Living with Neck Pain - Unlocking the Importance of the 1st and 2nd Ribs.
The holidays are upon us! For so many of us this can mean increased stress levels... for a multitude of reasons. A commonality that I see with a lot of my patients is the tendency to ‘carry our stress’ in our shoulders because we are GO GO GO.
What does that truly mean, to ‘carry our stress’ in our shoulders’? It’s more than just muscle tension. It’s often a combination of a forward head position, elevated shoulders, and elevated 1st and 2nd ribs, which cause those upper back and neck muscles to work overtime and develop significant tightness and, subsequently, neck pain.
Many people are surprised to learn that the 1st and 2nd ribs can affect the neck and shoulders. Those 1st and 2nd ribs that are elevated, how did that happen? Over time, they can get pulled upward by overactivity in the scalene muscles (muscles located on the front of our neck) brought on by a forward head posture. Add into that equation a byproduct of being busy- we don’t take enough deep diaphragmatic breaths and incorrectly use these “extra” breathing muscles as our main breathing muscles. This phenomenon creates significant tightness in those neck muscles.
Unfortunately, I can include myself in this patient population as I am a textbook candidate for neck and shoulder issues. I’m tall and would stubbornly not listen to my mother when she told me to stand up straight as a child (I’m sorry mom), I have been in two car accidents that left me with major whiplash injuries, and I work as a PT -everything we do is in front of us, like most professions.
I can commiserate with what my patients are going through because oftentimes I’m dealing with it too. Some days when I’ve been spending too much time on the computer or my phone, dizziness can start to creep in too (cervicogenic dizziness). I know that I need to stop what I'm doing, break up those prolonged positions, and lie down on my foam roll to stretch my chest (pecs) and do some deep belly (diaphragmatic) breathing... and get myself scheduled with my PT.
Here are some of the things that I prioritize with my patients in the treatment of neck and shoulder issues, and things that I follow for my own care as well:
“The best posture is your next posture.” --a phrase coined by Peter Opsvik. This is a commonly used phrase to educate our patients on the importance of avoiding prolonged positions whether it’s sitting or standing with good posture. Of course you should avoid using bad posture, that’s just a given! Your goal is to sit or stand with good posture (a neutral spine) and to change your position as frequently as you realistically can. This is not the easiest thing in the world, so do the best you can.
Minimize time spent looking downward whether it’s reading, phone screen time, or computer screen time. Our neck doesn’t like to be supporting our heavy head in extreme positions for more than a few minutes. So this includes looking downwards, turning to the right or left, looking upward, or sitting with a forward head. Looking at your computer ergonomics can help with achieving a more neutral spine alignment by giving you a better work station set up. And to go back to that quote above, alternating between a sitting and standing desk can be very beneficial if you need to work at your computer all day long.
Strengthen the deep cervical flexors and scapular stabilizers and stretch the pecs. Addressing where someone is weak and has limited flexibility is instrumental in getting to the heart of neck and shoulder pain. When we have a forward head and rounded shoulders day in and day out, it feeds into a body position that shuts those important muscles off. Therapy focuses on education about how to use those muscles, issuing exercises that strengthen those weak muscles, and then the ever challenging task of using better mechanics to use those muscles in everyday life. This last part is often the hardest part for people because we have to be more mindful about how we move and do things. When we are more mindful, amazing things can happen.
Furthermore, getting treated by a Physical Therapist truly helps me. I don’t know what I would do without physical therapy. When I see my co-worker, Kristin, she is able to use manual techniques that help lessen my rib elevation and I leave the appointment with better neck range of motion and minimal pain. I treat Kaite, who just completed her second Ironman Triathlon. Don’t worry, she gave me permission to discuss her case:). She is a great example of someone who spends several hours at a time on her bike during her training, or in front of her computer for work, and that’s just her reality. It’s hard to get around some of those prolonged positions. She often comes to me with significantly limited neck range of motion and is in pain. After some mobilization to her upper ribs, (we shorten it to “rib mobes”) she will be able to turn her head with minimal pain and improved motion. Those darn 1st and 2nd ribs...who knew?!?!
So please do yourself a favor this holiday season. Put yourself first and make your health a priority. Call us at (262)236-0176 if you’d like to set up an appointment. Thanks for reading!
