The Neck - lower rear

The Neck 

I wanted to write about the muscles of the neck this month and the common complaints that I see in the clinic. I will break down the neck into four parts 

1.   The upper rear neck, base of skull to C2 

2.   The lower rear neck C3-C7 

3.   The front 

4.   The sides 

The lower rear neck 

The main problems that you will notice are; deep pain at base of skull leading towards the eye, headaches, stiffness, poor range of motion, blurred vision, can lead to bony spurs, mimics migraine patterns, trapped nerve pain (occiput neuralgia) and vertigo. Knots and tightness to the surrounding areas.

The main muscles are 

• Splenius capitis/cervicis muscles, these help with extension of the head, rotation, lateral flexion and help coordinate the head position during movements.

  • Splenius capitis originates on the spinous processes of C7-T3 and the nuchal ligament and inserts at the base of the occiput, and the mastoid process of the temporal bone.

  • The splenius cervicis arises from the spinous processes of vertebrae T3-T6 and inserts onto the transverse processes of vertebrae C1-C3.

• Cervical Transversospinalis (which has three muscles- semispinalis capitis/cervicis and multifidus) these muscles help with extension, rotation, flexion and act as spine stabilisers, proprioceptors and posture control. 

  • Multifidus are short muscles that attach across 2-5 vertebrae above their origins these are the muscles in the groove between the spinous and transverse processes of vertebrae.

  • Semispinalis capitis arises from the articular processes of C4-C7 and transverse processes of T1-T6 travels up and inserts at the base of the occiput.

  • The Semispinalis cervicis are from the transverse processes of T1-T6  and travels to the spinous processes of vertebrae C2-C5.

These muscles are deep and prone to weakness and atrophy from trauma or prolonged poor posture fatty tissue replaces atrophied muscles this decreases the curve in the neck and increases stiffness. Spasms occurs when these highly dense muscle spindles attempt to guard against underlying instability. When these deep stabiliser muscles fail it creates a feeling of heavy head and can develop abnormal joint movements. If left and not treated long term issues such as spurs and osteoarthritis may occur. Whiplash, direct trauma and poor prolonged posture are the main problems we see in the clinic.

What can we do to help these muscles?

Myofascial release to the neck and upper back will help release the tension, chiropractic adjustments, acupuncture to relieve the pain. Massage to the neck and upper body to relieve tension and stress.

What you can do at home?

To help you can apply heat to the region, perform gentle chin tucks to aid in the forward head posture and light stretching.

A gentle stretch that can be performed between 5-10 repetitions and up to twice a week. While sitting with your right hand place on the right temple, give very light resistance while turning your head back towards the spine (think turning head to the right). Perform this on both sides.

Craniocervical Flexion Exercise (CFE) Lie on your back with knees bent and feet flat. Maintain a neutral spine, gently nod your head, tucking your chin toward your neck without lifting your head off the floor. Hold the position for 10 seconds, breathing comfortably and repeat 10 times try for 3 sets.

Chin Tucks, this is the foundation for strengthening deep neck muscles and correcting forward head posture - Sit or stand upright. Draw your chin straight back as if creating a "double chin." Hold for 5–10 seconds. Repeat 10-20 times.