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Neck retraction exercises are used to treat cervical radiculopathy, which occurs when a spinal nerve in the neck is irritated or compressed, causing pain and weakness. These exercises aim to stretch the neck muscles, improve flexibility, balance, and range of motion, and strengthen the deep neck flexor muscles. The chin tuck exercise, for example, involves pulling the chin straight back to create a double chin and holding this position for a few seconds. While neck retraction exercises are beneficial, they should be performed carefully as strong forces acting on the neck muscles can damage the discs.
| Characteristics | Values |
|---|---|
| Purpose | Treat cervical radiculopathy, restore cervical lordosis, reduce neck pain, improve flexibility, balance, and range of motion, strengthen deep neck flexor muscles, improve posture, and relax muscles |
| Exercises | Neck retraction, chin tuck, shoulder circles, isometric holds, cervical and shoulder retraction, isometric neck extension, quadruped neck retraction/extension |
| Muscle Groups | Deep neck flexors, cervical extensors, trapezius, splenii, SCM, middle trapezius, pectoralis minor, scapular retractors, multifidus, semispinalis cervicis |
| Precautions | Avoid tilting head back into hyperextension or excessive flexion, do not force movement, maintain neutral chin position, avoid sticking chin out past neutral, do not exaggerate forward motion, be careful not to damage discs |
| Frequency | Recommended frequency varies: hold poses for 20-30 seconds, up to four times a day; repeat chin tucks 20-25 times, twice daily; perform exercises several times a day |
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What You'll Learn
Neck retraction exercises help strengthen deep neck flexor muscles
Neck retraction exercises are an effective way to strengthen the deep neck flexor muscles. These exercises are designed to counteract chronic forward head posture, a common issue for those who work at desks, by improving slouched posture and bringing the head and upper back backwards.
The deep neck flexors, or prevertebral cervical muscles, are the equivalent of the core for the neck. They play a crucial role in stabilising the cervical column and the skull. Injury to the cervical region or extended periods at a desk can cause these muscles to become underactive, leading to issues such as cervicogenic headaches.
The neck retraction exercise, also known as the chin tuck exercise, is simple to perform. It involves pulling the chin straight backwards, attempting to make a double chin. It is important to keep the chin relatively neutral, only tucking it slightly downwards, and avoiding tilting the head back into hyperextension or excessive flexion. The position is held for two to three seconds, released slightly, and repeated 20 to 25 times, twice a day.
It is important to note that neck muscle strengthening exercises must be done carefully, as strong forces acting on the neck muscles can damage the discs. Isometric holds, where a specific neck position is held still, are a good option for those recovering from injury.
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Exercises to improve neck extension and range of motion
Neck extension and range-of-motion exercises are important for improving neck posture and flexibility, reducing pain, and preventing injury. Here are some exercises that can help:
Neck Retraction or Chin Tuck Exercise
This exercise targets the deep neck flexor muscles and helps improve neck posture. Start by sitting or standing with a neutral posture. Pull your chin straight back, attempting to create a double chin. Hold this position for about two to three seconds, then release slightly. Aim for 20-25 repetitions, twice a day. Ensure your chin remains neutral and avoid tilting your head back or down excessively.
Neck Flexion
Neck flexion is the action of moving your chin down towards your chest. This exercise helps improve range of motion and relieve tightness in the neck. Start by sitting or standing with good posture. Slowly lower your chin towards your chest, hold for 5-30 seconds, then return to the starting position. Aim for 2-4 repetitions. To deepen the stretch, place one hand behind your head, guiding the movement with your fingertips.
Shoulder Circles
Shoulder circles help relax the upper and lower neck muscles and improve postural awareness. Sit upright in a chair and slowly lift your shoulders up to your ears. Then, roll your shoulders backward, pinching your shoulder blades together as you do so.
Neck Rotation
This exercise helps improve overall neck mobility and range of motion. Sit upright and turn your head to one side as far as you can. Hold this position for a few seconds, then return to a neutral position. Repeat 10 times on each side.
Isometric Holds
Isometric holds are exercises based on resistance. They can be performed while standing or sitting. For the neck, hold your neck in a tilt for 30 seconds by pressing against it with your hand, then release.
It is important to note that these exercises should be performed with slow, controlled movements, maintaining correct alignment and posture. Avoid forcing any movements or exacerbating pain. Consult with a physician or physical therapist to determine the appropriate exercises and treatment plan for your specific needs.
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Isometric holds for shoulder and arm muscles
Isometric exercises are a great choice for building strength and endurance. They are exercises in which your muscles are engaged but do not change in length. For example, when you hold a plank, you are contracting the muscles in your core, legs, and upper body to hold yourself up while remaining in the same position.
Isometric holds are also used for cervical retraction exercises, which are commonly used to treat cervical radiculopathy. These exercises are meant to stretch the affected area to improve flexibility, balance, and range of motion.
Isometric holds for the shoulders and arms can be done in a few ways. One way is to lie on your left side with your legs straight and stacked, bend your left elbow, and place your forearm on the ground under your shoulder. Push your left forearm into the ground to lift your torso and hips off the ground, keeping your core tight. Lift your right arm straight into the air or keep it by your side. Hold this position for 10 seconds or more, and then switch sides.
