Sneezing and neck pain

If you suffer from neck pain when you sneeze or cough there is a simple way to remedy this. One of the major causes of neck pain when you sneeze is holding your neck in a flexed or forward position at the time of sneezing; in other words, having your head looking downwards toward the ground. This can put enormous stresses on your discs and ligaments and create pain. If your head is protracted as well (head forward position) you are stressing them even further. Add to that the enormous forces generated when you sneeze (a sneeze comes out of your mouth at 100 miles per hour) and it’s no wonder your neck hurts!

A great way to keep this from happening is to keep your head in a more neutral position this means, neither forwards or looking down so that the pressure is much less on your neck structures. Keep your head ever so slightly retracted (see the double chin exercise) and you can even have your head looking slightly upwards. This will help enormously. Just make sure to cover your mouth!

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Unless this is the first ever blog post of mine that you are reading you should be well aware that good posture both in standing and sitting is essential for neck and shoulder health.

If you are slouching your thoracic spine is hunched forwards, your neck is in a protracted position (head forward position) and then this leads to muscle imbalances and pain. In short, your chest muscles become too tight as do your frontal neck muscles and the opposing muscles become too long and weak. This leads to your shoulder blades rounding around your rib cage getting further away from each other at the spine. If you can imagine that the distance between your two shoulder blades should be about three inches apart from each other, well they literally drift apart making that space further as you keep hunching forwards at your computers, steering wheels, eating your breakfast etc.

What’s the problem with having my shoulder blades drifting apart?

So now you have your shoulder blades getting further away from each other which means the muscles that should hold them in their place are getting lengthened and weaker and the muscles in front of your chest are getting shorter and tighter (the opposing muscles). This is where things get messy for your shoulders. For a moment let’s forget about the problems slouching does to your muscles, ligaments and discs in your lower back and necks and let’s just keep focused on your shoulders themselves. If your back is now rounded making your chest too tight this also pulls your shoulder inwards. They are now rotated too far inwards(internally)! Now you are looking at a head on collision with your humerous (arm bone) mashing your rotator cuff tendons.

A quick test to see if your shoulders are rotated inwards

A very easy way to check is to stand with your arms at your sides. Now look down at your thumbs. Do they point forwards or point inwards at each other? They should be pointing towards the front. If they are pointing more towards each other, or worse, you are looking at the backs of your hands when standing there and your thumbs point sideways towards your midline, your shoulders are too tight and rotated inwards.

What to do to help your internally rotated shoulders

So now you know that your shoulders are inwardly(internally) rotated which means your chest muscles are too tight which means that your shoulder blades will more than likely have been pulled too far apart which means problems for your shoulders! At least 90% of shoulder problems will have problems with the shoulder blades, they are vital for good shoulder mechanics. So to help this problem we need to stretch the tight muscles and strengthen the weakened ones to get good balance again.

You need to start stretching out your chest muscles, both pectoralis major and minor and strengthening your middle back and shoulder external rotators. It makes sense really doesn’t it? Your shoulders are too far internally rotated which means that the internal rotators are too tight and shortened leaving your external rotators too long and weakened.

Therefore, stretch your pec. muscles and do the ‘I’ve got no money’ exercise.

The ‘I’ve got no money’ exercise

Here is a great exercise to strengthen the middle back and external rotators of the shoulder to get those shoulders working better again.

Stand upright with your arms by your sides and now bend your elbows with your palms face up as if you were about to carry a large tray. Have the insides of your elbows locked against your ribs. Stand tall and retract and depress your shoulder blades. In other words, before you start the exercise you want to contact your shoulder blades ‘down and back’. A nice way to think of this is imagine that you have a pencil between your shoulder blades that you want to keep in place with your shoulder blades. Make sure you are not shrugging your shoulder blades though! The motion is ‘down and back’ not ‘lifting up and back’. Now that you have put your shoulder blades in good position you start by rotating your hands away from each other to the sides but keep your elbows on your ribcage! Then return to where your palms are back in front of you again as if you are holding a tray.

Do this 6-8 times 3-4 times a day. Remember that once you have stretched your chest muscles and done this exercise you should then attempt to sit and stand in good posture throughout your day in everything that you do. Three minutes of exercises a day will do little to help you if you spend 10 hours a day of slouching at the computer!

