Neck & Shoulder Pain: Through the Lens of Running
Strategies to decrease neck and shoulder aches and pain during and after a run.
Tight neck and shoulders while running. Thank you @andrewtanlao and unsplash.
Neck and shoulder pain is more common than you think in runners.
Runners get injured at an alarming rate but often we think of knees, and feet as the painful areas post run. However, neck and shoulders are another common presentation and can be just as frustrating to combat. As a disclaimer: the following information is presented to be a tool for you to help notice and be aware of your body, how it moves and how you can work to move better; not to diagnose or self-treat. Understanding and identifying the specific origin of your pain is best left to a health care professional, specifically one who is versed in treating athletes.
Most neck pain, without a precipitating trauma, is due to poor posture.
Regardless of the hours and miles you might be logging if you are experiencing neck pain during or after a run we have to visit your normal posture. By this I mean, how you sit, stand or the position you spend most of your day in. The shear volume of hours you spend at your desk most likely out weight the amount of time you spend on the road and or at the gym and thus those habits translate and directly influence your ability to run. Most commonly the office/desk worker presents with a forward head carriage or with upper crossed syndrome. This means you spend most of your time with you head and neck jutted forward, and your shoulders and mid back rounded to the anterior. Shortened and tightened muscles result in the front of your body, your anterior neck muscles and pectoralis major while long and weak muscles such as the rhomboids and lower trapezius occur on the front of your body. There is nothing strong or efficient about this posture. Over time it creates excess strain and demands on your posterior neck muscles as they work hard to hold your head upright, since you are no longer using your vertebrae to structurally aid you in this task. Your breathing most likely becomes shallow and the movement dominated by your accessory breathing muscles such as your scalenes and sternocleidomastoid.
Please feel free to visit a previous blog I wrote on sitting & posture for more details.
Combat your poor posture by building mindful awareness
In order to start putting yourself in a better position throughout your day and get moving more, you must first notice just how you spend your day. Ask yourself these questions and always make sure to assess your position when you notice yourself in pain.
Does your chin jut forward or stick out?
Do your ears sit over shoulders from a side view?
Are your shoulders or mid back rounded forward or feel collapsed?
Are you shoulders slightly elevated up towards your ears?
Are you looking up or down? With your whole head or just your eyes?
If you turn to the left or right do you feel limited in motion? If you take a second to the sit up tall and turn to the side do you notice a far greater range of motion?
Are you breathing from your chest or your belly?
You could have answered yes to one or many of the above questions. Meaning you can just have a chin that juts forward or shoulders that droop.
Chin tucks & retraining your nervous system
Patterns and habits built over years form most of the ways we move through space. Changing these positions takes continued effort, dedication and patience.
Chin Tuck | Perform 8-10 repetitions once an hour throughout your day.
While sitting up tall draw your chin backwards or laterally translate your head so your ears sit over your shoulders. Keep your eyes level with the horizon. Try to keep muscles relaxed through this motion (especially those front neck muscles). Once your reach your end range return to resting position before your repeat the motion.
This might feel uncomfortable since you are working and waking up deep neck flexors that have most likely been asleep for some time. Keep this routine up daily for 2 weeks and you will more often than not start noticing that this movement becomes less conscious and actually resembling a new normal head position.
Another Tip
Think about and be aware of where your head is in space when reading or looking at a computer screen or your phone. Often times we let our whole head droop forward during these activities.
Instead try a slight nod to glance downward at a desk in front of you drawing your chin back towards your spine and nodding about 30 degrees.
Try to holding your phone up in front of you at eye level rather than down and in front.
Other strategies to try
Roll It Out | Wake Up The Nervous System and Combat Trigger Points
Myofascial trigger points are those tender sore spots or bands that can be found in your muscle, ligaments and fascia. When you hold and compress them ischemic pressure they will often dissipate and work themselves out with repetitive rolling or trigger point manual therapy from a chiropractor, physical therapist or massage therapist.
Foam Roller For Your Thoracic Spine: While lying down, supine, or on your back place a foam roller perpendicular to your spine with your knees bent and feet anchored into the floor. Slowly roll up and down your mid back with your hands pressing into the ground at your side for greater stability or folded across your chest for a greater challenge. Scan the area slowly stopping to hold in areas that are tender while you focus on taking a few deep breaths to help the discomfort dissipate.
Lacrosse/Tennis Ball to your Pectoralis Major (chest muscle): While standing in a doorway with one side of your chest and shoulder in front of the wall to the side of the door opening place a ball on your pectoralis muscles. Slowly scan the area, stopping and performing a micro massage on any trigger points to work them out.
Stretch It Out | Loosen Up your Neck and Shoulders
Before you start your run get your neck and shoulder moving to increase blood flow to those areas and spend a moment for your central nervous system to check in on those muscles and what position in space they are holding.
Cervical Range of Motion: Standing in a comfortable position, drop your chin to your chest and hold for a few seconds then roll your neck to the left, then right before returning to neutral. Then look up and hold again for a few seconds.
Shoulder Shrugs & Circles: Relax and return your head to a neutral spinal position before shrugging your shoulders as high as you can to your ears with a sharp inhale, as you exhale let them drop dramatically and relax. Repeat this shoulder shrug with an accompanied breath a few times before doing some arm circles both in front of you and to the side.
In conclusion
Pain is always something to listen to. It is your bodies way of telling you something is wrong and not working properly. Always use this as a tool to self-reflect and start questioning the patterns and movements that led up to the onset of this pain. Sometimes it will be obvious, a slip and fall, but others it will be insidious and hard to put your finger on. Posture tends to be a gradual change in all of us and neck pain can be challenging to combat. Being consistent with your warm up and stretches before you run as well as rolling out and checking in on your body at the end of a long day or a run are invaluable tools that will help you maintain awareness of how your body is doing.