Another isometric hold for the shoulders and arms is the wall sit. Stand about 2 feet away from a sturdy wall, lean your back against it, and bend your knees. Lower your bottom down so that your knee joints form a 90-degree angle, resembling a sitting position. Hold this position for 15 seconds or longer, keeping your hips and shoulders in contact with the wall.
Isometric shoulder external rotation is another exercise that can help strengthen your rotator cuff muscles. Stand perpendicular to a wall about 6 inches away, with the shoulder you are exercising closest to the wall. Bend your elbow 90 degrees, make a fist, and press the back of your hand into the wall as if rotating your arm outwards. Gently press into the wall for about 5 seconds, then slowly release the pressure. Do 10 to 15 repetitions, and then start the next rotator cuff isometric exercise.
Isometric holds are a good choice for rehabilitation as they target a specific spot. Ask your physical therapist if isometric holds for your shoulders and arms may help with your condition.
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The head/neck extension test for cervical extensor dysfunction
The Head/Neck Extension Test is used to assess cervical extensor muscle balance and identify cervical extensor dysfunction. It is performed with the patient lying prone, with their head and neck extended past the edge of the table and the cervico-thoracic junction stabilized. The patient is instructed to maintain a chin tuck position, with their chin tucked towards their neck, for 20 seconds. During this time, the pattern of muscle contraction as the head lifts is observed, and the Levator Scapula and Upper Trapezius muscles are palpated to ensure they remain relaxed.
A positive finding for weakness of the deep neck extensors is observed when the "chin length" increases with neck extension, indicating dominance of the superficial extensors of the neck. This can lead to hyper-extension of the upper cervical spine and excessive flexion and anterior shear of the lower cervical spine. Impairment of the deep neck extensors can result in functional restrictions, pain, and instability of the cervical spine.
To address cervical extensor dysfunction, corrective exercises are recommended to restore normal function to the stability muscles. These exercises typically begin with the head retracted and chin tucked position, ensuring the patient is familiar with this movement before progressing. One such exercise is the neck retraction or chin tuck exercise, where the chin is pulled straight back towards the neck, creating a double chin, and held for two to three seconds before releasing slightly. This movement can be practised throughout the day, even while performing everyday activities.
Another exercise to improve neck extension and range of motion is the cervical retraction neck exercise, which involves stretching the neck to the point of a tingling sensation or minor pain. This exercise is designed to improve flexibility, balance, and range of motion, helping to correct forward head posture. The National Academy of Sports Medicine recommends holding these stretches for 20 to 30 seconds, up to four times a day, in conjunction with other exercises like self-myofascial release.
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Deep neck extensors (DCE) provide stability and control for the neck
The deep neck extensors (DCE) are a group of muscles that provide stability and control for the neck. They are a part of the deepest layer of intrinsic back muscles, called the transversospinalis group. The DCE muscles include the semispinalis cervicis and the multifidus. The semispinalis cervicis acts as a cervical extender and maintains head posture, while the multifidus acts as a segmental stabilizer as the spine moves. It is believed that the unique design of the multifidus gives it extra strength.
The DCE muscles work in synergy with the deep neck flexors to provide posterior support for cervical lordosis and prevent a forward head position. The deep neck flexors are also known as the prevertebral cervical muscles and are considered the equivalent of the core for the neck. They play a crucial role in connecting and stabilizing the cervical column and the skull.
Maintaining the strength and endurance of the DCE muscles is essential for overall neck health. Impairment or dysfunction of these muscles can lead to key functional restrictions, pain, and an increased risk of injury. For example, neck pain can cause structural changes in the deep cervical extensors, such as a higher concentration of fat within the muscle, variable cross-sectional area, and higher proportions of type II fibres.
To assess and improve the strength of the DCE muscles, specific exercises such as the Head/Neck Extension Test and the Quadruped Neck Retraction/Extension exercise can be performed. Additionally, physical therapy, including isometric holds and cervical retraction neck exercises, can help manage pain, improve flexibility, balance, and range of motion in the neck. These exercises are often recommended for individuals experiencing cervical radiculopathy, which occurs when a spinal nerve in the neck becomes irritated or compressed, causing pain and weakness.
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Frequently asked questions
Cervical retraction is a neck exercise used to treat cervical radiculopathy. It involves stretching the neck to improve flexibility, balance, and range of motion.
Cervical retraction exercises target the deep neck flexor muscles. These muscles are also known as prevertebral cervical muscles and are important for the stabilization of the cervical spine.
To perform a cervical retraction exercise, sit upright in a chair and pull your chin straight back, attempting to make a double chin. Hold this position for 2-3 seconds, then release your neck back to the neutral position. Repeat this motion 20-25 times, twice a day.
Cervical retraction exercises can help manage pain, improve the range of motion in the neck, and strengthen the muscles. They are particularly useful for treating forward head posture, a common issue for people who work at desks.