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As a general rule whether you sleep on your side or your back you want to make sure that your neck is not getting pushed forwards, backwards or sideways. It should be fairly level. If you are sleeping on your back you definitely do not want too many pillows that push your head into a forward position like we have seen in poor sitting postures. This is very common and is a common reason why people wake up with neck pain. I have talked at great length in many of my other articles about the importance of keeping your posture with your head on top of your shoulders, not out in front of them. You need to imagine that your head and shoulders should be like a golf ball sitting on a tee. Then your head sits on top of your spine which reduces the stress and strain on your neck muscles and ligaments enormously. The same goes for sleeping; just because you are now horizontal it does not mean that you can now have your head pushed forward again.
If you sleep on your back you want a pillow that keeps your head in a reasonably level position with your body. You don’t want your head sinking backwards into the pillow nor do you want it pushed forwards.

Lying on your side to sleep
if you lay on your side to sleep you doesn’t want your head sinking too far into the pillow nor getting pushed up. If you are lying on your side you want the feeling that your head is pretty much in a neutral position as opposed to being bent to the left or right. Imagine if you were told to stand or sit with your head to one side for 8 hours, by the end of the day it would feel very sore wouldn’t it. This is what is happening if your head is kept in poor position all night from a bad pillow or wrong pillow.

Is it OK to sleep on your stomach?

When it comes to the question of whether you should sleep on your stomachs I want you to do this little experiment. Do it carefully though. I want you to turn your head to one side as far as you can and now tilt it backward a little. Now imagine if I pushed your head a little further around and a little further backwards and you had to keep that position for an hour or so and then we would do the same on the other side and continue this for eight or so hours. This is the position you have when you are on your stomachs with the pressure of the mattress or pillows pushing your head further. Your head is fully rotated and pushed backwards. If it’s not comfortable to do standing up it’s definitely not going to be comfortable for your neck lying down either. Furthermore, your discs swell up overnight as they fill with fluid which puts even more intra discal pressure on the spine and its surrounding ligaments adding even more stress. Therefore, make sure that you have a good pillow and I have written which pillows are good for your necks in a previous article. As far as sleeping on your stomachs goes, this is most definitely not healthy for your necks!

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As more and more people drive cars these days we also inevitably are seeing an increase in car accidents. Whiplash is a common injury and females are 2 times more at risk than males and they are also more likely to develop long term symptoms. It is not well known why this is the case but it is thought that males have stronger neck muscles than females which may help and also because women tend to sit slightly more forward in their seat. When sitting further forward the head travels further before it hits the headrest. Another interesting fact is that drivers tend to have more serious neck injuries than the passengers. This is thought to be because the passengers tend to sit back in more of a reclined position with their heads against the headrests.

Now I have mentioned the head rests a couple or times in regards to whiplash injury but lets take a closer look at these things that we tend to think of as luxury items. I guess it’s because of their names which make us think of them as nothing more than something to rest our heads against. However, they are so much more than that.

How to decrease your risk of whiplash by 40%

When a rear collision occurs the head is thrust backward and into extension of forces up to 12G. A head rest or better termed, head restraint is designed to reduce that rearward motion of the head greatly decreasing your chances of a whiplash injury. With rear end collisions being so common it’s perhaps one of the most important safety features you have in your car.

It should be at head height that means your center of your head should meet the center of the head restraint. You should check yours the next time you decide to go for a drive and spend the time to position it correctly. It’s too late after a crash occurs. A head restraint that is too low allows the head to propel back and OVER it. You also don’t want your head too far forward. It should be no more than 4 finger widths from the head restraint. If you can’t do this comfortably you may want to invest in a car head support for better protection against neck injuries. Research has shown you will decrease your chance of neck injury by 40% with a correctly positioned headrest.

The National Highway Traffic Safety Administration (NHTSA) told automakers the head restraints in their passenger vehicles will have to extend higher and fit closer to the backs of people’s heads. For the first time, the new standard addresses the back set. Head restraints will have to be within about 2 inches behind the head.

