I. What is the “deep posterior cervical muscle group”?
The so-called deep posterior cervical muscle group refers to the muscle group located in the posterior part of the coronal plane of the cervical spine, which is deeper (close to the cervical spine) in relation to the superficial muscles and smaller in size than the superficial muscles – mainly including (from superficial to deep)
cephalic semispinalis, cervical semispinalis
cervical multifidus
cervical gyrus
Cervical interspinous muscles
(i) Relative to the superficial muscle groups
Although these muscles have the function of dorsiflexion, lateral flexion or rotation of the spine; their significance is more focused on the stabilizing function of the spine compared to the large muscle groups of the superficial or middle or body layers – such as: trapezius, sternocleidomastoid, cephalicus, cervicalis, etc.
(ii) Relative to other deep muscle groups
Relative to the longest muscle, which is also a deep muscle, the function of the above-mentioned muscles is mainly in the regulation of fine movements. In contrast, relative to the deep posterior occipital muscle groups (posterior major rectus, posterior minor rectus, superior oblique, and inferior oblique), the differences are mainly reflected in the regulation of head and neck movements.
(C) Why do you need to exercise the deep posterior neck muscle groups
Due to reduced exercise, sedentary, long time low head/computer work and other reasons, modern people generally formed a “round shoulders, hunchback, head leading forward” bad posture. In this posture, the posterior occipital muscles are shortened for a long time (shortening lock), while the posterior cervical muscles are elongated for a long time (lengthening lock) – both conditions cause muscle strain, but the damage to the posterior cervical muscles in lengthening lock is more obvious.
Degeneration of the deep posterior cervical muscles – When evaluating patients, we find that many cervical spine patients are unable to quickly differentiate between “head back” and “neck back” movements In some cases, they are unable to make the “cervical extension” movement at all – with the consequent reduction in cervical spine stability.
Many patients with cervical spondylosis complain of neck and shoulder pain, dizziness, tinnitus or finger paralysis after prolonged head-down/computer work; most of these symptoms can be partially relieved after bed rest. Even though appropriate manipulative treatment has a good therapeutic effect on this type of cervical spondylosis, the symptoms appear one after another just after the patient leaves the hospital and returns to the living environment. This is the fault of the degeneration of the function of the deep muscle groups at the back of the neck and the decrease in the stability of the cervical spine!
Therefore, for this type of cervical spondylosis patients, manipulation treatment can only achieve short-term results. If you want to get a better long-term effect, the stability training of the deep muscle groups at the back of the neck is essential.
Example of posterior cervical deep muscle stability training
As the name implies, this is a strengthening exercise for the deep posterior cervical muscles. We recommend that, in general, the spastic superficial and middle muscle groups be loosened through manipulation and the misaligned joints be corrected before this type of muscle strengthening training is performed. This is because it is difficult to truly relax the superficial muscles when the muscle spasm, misaligned joints or pain symptoms have not been relieved, and reluctant force is likely to cause more secondary injuries.
Here let me share some safe and effective methods of stability training for the deep muscle groups in the back of the neck. I hope it can inspire or help you.
Note: The following introduction is for theoretical purposes only, for specific operation specifications, please information related professionals! If you are not a professional doctor, therapist or trainer, please do not imitate blindly!
(A) Prone position “neck and shoulder separation” training
Description.
In daily life, the large superficial muscles of the neck and shoulder often work simultaneously. Muscles such as the upper trapezius can be involved in both neck and shoulder activities – the brain is also happy to command these “obedient” muscles, making them work too much, causing chronic strain; while the deeper The “disobedient” small muscle groups are always in a “dormant” state, not used and become weak. Over time, it will form an unhealthy movement pattern.
It is generally believed that muscles that span more than 2 joints do not work well to complete the activities of 2 joints at the same time. For example, the rectus femoris muscle does not do a good job of flexing the hip while contracting to complete the extension of the knee – and the more fully the knee is extended, the weaker the ability to flex the hip. (This principle can be widely used in muscle function testing, identification, stretching and training.)
The so-called “neck and shoulder separation” training means that in the pre-fixed shoulder (external rotation, horizontal abduction unilateral upper arm) action, so that the upper trapezius muscle group of the neck and shoulder in a contracted state (for the control of the shoulder / scapula, but not for the control of the neck), and then trigger the neck (posterior extension) action; so that the neck deep small muscle groups to be activated and exercise .
1.Basic
Patients take prone position, head and neck outside the bed; available abdominal or transverse breathing method.
Naturally close the lower jaw, so that the lower jaw is close to the neck.
Externally rotate and horizontally abduct the unilateral upper arm as shown, bend the elbow and make a fist.
The neck is extended posteriorly so that the “posterior occipital region – neck – back” is in a straight line.
