JM: L Neck/Clavicular Pain with Thoracic Hypomobility: Phase 1 (9-24-18)

Hopefully you are about to learn a lot this first week
This week is designed to add a new movement each day to assess your response to each exercise
Your goal is to get through each movement without increase in symptoms
With each exercises you should ask yourself a very important question
- IS MY PAIN GETTING BETTER, GETTING WORSE, OR STAYING THE SAME?
- This goes for during the exercise, after the exercise, and the following day
- If the answer is getting better or staying the same….THAT IS GOOD
- If the answer is it hurts a little, with only mild pain afterwards that is gone the next day…ALSO GOOD
- If the answer is it is getting worse the more I do it OR I know this is going to hurt when I am done OR I was really sore after and had trouble sleeping OR It hurt for 2-3days after doing that exercise…. NOT GOOD…I HOPE YOU GET THE IDEA
I know this is a little repetitive, but you have to understand….I have no idea what you are feeling when you do this stuff and any exercise you do can be helpful or harmful depending on what you are personally getting out of it
Your goal is not to be really good at these exercises…your goal should be “I am going to do the movement he is talking about, I am going to do it slow and controlled, if I feel pulling or muscle fatigue, that is good, if I feel pain I will see if I can stop just short of pain but if that is not possible I am going to hold off and email him. My goal is to get through each movement, even if I make it easy so that I can prove to Dr. Brad that I am able to control my body during these very basic movements and then he will be able to give me harder stuff that gets me closer to my goals”
I run into some road blocks with this online approach, and above is the big one
Goals:
- Minimize Irritation using ice as needed
- Avoid over stretching, this will likely cause significant pain
- Light controlled motion well short of pain, this week is meant to be easy
- Pay attention to anything that feels different on the painful side and does it feel more like the non-painful side as you do it more
NOW….Time to get started
- Do each movement 5-20 reps SLOW and CONTROLLED, the slower the better
- 1-2x/day
- Some of these movements may feel good and help to relieve pain, you are welcome to do a couple of them frequently throughout the day to help reduce/prevent pain
Day 1
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
Day 2
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
  - 5) Neck Rotation Self SNAG VIDEO
  - 3) Chin Tuck with Side Bending VIDEO
    - if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
    - Part of this first week is assessing your response to movement
Day 3
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
  - 5) Neck Rotation Self SNAG VIDEO
  - 3) Chin Tuck with Side Bending VIDEO
    - if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
- 51) Prone Cervical and Scapula Positioning Drill VIDEO
  - This is meant to assess your ability to keep neck relaxed as you isolate scapular control
Day 4
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
  - 5) Neck Rotation Self SNAG VIDEO
  - 3) Chin Tuck with Side Bending VIDEO
    - if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
- 51) Prone Cervical and Scapula Positioning Drill VIDEO
  - This is meant to assess your ability to keep neck relaxed as you isolate scapular control
- 10.1) Supine Wing ER Breathing VIDEO
  - Light movement that will set us up for some posterior shoulder strengthening
Day 5
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
  - 5) Neck Rotation Self SNAG VIDEO
  - 3) Chin Tuck with Side Bending VIDEO
    - if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
- 51) Prone Cervical and Scapula Positioning Drill VIDEO
  - This is meant to assess your ability to keep neck relaxed as you isolate scapular control
- 10.1) Supine Wing ER Breathing VIDEO
  - Light movement that will set us up for some posterior shoulder strengthening
- 11.3) Pillow Case Active Shoulder Extension Hands Progress Closer VIDEO
  - Make sure you don’t go too far too fast
  - I want to know is this feels tighter on the R or L
Day 6
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - Do this carefully and gently
  - Can be done in sitting as well and is typically helpful to complete lightly and frequently throughout the day
  - If this feels fine you may want to try the seated version throughout the day seen below to break up seated postures for long periods
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
- Progress the motion that feels better, compare between the 2 exercises below and pick the one that feels most helpful
  - 5) Neck Rotation Self SNAG VIDEO
  - 3) Chin Tuck with Side Bending VIDEO
    - if either feel like they make it worse, try to decrease how far into the movement you go or hold off all together
- 51) Prone Cervical and Scapula Positioning Drill VIDEO
  - This is meant to assess your ability to keep neck relaxed as you isolate scapular control
- 10.1) Supine Wing ER Breathing VIDEO
  - Light movement that will set us up for some posterior shoulder strengthening
- 11.3) Pillow Case Active Shoulder Extension Hands Progress Closer VIDEO
  - Make sure you don’t go too far too fast
  - I want to know is this feels tighter on the R
- 51.1) Humeral Head Depression at 90deg Abduction VIDEO
  - Ideally light pulling in the front of the shoulder is ok, not on the top or in the back, stay short of feeling top or back of shoulder in regards to pinching or pain
Day 7
- Email me some feedback concerning the progression of the week so I can utilize that information to create phase 2