Also, if you know your going to get hit try to decrease your risk of injury.  If you have your head or body turned during a collision it can greatly increase your chances of a significant injury. Keep your eyes on the road and your head straight. If you know you’re going to get hit, then reduce the distance between your head and the head restraint   by moving your head back. The car neck pillow reduces the headrest distance and increases your level of safety.

What to do if you know a car is going to hit you from behind

Crashes involving whiplash neck injuries happen at lightning-fast speeds, but if you have time to prepare: Put your head and your neck all the way back so that you’re in contact with the seat back and the properly adjusted head restraint. Straight-arm the steering wheel and get a good grip. If you are stopped, put your foot on the brake as hard as you can. Look straight ahead, not in the rearview mirror – don’t have your head turned at all. Put your neck back slightly so your eyes are looking level up at about the top of the windshield. Scrunch your shoulders up toward your ears and then brace.

I hope you never have to be involved in a car collision but at the very least I hope this will help you if something does happen. Happy motoring!

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Here is another one of those myths that I hear all of the time. People telling me that they are stiff because it’s an unavoidable part of aging. When I ask them how often they stretch the answer is generally never. Or some people tell me that they stretch every day. When I ask these same people to show me their routine its generally something like this: they pull their arm across their chest for two seconds, bend their head to each side for a second, rotate the spine a couple of times in a fast jerky manner and do some kind of contorted shoulder rolls. The whole ‘daily stretching routine’ lasts for less than 15 seconds. Then they probably spend more than 5-6 hours minimum in a chair seated all day. This may be in the form of watching television, driving a car, sitting having meals, reading or at the computer and then expect not to feel stiff. This by the way is exactly what happens to all of us, not just older people-I just happened to use this title for this article to make a point that getting older is not synonymous with getting stiffer. If you have unhealthy postural habits or even healthy postural habits, spending 8-10 hours at your desk or the computer all day is going to stiffen certain muscles and 15 seconds of stretching will not help. You must have good posture at your desk, take regular breaks to decompress your spine, do some exercise daily and do some regular stretching everyday. This means more than a few token waves of the arms and neck rolls. You will regain flexibility, you will feel better within yourself and your quality of life will be better. This I can assure you of.

Kick start your body and mind and reap the benefits

Your body is like your mind. I am sure you have heard of the old saying ‘if you don’t use it you lose it’. I studied French for four years in secondary college and would be hard pressed to remember ten French phases because I have not been using it. When to comes to memory the same thing applies as it does to your body. If you want it to perform better you must use it regularly. This is one of the reasons they recommend elderly people to do things like crosswords so that they continually stimulate the brain and their memory areas of the brain. It literally keeps your memory ‘in good shape’.

When it comes to your physical body doing regular exercise and stretching will also have the effect of keep your muscles and joints in a much better flexible and strengthened state. You will be amazed how many of those aches and pains will ‘mysteriously’ leave you. It does not take much either. It may be as simple as deciding to take the stairs instead of the elevator, or waking down to the shops instead of taking the car every now and again or joining a tai chi or yoga class once or twice a week.

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This is a question I often get in the clinic. There are any joints that can make all kinds of cracks and pops. Some people’s knees crack when they get up out of a chair, others have shoulders that snap crackle and pop and others have hips that clunk. You may have worried about what these mean and if they are doing you any harm but the good news is that the vast majority of these noises are harmless. Let’s have a look at the differences in the cracks, clunks and pops:

The most common cracking sound is from gas in the joints. Your joints have a lubricant which is called synovial fluid; it is the ‘oil’ for your joints. In this fluid there are dissolved gases and when the joint is stretched the pressure in the capsule changes and carbon dioxide is released in the form of bubbles. The ‘crack’ you hear is from these bubbles bursting. This happens when you get an adjustment or cracking your knuckles.

Another common snapping or popping sound is that of the tendons and ligaments. When you move in a certain way these can ‘snap’ over a bony prominence which causes the snapping sound. This is common to hear in the shoulder joints. As you get older you can hear these more if your muscle mass decreases.

Another sound which you may have also heard is much like a bowl of ‘rice bubbles’ crackling in a bowl of milk at breakfast time. You may have heard this in people in their knees, shoulders or even hips. This can be from cartilage damage in the joints from an overuse injury or from an old injury. It could also be from arthritis.

