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Neck Pain in Office Workers – Correct. Stretch. Repeat.

Only English || This article emphasizes on the prevalence of pain in the sedentary population, particularly neck pain, and provides you with a self-treatment plan to reduce potential risk factors and manage musculoskeletal system disorders. This article is scientifically researched and contains material of our latest book ‘Mobility Guide Basic – 15 Minutes, Every Day’ and our workshop series ‘Fit@Work I+II‘. Before you continue reading, make sure to find yourself in an upright position.
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First of all, what exactly does ‚musculoskeletal‚ mean?
The musculoskeletal system is defined as complex organ system of the human body that consists of the active system — musculature and associated structures — responsible for locomotion; and the passive system (skeletal) — bones, joints and associated structures — responsible for protection, posture and shape of the body¹. In regard to disorders within that system, the WHO defined it as conditions that affect muscles, tendons,  bones, peripheral nerves, and vascular vessels, possibly caused by, precedent to, or worsened by repetitive or continuous use of a certain body part.
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Musculoskeletal disease was ranked the leading cause for absenteeism in 2018 in Germany, according to the annual DAK health report. I’d like to start by giving you a few facts and figures, so bear with me. In our society as much as in any other society of a developed country, absence of work due to impairments and diseases within the musculoskeletal system have been prevalent.  Due to obsolete work conditions and furniture every ordinary office is set up with, office workers are at high risk to acquire musculoskeletal system disorders. The male and female office workers most frequently complained of pain in the lower back (LBP), neck (NP) and thoracic spine (TSP). Those workers who had the most significant musculoskeletal system pain were sitting at the desk for long periods of time without taking regular exercise breaks throughout the day into account 2. The Robert Koch Institute stated that work-related sedentary behavior and improper posture belongs to the leading risk factors for musculoskeletal system pain.  Consequently, it claims that insufficient mobility, body perception, and general lack of fitness due to sedentarism is responsible for musculoskeletal disease and its severity. In regard to chronic pain, social, cognitive and emotional factors need to be taken into account as well. However, this article is not supposed to emphasize on those, nor on physical inactivity, which is detrimental and wreaks havoc on health.
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In a nutshell, the most sustainable plan to eliminate musculoskeletal system pain is to reduce potential risk factors of all kinds and manage existing impairments accordingly. This is what Team Movewell is dedicated to. Impactful work can be done by regaining proper posture and proactively removing risk factors that might appear over time. 

Are you ready for improvements?
The first step that needs to be taken is to increase your perception by visualizing your posture, alignment and setting you’ve been working in all day.

How does my posture look like, and what I am supposed to change? 

The optimal curvature of the cervical spine (C2-C7) lies somewhere between 20-40 degrees, which is necessary to protect the brain stem and spinal cord 3. Deviations are referred to as misalignment and are often associated with multiple impairments. In the sedentary population, computer-related work and smartphone usage are being held responsible for a severe misalignment, the forward head position (FHP) 4. Consequently, being stuck in the FHP for prolonged periods of time can cause severe disorders and trigger symptoms, such as migraine, headache, dizziness, postural imbalances, rounded shoulders, TMJ dysfunctions, respiratory dysfunctions (decreased lung volume) tinnitus, cervical spine injuries (sprain, fracture, whiplash, deformities), eyesight degeneration amongst other degenerative processes 5,6. Seemingly, the list is very long and the potential hazards are extremely unpleasant. Hence, we highly recommend to you to get screened and corrected professionally if you can’t solve it yourself. Here you can see the degenerative process of the cervical spine.

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yoga guide, mobility guide, physical therapy, personal training, Berlin, sports, education, workshops, gym, strength training, weightlifting, running, injury prevention, squat, deadlift, movement, movewell, balance, pain-free, health, fitness, lifestyle, habit, workshop, seminars, shop, shopping, amazon
yoga guide, mobility guide, physical therapy, personal training, Berlin, sports, education, workshops, gym, strength training, weightlifting, running, injury prevention, squat, deadlift, movement, movewell, balance, pain-free, health, fitness, lifestyle, habit, workshop, seminars, shop, shopping, amazon

Different angles are determined to measure the misalignment, however, to simplify the problem we mostly refer to the eye-ear-acromion line. It might be handy to have taken a picture of yourself whilst working in your accustomed position in order to spot deviations. Here you can clearly see the misalignment (picture 1) that you will want to optimize. Having the ear perfectly aligned with the bony shoulder cap is the first step towards risk reduction in neck pain (picture 2). Any possible side shifts in the cervical spine or deviations in the shoulder-shoulder line need also to be resolved. This is of high importance in scoliosis management. 