The physician places his hand lightly on the patient’s posterior occipital area and hands; and makes the patient exhale with his head, neck and hands confronting them simultaneously, keeping “head, neck and back” in a straight line.
Depending on the patient’s physical quality, after 15-30 seconds of confrontation, repeat the same action on the opposite side;
Complete bilateral movements as a group, rest 30~60 seconds between groups, can repeat 3~5 groups.
Key points.
1, let the patient keep breathing, can not hold the breath against;
2, detect and remind the patient to confront with the posterior neck extension action, rather than head back.
2.Raising Form A
On the basis of the basic posture, have the patient slowly rotate the head and neck to the left about 60° while holding the confrontation by exhalation;
Inhale and then exhale while rotating the head and neck to the right to return to the middle position;
Repeat the movement on the right side.
Complete the left and right movements as a group, rest 60 seconds between groups; repeat 3~5 groups depending on the patient’s physical quality.
3.Raise Form B
On the basis of Basic or Raise A, have the patient slowly open the palm of the right hand while exhaling to maintain confrontation;
Inhale and then slowly re-clasp the right palm;
Repeat the movement on the right side;
Complete 3 times of spreading and fist clenching action as a group; rest 1~2 minutes between groups; repeat 3~5 groups on each side depending on the patient’s physical quality.
(B) Sitting “neck and shoulder separation” training
1.Basic
The patient sits on a stable stool; slightly tuck in the abdomen and buttocks, stabilize the trunk (core), and maintain abdominal pressure.
The feet are parallel to each other, with the hips, supporting the torso.
Maintain a slightly tucked jaw, draw the head back, and extend the spine.
(Right upper extremity for example) Externally rotate and horizontally abduct the unilateral upper arm, bend the elbow and make a fist.
The physician stands parallel behind the patient, places both hands behind the patient’s occiput and right fist, and slowly and evenly applies appropriate thrusts forward;
The patient is asked to use abdominal breathing or transverse breathing, and during exhalation, abdominal pressure is maintained, and the head and hands are simultaneously opposed to the doctor’s thrusts so that the body is not displaced.
Complete 3 breathing movements as a group; rest 1~2 minutes between groups; repeat 3~5 groups depending on the patient’s physical quality.
Points to remember.
1, let the patient keep breathing, not holding the breath against;
2. Pay attention to monitoring and reminding the patient to relax the shoulders during the confrontation, do not shrug the shoulders or use torso rotation or leaning backward to counter the thrust of the doctor’s hands.
3. Pay attention to monitor and remind the patient not to show head tilting action.
2.Raise A
On the basis of the “basic posture”, let the patient slowly rotate the head and neck to the left about 60° while exhaling to maintain confrontation;
Inhale and then exhale while rotating the head and neck to the right to return to the middle position;
Repeat the movement on the right side.
Complete the left and right rotation action as a group; rest 60 seconds between groups; repeat 3~5 groups depending on the patient’s physical quality.
3.Improve the B
On the basis of the “basic pose”, let the patient slowly open the palm of the right hand while exhaling to maintain confrontation;
Inhale and then slowly re-clasp the right palm;
Repeat the movement on the right side
Complete 3 sets of spreading and clenching action; rest for 1~2 minutes between sets; repeat 3~5 sets on each side depending on the patient’s physical quality.
4.Raise C
Patients sit flat on the yoga ball (or lift one foot off the ground) and perform the above “basic” or “raised” training movements.
Note: When choosing the size of the yoga ball, the patient should sit on the ball with the thighs parallel to the ground and the feet touching the ground smoothly.
(C) Standing spinal roll training
The patient’s back against the wall, take a standing position (good flexibility to take a neutral position, poorer feet can be slightly away from the wall, but also to keep the trunk above the pelvis neutral);
Have the patient use abdominal or transverse breathing with slight tightening of the abdomen to maintain abdominal pressure;
The physician supervises and assists the patient in tightening the abdomen and jaw during exhalation, starting with the upper cervical vertebrae and moving one vertebral segment at a time forward away from the wall, curling forward and downward (may be cued: like a pearl necklace); until all lumbar vertebrae are off the wall.
Have the patient inhale again, and on exhale, starting with the 5th lumbar vertebra, press the wall backward, one vertebra at a time, and roll back upward (cue: like paving asphalt); until all cervical vertebrae are pressed against the wall and return to the starting posture.
Complete 1 back and forth rolling action for a group; rest 30 ~ 60 seconds between groups; depending on the physical quality of the patient, repeat 3 ~ 5 groups.
Key points.
When the patient is found to be unable to move section by section in some segments of the rolling movement (cross-sectional or piecewise movement), the physician should point this out, return to the previous movement phase, and instruct and assist him/her to complete the section-by-section rolling movement.