As a general rule though the snap cackle and pops of your joints are not problematic. If however you are also getting pain with these noises and or swelling then definitely get these looked at. Another thing about joint cracking is not to try self manipulation. I have seen many people over the years who could crack their necks but do not recommend this. If you are doing stretches and your spine or neck happens to crack then that is fine but to wrench your own neck around to get it to crack is just looking for trouble. And for goodness sake, don’t allow your friends, neighbors, cousins, mate at the pub or a completely unknown 17 year old Thai boy on the beach crack your back and neck!

When it comes to helping your joints and their health there are a few things that you ca do to help them. You may have heard of the supplements glucosamine and chondroitin sulphate. These are two substances that are in your cartilage and synovial fluid so this may help by taking these to supplement your joints. However, they can be great at helping some people and do nothing for others. This goes the same for all things. We are different and have different problem

If you are unsure about your particular ‘cracks or pops’ get them checked out if you are worried about them.

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WHIPLASH

What you need to know about it

As more and more people drive cars these days we also inevitably are seeing an increase in car accidents. Whiplash is a common injury and females are 2 times more at risk than males and they are also more likely to develop long term symptoms. It is not well known why this is the case but it is thought that males have stronger neck muscles than females which may help and also because women tend to sit slightly more forward in their seat. When sitting further forward the head travels further before it hits the headrest. Another interesting fact is that drivers tend to have more serious neck injuries than the passengers. This is thought to be because the passengers tend to sit back in more of a reclined position with their heads against the headrests.

Now I have mentioned the head rests a couple or times in regards to whiplash injury but lets take a closer look at these things that we tend to think of as luxury items. I guess it’s because of their names which make us think of them as nothing more than something to rest our heads against. However, they are so much more than that.

How to decrease your risk of whiplash by 40%

When a rear collision occurs the head is thrust backward and into extension of forces up to 12G. A head rest or better termed, head restraint is designed to reduce that rearward motion of the head greatly decreasing your chances of a whiplash injury. With rear end collisions being so common it’s perhaps one of the most important safety features you have in your car.

It should be at head height that means your center of your head should meet the center of the head restraint. You should check yours the next time you decide to go for a drive and spend the time to position it correctly. It’s too late after a crash occurs. A head restraint that is too low allows the head to propel back and OVER it. You also don’t want your head too far forward. It should be no more than 4 finger widths from the head restraint. If you can’t do this comfortably you may want to invest in a car head support for better protection against neck injuries. Research has shown you will decrease your chance of neck injury by 40% with a correctly positioned headrest.

The National Highway Traffic Safety Administration (NHTSA) told automakers the head restraints in their passenger vehicles will have to extend higher and fit closer to the backs of people’s heads. For the first time, the new standard addresses the back set. Head restraints will have to be within about 2 inches behind the head.

Also, if you know your going to get hit try to decrease your risk of injury.  If you have your head or body turned during a collision it can greatly increase your chances of a significant injury. Keep your eyes on the road and your head straight. If you know you’re going to get hit, then reduce the distance between your head and the head restraint   by moving your head back. The car neck pillow reduces the headrest distance and increases your level of safety.

What to do if you know a car is going to hit you from behind

Crashes involving whiplash neck injuries happen at lightning-fast speeds, but if you have time to prepare: Put your head and your neck all the way back so that you’re in contact with the seat back and the properly adjusted head restraint. Straight-arm the steering wheel and get a good grip. If you are stopped, put your foot on the brake as hard as you can. Look straight ahead, not in the rearview mirror – don’t have your head turned at all. Put your neck back slightly so your eyes are looking level up at about the top of the windshield. Scrunch your shoulders up toward your ears and then brace.

I hope you never have to be involved in a car collision but at the very least I hope this will help you if something does happen. Happy motoring!

