

The single dumbbell squat push and the barbell squat press are some of my favourites to use. They both allow the scapula to wrap around the rib cage which we have discussed so many times in this article is vital to the health of the shoulder. The barbell squat press has a unique angle to once again minimize the risk associated with vertical pushing movements.

Here is the video of several ways to improve overhead strength.

If you have been able to progress to this stage well it is fair to say your neck pain should be a thing of the past. Now you just need to be careful of over-doing things and aggravating your problem from excessive training and it is at this point stretching could be useful. However, this will take considerable time to get to this point so you must be patient.

Instead of stretching I prefer to spend time mobilizing my thoracic and releasing trigger points before using this exercise.

13: Turkish Get-up

The amazing changes that happen when you perform this exercise are varied for the simple reason it does so many things. I like to think of it as the "Swiss army knife" of exercise. It is also for this reason that it can be hard to learn, but the effort is well worth it for here is a list of the benefits to your body from the Turkish Get Up.

1. Greatly improves shoulder stability and thoracic mobility at the same time!
2. Improves overall body stability and integration between upper and lower body
3. Promotes reflexive stability of the torso
4. Encourages great mobility of the hips and thoracic spine, the two areas most people are lacking
5. Improves the body's ability to coordinate and enhance balance from lying to standing
6. Develops upper body strength, trunks strength, and glute strength

If you think that is impressive then this will blow you off your chair. In my recent article about core strength and analysing various exercises with EMG measurements, the Turkish Get-up was rated NUMBER ONE out of every exercise for core activation across all four muscles tested. It beat the deadlift, squats, and all abdominal muscle isolation exercises for total core activation!
As you can see this is so much more than just a simple strength exercise. Watch the video below to see how this works.

Putting It All Together

As you can see the shoulder and neck are very difficult to work with as there is so many moving parts and pieces to consider. To give you a template of a workout for this reason is impossible as the only way to determine what to do is assess your body first and let the tests dictate what to do.

Two people with identical symptoms may need completely opposing programs. One may need stacks of mobility where the other it may be the strengthening exercises that are of more importance.

To help you out with this process we created a detailed shoulder pain report that provides with all the tests and exercises in a step by step format so you can finally get rid of your problems for good. To see more about what is included in this detailed report click here and to download instantly click the image below.

Summary

Wow! I am sure you would agree that there is certainly a lot more to getting rid of a stiff neck than you realize. You can also begin to see why so many people never seem to get on top of their problem and if anything only serve to make it worse by constantly stretching and pulling on muscles that are already overstretched.

While strengthening is the ultimate answer it is not as easy as ripping out a few sets of shoulder press. You have to be very careful with the way you approach this to avoid making things much worse and causing all types of headaches and nausea.

I hope this article gives you some great ideas of where to start and how I might go about helping someone beat their neck pain for good. Sometimes it may be nothing to do with your exercise selection and could be related to stress or side effects of medications. But if you at least have a plan to follow you can begin to rule out the various factors that may be the trigger of the problem.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter by clicking here.

If you live in Melbourne and feel you need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 14 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise. He has worked with professional athletes in Golf, Tennis, Basketball and Football but is known throughout the local community more for his work with injury prevention and rehabilitation.  Having participated at high level in many sports himself and also recovering from several serious injuries he has spent considerable time developing detailed assessments and programs to cater for injury and pain.

References

• Movement - By Gray Cook
• Shoulder & Scapula Injuries in Athletes - By Chris Mallac
• Corrective Exercise Solutions for the Hip & Shoulder - by Evan Osar
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Low Back Disorders - by Stuart McGill
• Back Pain Mechanic – by Stuart McGill
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Scientific Back Training – By Paul Chek