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Shoulder Pain & Neck Posture Link (Key Rehab Exercise!)

Video Highlights

-- About Autonomic Nervous System
-- Sympathetic & Parasympathetic Nervous System
-- Goldilocks Position

Hi, I’m Dr Eric Cobb of Z-Health Performance and today we’re going to talk about forward neck posture and its impact on the upper extremity and the autonomic nervous system. Now that’s a mouthful. But if you are new to Z-Health we are brain-based education company which means we talk a lot about movement in its relationship to the brain and the nervous system. We work primarily with world-class doctors, coaches, and therapists so if you enjoy this subscribe and check out our free information. 
Alright let’s get into this! Forward head posture is a big topic and has been a big topic for many, many, many, years in the musculoskeletal community. What is it? Basically the chin is thrust forward of the center axis of the body and the question has always been, well I won’t say question, the assumption was always made that forward head posture would automatically translate into neck pain and shoulder dysfunction. Well the research on that is very very mixed. We actually can’t really prove at this point that posture and pain go hand in hand but what we can do is we can look a little bit more deeply into the literature. I’ve already talked about the impact of forward head posture on breathing and we gave you a couple of exercises for us to try out with that to see how your own head and neck posture was impacting your ability to breathe well.  
Today I want to talk about the autonomic nervous system. So whenever we talk about the nervous system, you’ll often hear people talk about sympathetic nervous system (which is your fight flight or freeze) and the parasympathetic (which is considered the rest and digest). So a study was done not too long ago and it’s quite interesting because what they did they did surface testing of nervous system activity. In other words, we can see with certain machines that the sympathetic nervous system or parasympathetic nervous system is becoming more or less active. Normally we’re looking at sympathetic tone in the skin so what they did is they took a group of people who had fairly normal head and neck posture and they took another group that had forward head posture and then they evaluated the amount of sympathetic nerve activity they found in their upper extremities. What they found was that people with the forward head posture showed increased levels of sympathetic activity in the upper extremity. What does that mean? It basically means that this posture may be related to to over activity or hyper active responses in the upper extremity to stimuli, so ultimately that means that we may be more prone to not only pain issues but more of specifically movement issues as well as some changes or ability to feel things like temperature issues. So it appears right now based on this most recent research that while we can’t draw a direct correlation between forward head posture and upper extremity pain. We can see that forward head posture is negatively potentially impacting on sympathetic tone in the body which basically puts you into a more protective mode. So what I like to do is get people to explore how neck and spinal posture influences shoulder movement. 

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If you think about our shoulders, we often are reaching up over our head during the day. This is considered shoulder flexion. If you watch most people when they go into full shoulder flexion, they will extend the lumbar spine extend the thoracic spine in order to get the arm higher so in order to create an illusion of more flexion. So what I like to have people do is to learn by experience. So what I want you to do is stand up relax your arms,  relax your shoulders, bend your knees a little bit and I want you to in your normal posture. Raise your arms, both arms up at the same time as high as you comfortably can. Just see what level of flexion you have. Notice what kind of tension you have at the top and then see as long as it’s comfortable if you can go any further. Now the next thing that I want you to do is, I want you to take your pelvis bend your knees and then tilt your pelvis forward. Alright, so we’re going to go into what’s called an anterior tilt. So you’re going to tilt it forward, this is the normal thing that most people do when they reach above their head, so I want you to tilt and then reach up and again. See? Alright how does that feel? Can I go any further? Now what I want you to do is, bend the knees, curl your tailbone under a little bit, alright so again curl the tailbone so I’m now tucking my pelvis as a posterior tilt once I’ve done that I’m going to breathe out, and try to pull my ribs down a little bit toward my pelvis. Now, without doing anything to your neck, I want you to just leave your neck how you would normally hold it. Try the shoulder flexion again. Most people will find I’m a little bit restricted here. Now we’re going to add the neck in so I want you to do curl the pelvis, bring the ribs down, take the arms up. Now I want you to drive your head forward even further and notice how much tension that creates and now I want you to slowly begin to pull your head back into a more neutral position. Tuck your chin a little bit and see what happens to your shoulder range of motion. Finally, I want you to then pull the neck even further back and you’ll probably start to feel tension building up again and it will become uncomfortable so I like to call this the Goldilocks position. If you’ve ever familiar with the Goldilocks story, we’re looking for the head position that for you is the perfect kind of Middle Ground that is comfortable. A lot of people when they’re beginning to work on postural correction for their head and neck, they vastly overdo it and they create so much tension that everything else in their body becomes restricted. So we typically have people do this in the beginning of our sessions with them and then over time what they will often find is that if initially this level of retraction allowed them the most shoulder flexion as their spinal motion and control improves, that may move even further back and further back until they are in a more neutral position. We like to talk to people about coaxing better movement from the brain rather than forcing better movement onto the brain. So if you approach this from that perspective I think it’s a really valuable exercise check it, you know test this every few weeks as you’re working on some of the other things that you’re doing to improve that forward head posture. I think you’ll find this a super useful way to understand where you can find your most optimal position.

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