SST: 21 y/o with Neck Pain/Whiplash Post MVA Left Suboccipital: Phase 1 (4-30-18)

Hopefully you are about to learn a lot this first week
This week is designed to add a new movement every 2 days 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:
- Decrease symptoms with movements or positions that reduce pain
  - Kinesiotape is an option for this with video below including option to reduce upper cervical pain
    - LINK for Taping Application VIDEO
  - Try to spend as much of time as you can with head supported
    - lay on the floor with head propped up slightly
NOW….Time to get started
- Do each movement 5-20 reps SLOW and CONTROLLED, the slow
Movement #1 (Try for 1-2days)
- 53) Deep Neck Flexor Activation Head Supported Chin Tuck VIDEO
  - The light tuck of the chin can be done frequently throughout the day
  - This can be done seated with hands behind your head as a portable head rest
    - 55) Deep Neck Flexor with Thoracic Extension Seated and Foam Roll VIDEO
      - Beginning of this video shows the seated position
  - This can be done in the car lightly pressing your head back into the head rest
  - Ideally this can be done lightly 5-10x every couple hours
  - Do it lightly, pushing too hard may cause pain
Movement #2 (Try on day 3-4 in addition to the movement above)
- 14) Tall Kneel with Scapular Depression/Retraction VIDEO
  - This can be done in standing or kneeling and can be done frequently throughout the day
  - This is another movement to break up seated look down positions
  - 5-10x hold each for 3-5 sec
Movement #3 (Try on day 5-6 in addition to both movements above)
- Below are 2 options to address rotation
- Choose the movement that is most comfortable
  - Option #1
    - 5) Neck Rotation Self SNAG VIDEO
      - Sometimes I recommend doing this lying down first with the head supported so it is less stressful on the suboccipital region, but it can be done seated or standing as shown in the video if not painful
      - Start by moving in the direction that is less painful 5-10x
      - If the opposite direction is too painful, avoid it for now and move only in the direction that feels better, but after doing the easier direction, the more painful direction may get easier and can be done lightly if that is the case 5-10x
  - Option #2
    - 4) Chin Tuck with Rotation VIDEO
      - This builds on the first movement and bias one side at a time
      - Can be done lying down or seated
      - If painful avoid this movement, but it will stretch one suboccipital region at a time when done correctly
After you get through the movements above, email me with some feedback in regards to how the movements went. What was helpful…what hurt so you didn’t do it. Also feel free to email me at any point along the way with questions. This concept really relies on our ability to effectively communicate. If something doesn’t feel right…EMAIL ME RIGHT AWAY and I will figure it out