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Neck Pain-Look AT your computer not INTO it

If you are sitting poorly, standing poorly or doing you daily activities using poor bio-mechanics you will be injuring your neck time and time again. When a person is sitting slouched with the chin jutting forwards they are continually straining the ligaments. The ligaments surround the joints and are responsible for supporting the discs that lay between the vertebrae. After prolonged poor postural habits the ligaments can actually tear. This can then cause pain and if the person continues to have poor posture the ligaments will not heal properly. If good posture is performed this give the ligaments a chance to heal. Think of cutting your elbow, if you continue to bend your elbow you continue to re-injure your cut and the elbow doesn’t heal. However, if you stop bending your elbow, the cut will have a chance to heal and will get better quickly. This is the same with your ligaments of your neck, stop slouching putting your neck into a forward position and your ligaments get a chance to heal finally- thus removing your pain. If you damage your ligaments further though, they can lose the ability to hold your disc in place and the disc may eventually bulge and can press on  spinal nerves causing pain or numbness or pins and needles in the shoulders, arms or hand. The good news is that this too can be helped using some specific exercises and adhering to good postural habits. The exercises will fast track your healing by re-aligning the disc and taking pressure off the ligaments to allow them to heal.

Let’s look at the example of a person at a computer. You will see this all day every day, the person is sitting with their head protracted (pushed forwards). In other words, if you were to hang a plumb bob (piece of string with a weight on the end) from their chin it would hit the floor. Their head is too far forward. This then puts the lower neck into a position of flexion. From years of poor posture certain muscles will also chronically shorten causing more pain and dysfunction. This can cause more pain and be a mojor cause of headaches. Imagine you have a balloon between your hands with one hand above the other. Your hands represent the vertebrae and the balloon is your disc. If you put pressure through the heels of your hands, the balloon will be forced out through your fingertips. If you press through your fingertips the balloon will be forced back out the opposite way through your heels. This is what is happening when you are sitting with your head in a forward position. You are continually injuring your neck, your lower vertebrae are flexed and are pushing your disc backwards. By reversing this, you allow your neck to heal, reposition the disc, and remove your pain.

TIP: Remember to look AT the computer not INTO the computer

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The lower back quiz -Question 2

Ok folks, I hope you all did very well last week on my quiz. Here is this week’s true or false statement. Remember, the more you know about how to save your back from harm the less back pain you will have-you MUST remove the things that cause your back pain in the first place!

TRUE or FALSE

Whether you suffer from lower back pain or just want to have good back health you should start your day by doing some exercises such as touching your toes, lying on your back to bring your knees to your chest and curling up into a ball to lengthen your lower back muscles. This will greatly relieve your pain and back problems!

You should not be doing exercises that increase flexion in your spine bending forwards to touch your toes or bringing your knees to your chest. The loads on you discs and ligaments are very harmful to your lower back. In the mornings your discs are swollen because they absorb liquid during the night through osmosis. They are like little sponges.  This however increases pressure in your spine and in the first hour after you wake up you have a 300% greater risk of disc injury! Therefore doing flexion exercises in the morning is very high risk indeed. There have been studies done showing where people who were doing toe touching, knees to chest type exercises each day to relieve their back pain stopped doing those exercises and found that their back problems were much better.  Just from stopping these exercises! Now you know why.

But for now,

Rest assured I am watching your back

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The lower back pain quiz

Are you damaging your back?

Ok folks here we go. I am sure many of you reading this have a good idea of your lower back and what you should be doing for it and what you should be avoiding.

Right? Hmm, let’s see shall we.

After all, the majority of people I see in the clinic are damaging their backs on a daily basis. A large part of my job is to remove the causes of their back pain by educating them to stop wrecking their backs every day in the little things that they do. So commonly I hear my clients say ‘ I had no idea that was bad for my back!?’ as you can imagine, you can have massages, chiropractic adjustments, acupuncture etc but if you have not removed the causes of your back pain you will be back in pain before too long.

So, every week I will have a question to test your lower back knowledge-good luck!

1. when  you do sit-ups you should have your knees bent to protect your back rather than having them straight

I have started your quiz with an easy one this week.

Of course the answer is false. It matters not whether your legs or knees are bent, straight or tucked behind your ears when you do sit-ups. The bottom line is that you should not be doing sit-ups!!

If you are wondering why then have a look at my previous post on boquetehealth.ning.com and you will see exactly what damage you are doing with every sit-up.

But for now,

Rest assured I am watching your back

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