Here comes the rub: So, wait before you start adjusting your head right now. Since the spine (column vertebrae) consists of multiple joint complexes that are inseparably connected to each other, be aware that moving on the upper part (cervical spine) directly influences the mid or lower part of your spine as well, not to mention the pelvis, the lumbar fascia, muscle tension et cetera.  In an organic system like the human body there’s no single action without consequences on other ends. Adjusting the mid section (thoracic spine, T1-T12), however, is what you want to do in order to fix a forward head position.

If you need to correct the FHP, the thoracic spine including the rib cage has to be erected or rather extended to its neutral position right before the lower back (lumbar spine, L1-L5) would overextend. Important to say that independent on the desktop task, the measured forward head position is clearly increased in sitting positions compared to standing positions 5. Phrased differently, people have a harder time correcting the faulty posture being seated instead of standing upright. Therefore, we recommend to practice as often as possible in standing positions or eventually start working at a standing desk, so that you can eliminate the FHP risk factor rather quickly.

I final remark, since the FHP has also become highly prevalent in many modern leisure time activities, such as TV watching, or smartphone usage. In total, the amount of time spent on those activities in improper positions will determine the likelihood of postural impairments, disorders, or symptoms. It’s not a matter of age, or occupation, or lifestyle, it is simply a matter of sufficient or insufficient body perception and accordingly, proper behavior. Neck pain is common, yet it isn’t normal. Refining your perception will make you change your behavior.
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After correcting the misalignments, in the second step, you would want to eventually release muscle tension of the strained neck muscles by mobilizing all affected cervical spine, neck and throat muscles. Relieving symptoms like discomfort and pain is the desired effect, however, more importantly is the effect on joint positions. A muscle’s job is to contract and relax, if it is stuck in a contract position, it’ll lock the joint and create shear force and misalignments in the first place, not to mention the muscle (tissue) damage. Since muscles move joints, it is the only way to realign joints and keep them aligned. 

The two exercises shown below will provide you with an idea on how to release muscle tension quickly and without any equipment or whatnot. Make absolutely sure that you find yourself in a corrected and upright position before you start performing the drills below. 

‘Head Rotation’

Setup: parallel stance, arms hanging; chin is slightly tucked in; view slightly below horizontal eye line
Action: move to one side as far as possible whilst having the chin tucked in; hold on for 1-3 seconds in the furthermost position and return to start
Frequency: Perform 15-20 reps on the left, and 15-20 reps on the right side to accumulate 1-2 minutes in total; repeat it 2-3 times a day

‘Double Head’ 

Setup: parallel stance, arms hanging; chin is slightly tucked in; view slightly below horizontal eye line
Action: 1. tucking in the chin | 2. pulling the head towards the sternum (chest); the complete movement can take up to 5-8 seconds
Frequency: Perform 10-15 reps to accumulate 1-2 minutes in total; repeat it 2-3 times a day
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The demonstrated exercises are an excerpt from our book ‘Mobility Guide Basic – 15 Minutes, Every Day.’ To holistically approach the FHP or other misalignments in regard to pain and tension release, we recommend to apply up to 8 precise cervical spine/neck drills. 

In the third step we would apply different methods to foster and strengthen the optimized ‘correct’ position, which makes it finally easier for you to keep the head in a neutral position while having the shoulder blades actively engaged throughout the day. This step is about changing behavior and reacquiring posture, which is by far the most complex one, because it requires you to remind yourself intentionally and every second, so that you don’t default to the former ‘bad’ posture. 

By repetitively performing certain movements and task from an optimized ‘corrected’ position,  such as working, using your smartphone, reading a book, doing strength and mobility exercises,  which is considered a behavioral change, you’ll adopt to this corrected posture. Ultimately, you have eliminated one hazardous risk factor for musculoskeletal system diseases.  

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Taking action and being proactive in regard to physical impairments is vital for a pain-free life.

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Correct. Stretch. Movewell. 

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References
1: www.khanacademy.org/science/high-school-biology/hs-human-body-systems/hs-the-musculoskeletal-system/a/hs-the-musculoskeletal-system-review
2: Celík et al. 2016 ‚Determination of Pain in Musculoskeletal System reported by Office Workers and the Pain Risk Factors‘, International Journal of Occupational Medicine and Environmental Health 2018;31(1):91–111.
3: Grob et al. 2006 ‚The association between cervical spine curvature and neck pain‘, European Spine Journal (2007) 16:669–678.
4: Jung et al. 2016 ‚The effect of smartphone usage time on posture and respiratory function‘, The Journal of Physical Therapy Science 28: 186–189, 2016
5: Ahmandi et al. 2015 ‚Evaluation of forward head posture in sitting and standing positions‘, European Spine Journal
6: Lee et al. 1995 ‚The Relationship between Forward Head Posture and Temporomandibular Disorders‘ Journal of Orofascial Pain 1995;9:161-167

2019-01-19T21:27:27+01:00

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Founder || Physical Therapist | Movement Coach

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