By Lindon Beh, Physiotherapist
can Physiotherapy Help Me Fix My Tight Shoulder, Neck and Headache Pain?
In the past few months we have seen a DELUGE of neck, shoulder and headache pain. Melbourne was asked to go into a strict lockdown where school children and workers had to work from home if possible.
There was an increase in sitting, computer and screen time and conversely a decrease in incidental physical activity (think walking around the office, walking to get a coffee, going out to buy a coffee).
This imbalance in activity vs sedentary behaviour saw a spike in neck, shoulder and headache pain.
So if you are an office worker, have been studying or have been watching heaps of Netflix, keep reading this blog to find some solutions for you!
What Causes Neck and Shoulder Tightness and Tension?
This pain is susceptible when there has been decreased movement in the upper back, neck and shoulder muscle groups or there is decreased tissue capacity in the regions.
As listed above, when there is a big imbalance in upper body activity vs sedentary behaviour, the body can be susceptible to generating pain.
This is why you may feel better when you are active in the upper body (tennis, swimming, gym etc) and why you may have pain flare ups when you have periods of increased sitting (deadlines, big days in front of the desk, studying for assignments, assessments etc).
What Causes the Headache Pain?
When a headache is caused from the neck and radiates to the front of the head, it is called a cervicogenic headache. Symptoms will often occur from the base of the skull (the occiput) and radiate behind or around the eye, around the top of the forehead or into the jaw.
Cervicogenic headaches generally occur on one side of the neck/head, and are often confused with migraines and tension headaches.
The ‘Trigeminal Nucleus’ is responsible for sensation to the face and jaw, and for moving the jaw. The spinal nerves of C1-C3 converge with the Trigeminal Nucleus. Increased load, tension, strain, trauma, whiplash and persistent spasm of the upper back, shoulders or neck can increase the sensitivity of the cervical joints and spinal nerves.
When the C1-C3 spinal nerves relay pain signals, they can blend into the Trigeminal Nucleus which causes the referred pain around or behind the eye, forehead and jaw.
Does Posture Matter?
We have all been taught from school age to sit up with ‘good posture’ - with our shoulders back, upper back erect, chest puffed out and neck straight!
However the best research is showing us posture does not correlate with pain, but moreso sustained positions and lack of movement drives pain flare ups.
So if you sit in front of the computer with ‘perfect posture’ compared to sitting with ‘slouched posture’, if you hold either long enough you will get sore in a certain part of the body eventually!
It Feels Tight, Can’t I Just Stretch it Out?
Stretching can help in the initial stages when you have tension to decrease pain. However stretching does not help in preventing flare ups. Stretching can be seen as a band aid solution or pain killer, but does not target the cause of flare ups.
How Important is Ergonomics for Neck Pain?
Ergonomics has an important role in neck pain. An ideal ergonomic set up can keep the body relaxed and avoid excess fatigue in postural muscles.
However ergonomics is not fully preventative with neck pain. Even if you have the best ergonomic equipment and set up, if you are in a sustained position for long enough you will be susceptible to experiencing pain.
The Importance of Strength Training
The best sports medicine articles repeatedly conclude with the same results: exercise to the upper back, shoulder and neck (mainly in the form of resistance training) is best for pain and reducing flare ups.
Resistance training to these regions is shown to reduce flare ups, reduce days missed of work, reduce the length and intensity of flare ups and improve worker wellbeing.
A Danish study enrolled 42 female office workers who all had a history of chronic neck, upper back and shoulder pain. The participants were randomly divided into three groups: specific strength training, general fitness training and a control group. The interventions were implemented over 10 weeks.
The specific strength training group exercised three times a week for approximately 20 minutes. They chose three exercises out of a library of five exercises (upright row, front raise, lateral raise, reverse fly, 1 arm row) and performed 3x8-12.
The general fitness training group performed upright cycling on a stationary bike. They cycled three times a week for 20 minutes.
The control group received individual and group counseling on ergonomics, diet, health, relaxation and stress management for a total of 1 hour per week. No physical training was prescribed to this group.
With the results, only the strength training group had significant improvements! The strength training group reduced pain levels by more than 50% and improved muscle strength.
These results have several implications.
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Strength training massively reduces neck and shoulder pain and can have a preventative effect.
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General fitness (running, cycling etc) does not give as much benefit to neck and shoulder pain as a resistance program tailored to this region
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Ergonomics are not as beneficial as strength training
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You don’t need to do that much, the exercises suggested are simple and can be performed very quickly! (Another study compared 10 minutes vs 20 minutes of upper back and neck strengthening, and found no differences between groups!)
Reference: Andersen, L. L., Andersen, J. L., Suetta, C., Kjær, M., Søgaard, K., & Sjøgaard, G. (2009). Effect of contrasting physical exercise interventions on rapid force capacity of chronically painful muscles. Journal of Applied Physiology, 107(5), 1413-1419. doi:10.1152/japplphysiol.00555.2009
What Can I Do?
Fortunately strength training does not have to be too complicated. Many of the research articles use simple exercises.
Try these exercises out 2-3 times a week for a good 2 months for a change in your symptoms!
Consistency is key, even if you can do 1 exercise more often it will be better than nothing!
Reverse Fly (Dumbells or Band):
Front Raise:
Lateral Raise:
Shrug:
If you suffer from neck, upper back, shoulder or headache pain, book in with one of our gun physiotherapists in Blackburn, Essendon or North Melbourne to solve your problem! If you enjoyed this blog please feel free to share it with your friends!
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!
You can make an appointment by calling or booking online.
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