BW: Neck Pain with Bilateral Shoulder and Low Back Pain: Week 3

This week is designed to organize what has been most effective and breakdown some areas that have been more challenging
Addressing your concerns
- It sounds like positions where your neck is unsupported and doing a resistance movement, you have difficulty maintaining good cervical posture while strengthening through the shoulders
- One option is to pause in the tense position of each rep and turn your head side to side
  - If your neck is relaxed you should be able to turn your head the same amount during the exercise that you can turn it while at rest
- It is common that the neck will want to tense if the shoulder is either tight or weak
- Another difficulty is the capacity to isolate certain muscles while keeping others relaxed
  - It is alright for some of these movements to feel almost too easy at first as you try to correct the pattern of activating certain muscles while keeping others relaxed
  - It is really important to establish the good pattern prior to increasing the challenge
    - Many people in their desire to get better faster rush into pushing themselves too hard too fast and they fall right back into that old compensatory pattern and they irritate their symptoms again
    - Cementing that new pattern does take time so don’t rush it
- If your bands feel too tight, either get a lighter band or don’t worry about getting into the range where you begin to feel neck tension
Goals:
- Start to organize strength and mobility circuits
  - Mobility circuits will focus on body awareness and mobility with the goal of establishing a multi-planar warm up or cool down pre/post activity
    - This may be utilized on a daily basis
    - 5-20 reps
  - Strength Circuits
    - Will include 3-4 movements that challenge the body in opposing motions
    - Each circuit will attempt to pair less threatening more comfortable movements with more threatening/challenging movements
    - As the list of strength circuits grows, they will continue to increase in difficulty with a progression towards desired activities
Ice should be used 10-15min following if any pain or soreness is felt
5-20 reps of each exercise or 30sec to 2 min
Mobility/Body Awareness
- 1 set through the circuit 5-20 reps or 30sec to 2 min
Strength Circuits
- 5-20 reps or 30sec to 2 min, go through circuit a second time but complete 1/2 as many reps or time as first set
Day 1
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
Day 2
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Strength Circuit #1
  - Prone Shoulder Extension Off Edge of Bed VIDEO
    - Focus on scapula position
  - Downward Dog Progression From Higher Level to Floor VIDEO
  - Table Top Progression VIDEO
Day 3
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
Day 4
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Strength Circuit #2
  - Shoulder Wall Ball Multiple Positions VIDEO
    - Start with first position only
    - Let’s try this as a substitute for bicep loading
  - Prone Shoulder Extension Off Edge of Bed VIDEO
  - Band Pull Down 3 Planes VIDEO
    - Start with one plane of motion focusing on the one that is most comfortable
Day 5
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
Day 6
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Strength #3
  - Band Extension Deadlift VIDEO OR Shoulder Flexion & Forward Reach Towel Slide to Ball Roll Out VIDEO
    - Both of these are meant to improve forward reaching while maintaining humeral head depression
      - They are similar motions, pick the one you feel you are best able to control
      - Try to turn head with each rep when you feel your neck tensing up and see if you can maintain the same mobility during the exercise that you have at rest
  - Laying on Back External Rotation Phase 1 VIDEO
    - Try to keep the feeling in the back of the shoulder/armpit
  - Supine Rolling With Activation of Posterior Shoulder and Scapular Stability VIDEO
    - Coordinate posterior shoulder stability with rolling pattern
    - You can do this with your head supported on a pillow so there is less tension in the neck with the rolling
Day 7
- Mobility/Body Awareness
  - Scapula and Cervical Positioning Drill VIDEO
    - If this position bothers the shoulder, take hands further apart and put a small towel under forehead
    - Yes you can think about elbow downward pull
  - Tall Kneel with Scapular Depression/Retraction VIDEO
    - Progress to the following, especially second option in the video below
      - Sleeper Stretch->Behind Back with Towel->Reach Opposite Arm VIDEO
  - Puppy Pose Progression VIDEO
    - Be careful to stay short of pain
  - Laying Down Humeral Depression with Progression to Pec Stretch VIDEO
  - Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO