How to move: with neck and shoulder pain

Exercise is important but there are key things to consider before starting – and no fixed recipe for treatment

Shoulder and neck pain can result from traumatic events such as a car crash, but one of the most common causes for non-traumatic shoulder and neck pain is a head-forward posture many people adopt in their workstations, says Phillip Hughes, a physiotherapist and president of Musculoskeletal Physiotherapy Australia.

Athletes whose sport involve throwing and tradies whose jobs require them to hold their hands over their head for a long time are also at risk of neck and shoulder pain, he says. “Excessive overhead activities can cause what we call a tendinopathy of the rotator cuff tendons, and that can lead to tearing of those tendons and significant pain.”

Pain can be a barrier to exercises, says Prof Michele Sterling, a physiotherapist and researcher at the University of Queensland. “But often, once people get moving – it can be quite a low-level or low-load type of exercise – their pain feels better.”

She says people’s natural inclination when something is sore is to rest but avoiding movement can often be counterproductive.

Sterling says there is no robust evidence that one form of exercise is better than another but research shows that exercise – as part of physiotherapy treatment – should be the first treatment approach.

There is no fixed recipe for shoulder and neck pain treatment, and every person has to be assessed and prescribed exercise therapy by a physiotherapist, but here are some tips that can help you get moving.

The class: yoga, pilates and tai chi

In a 2020 systematic review published in the British Medical Journal of Sports Medicine, Sterling and her colleagues compared the effectiveness of different physical exercises for chronic neck pain.

The review included 40 randomised controlled trials. “We found that low-load motor control exercises and classes like yoga, pilates and tai chi are somewhat more effective than things such as stretching exercises,” Sterling says.

Classes that have a strong focus on improving head, neck and shoulder posture can be highly beneficial in relieving neck and shoulder pain, agrees Hughes.

Woman as part of class practising tai chi in a park
Tai chi can help relieve neck and shoulder pain but you should listen to your body when practising. Photograph: Xinhua/Rex/Shutterstock

If you have never tried these classes before, Sterling suggests to approach them with caution. “Listen to your body,” she says. “Start at a lower load, with pain-free movement. Then gradually work up to higher loads and stronger exercises, and as in the case of yoga, pushing more into the range of movements.”

The move: the chin nod

Lie down with a soft pillow under your neck. Flatten the back of the neck against the pillow very gently, nodding your head forward as if to say yes.

You might feel the muscles at the back of your neck slowly extending but stop before you feel the front muscles hardening.

Hold the nod position for five seconds, then return your head to the start position.

“[The chin nod exercise] is really important for giving stability to the neck and supporting the neck by strengthening the muscles very close to the spine, at the front of the spine,” Hughes says.

He says building up strength and endurance in this exercise is crucial, and the final goal should be 10 holds of 10 seconds.

“Everybody could benefit from strengthening those muscles, but especially those who spend a fair amount of time on the computer.”

The activity: swimming

Swimming is a great activity to promote stability and strengthen the neck and shoulders, says Hughes. But he warns that it might not be for everyone. “Swimming is certainly not for people with more severe or acute conditions.”

Sitting and spending many hours in front of a computer are significant contributors to neck and shoulder pain. “Even just getting out of that position – walking, swimming, cycling or anything that gets you moving – can be enough to relieve the pain,” Sterling says. “It’s important the person enjoys it.”

The hard pass: lying on your stomach

Hughes says lying on your stomach with your head twisted to one side can harm the neck. He also suggests choosing the right pillow for your sleeping habits.

“If you lie on your back, you need a flatter pillow,” he says. “If you lie on your side, you need a higher pillow.” The focus remains a correct posture of the head, maintaining the back of the neck in line with the rest of the spine.

Manuela Callari

The GuardianTramp

Related Content

Article image
How to move: exercising with fibromyalgia
Exercise can exacerbate fibro symptoms – but it can be one of the most effective ways to alleviate them too

Manuela Callari

02, Mar, 2022 @4:30 PM

Article image
How to move: with Chronic Fatigue Syndrome/ME
Physical activity is not appropriate for everyone living with CFS/ME but if it works for you, here is a beginner’s guide to doing so safelyGet our weekend culture and lifestyle email and listen to our podcast

Manuela Callari

09, Mar, 2022 @4:30 PM

Article image
How to move: exercising after having Covid-19
Even a mild Covid infection can cause lingering fatigue, but exercise plays a crucial role in recovery

Manuela Callari

16, Feb, 2022 @4:30 PM

Article image
How to move: with foot pain
Nearly one in five Australians experience foot pain, but exercising effectively can provide huge benefits. Here’s what to consider before getting started

Manuela Callari

11, Jan, 2022 @4:30 PM

Article image
How to move: with chronic back pain
Exercise is critical for the millions of people who live with chronic back pain. But how can you do it safely and effectively?

Manuela Callari

03, Jan, 2022 @4:30 PM

Article image
How to move: with endometriosis
Regular exercise may help reduce the pain, inflammation and risk of getting endometriosis, say experts. But here are some things to consider

Natalie Parletta

17, Jan, 2022 @4:30 PM

Article image
How to move: with migraines
Migraines can be debilitating, but exercise may help limit their frequency and intensity. Here are some points to consider

Manuela Callari

16, Jan, 2022 @4:30 PM

Article image
How to move: with osteoporosis
The benefits of exercise for those with osteoporosis are great, and many exercises may be safe – so long as you avoid the risk of falling

Natalie Parletta

10, Jan, 2022 @4:30 PM

Article image
How to move: with rheumatoid arthritis
Activity encourages the body’s healing functions – ‘if you rest, you rust,’ a rheumatologist says – and every form of arthritis can benefit from exercise

Manuela Callari

02, Jan, 2022 @4:30 PM

Article image
How to move: with heart conditions
Exercising with a heart condition can be a daunting prospect, but done correctly can have an array of benefits – and even be a lifesaver

Natalie Parletta

09, Jan, 2022 @4:30 PM