More than 20 percent of adult Americans have some type of chronic pain (1). For roughly eight percent, this chronic pain is "high-impact." This means that it has limited their work or life activities almost every day for the past six months.
What do you do when your personal training client reports chronic neck pain or shoulder pain that just won't go away? First, ensure your client has talked with their doctor and is cleared for physical activity. Then, start by learning about what typically causes pain in these upper body areas.
When clients have sore neck muscles or a stiff neck, it impacts their ability to workout. Some of the most common causes of neck pain include (2):
Overuse-related neck muscle pain. Spending a lot of time hunched forward can strain neck muscles. Working long hours at a computer results in this type of neck pain. Hunching over while reading or playing on your phone has the same effect.
Aged or deteriorating neck joints. Over time, joints in the body begin to wear down. Neck joints are no exception. In some cases, they may actually begin to deteriorate. This can result in continuous neck pain.
Compression of nerves in the neck. The spine houses our spinal cord. So, if the spine is out of place, vertebrae can compress on nerves extending from the spinal cord. This can create pain in the neck. Sometimes these compressions occur in the cervical spine (neck). Other times they are in the thoracic spine (upper back) and the pain radiates upward.
Suffering a neck injury. Auto accidents and slip and falls can cause injury to the neck. Collisions occurring in a sports match can also instigate neck pain.
Being diagnosed with a certain disease. There are some diseases in which neck pain is a symptom. Among them are rheumatoid arthritis, cancer, and meningitis.
Poor posture can also lead to increased neck pain. Spine-Health reports that holding the head forward one inch in a poor posture position places 10 pounds of pressure on the cervical spine (3).
Stress is another potential culprit. Stress causes neck pain by causing the muscles to tense up. This increased neck tension can cause slight discomfort, as in a stiff neck. If left untreated, chronic neck pain can result.
Shoulder pain can also sideline a client's workout. Not to mention, it can also make it difficult to do everyday activities. Carrying groceries, picking up children, and household chores all utilize shoulder muscles and joints.
The American Academy of Orhtopaedic Surgeons reports that shoulder pain is usually due to (4):
inflammation or tearing of the tendon
arthritis in the shoulder joints
bone fractures, such as breaking the shoulder blade or collarbone
Research reveals that clients in certain occupations are more likely to develop shoulder pain (5). Work-related risk factors include handling heavy physical loads, using awkward postures, and engaging in repetitive movements.
When a client experiences neck and shoulder pain, physical therapy may provide relief. Studies also indicate that yoga can help.
For example, in 2017, researchers conducted a review of three studies involving 188 patients (6). Each patient had chronic, non-specific neck pain. Engaging in yoga provided participants short-term relief. It also improved their mood and quality of life.
A 2010 study explains that yoga helps ease pain in many ways (7). One is that it reduces muscle tension via a "relaxation response." It also positively impacts the hyperarousal of the nervous system.
Because yoga strengthens the upper body, it can reduce pain this way as well. Stronger muscles are better able to support the spine. This reduces the risk of neck and shoulder pain by improving poor posture. It also lowers injury risk due to weak muscles.
When creating a yoga sequence for clients with neck pain or shoulder pain, certain poses provide more benefit. Some of these yoga poses provide relief by strengthening the neck or shoulders. Others work by easing shoulder or neck tension. Here are some of the most effective poses to include in your client's healing yoga therapy plan.
This yoga pose is also called the "thread the needle pose." It works by providing a good shoulder stretch. It's also helpful to clients experiencing back pain. The needle pose begins by getting on the floor on your hands and knees. Knees should be hip-width apart with your head in a neutral position. Exhale while moving your right arm underneath your left arm. The palm of your right hand is facing up. Take your right shoulder to the floor and rest your right cheek on the floor. Lift your left elbow, being careful not to place too much weight on your head. Relax your lower back and broaden your upper back. Hold for 60 seconds and let the tension slip away.
This yoga pose is great for beginners. It helps strengthen muscles in the neck. It also provides a good neck stretch. To do it, stand with your big toes together and heels slightly apart. Arms are hanging at your side with palms facing out. As you exhale, change your stance so your feet are 3 ½ to 4 feet apart. Raise the arms to shoulder height, palms facing down. Turn your right foot out 90 degrees while turning your left foot in just slightly. Exhale again and bend from the hips so your torso is over your right leg. Place your right hand on the floor next to your right foot. Your left arm will extend toward the ceiling. Keep your head facing forward or look up at your left hand. Remain in this yoga pose for 30-60 seconds before returning to a vertical position.
The child's pose is good for both a shoulder stretch and a neck stretch. It begins with kneeling on the floor and sitting back so your butt is resting on your feet. The palms of your hands should be resting on your thighs. Exhale and lower your upper body forward, arms extending on the floor in front of you and palms facing down. Let your shoulders relax and continue to breathe in and out.
Creating a yoga practice that incorporates these three poses can help relieve stress and tension in the cervical spine. It can also strengthen muscles supporting the neck, upper back, and shoulders. This relieves pain by aiding in a healthy posture.
When teaching clients how to use yoga to alleviate their neck pain or reduce discomfort in their shoulders, it's not uncommon for them to have questions. Here are a few that you might get, as well as their answers.
How long before you start to see results for your neck and shoulder pain when doing yoga?
Every client is different. Depending on the cause of the shoulder or neck pain, results may be noticed right away. Other times, it may take longer to get the muscle to relax enough to provide relief.
How do you determine if yoga is the right action for your neck and shoulder pain?
Many of the yoga poses are more like long, slow stretches. So, this type of workout is good for clients who prefer a low-intensity workout. Because the movements are so controlled, pain can be monitored more easily. If the neck flares up, for instance, the yoga pose can be stopped before any additional damage occurs.
How long should a yoga workout session for neck and shoulder pain last?
Yoga poses are typically held for 30-60 seconds each. If clients only focus on a few yoga poses directed toward the shoulders and neck, this session would be relatively short. Though it can also be expanded by sequencing through each pose a couple of times.
How do you avoid injury when practicing yoga for neck and shoulder pain relief?
To avoid aggravating a shoulder or neck injury further, use slow and controlled movements when practicing yoga. Pay attention to the way your neck feels or if your shoulders start to ache. Also notice any discomfort occurring in your cervical spine. If the pose appears to make the pain worse, stop and try another yoga pose instead.
If you're interested in becoming a yoga therapist, the ISSA offers Yoga Instructor Certification. This course teaches the history and philosophies of yoga. You also learn how to design a yoga sequence based on a client's fitness level. This credential is a great way to grow your personal training business.
Learn the benefits of yoga, techniques and tools for teaching, and fundamental information for jump-starting your career.
Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. DOI: http://dx.doi.org/10.15585/mmwr.mm6736a2.
Neck pain - Symptoms and causes. Mayo Clinic. (2022). Retrieved 25 August 2022, from https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581.
Gavin Morrison, P. (2018). How Poor Posture Causes Neck Pain. Spine-health. Retrieved 25 August 2022, from https://www.spine-health.com/conditions/neck-pain/how-poor-posture-causes-neck-pain.
Shoulder Pain and Common Shoulder Problems - OrthoInfo - AAOS. Orthoinfo.aaos.org. (2018). Retrieved 25 August 2022, from https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-pain-and-common-shoulder-problems/.
van der Windt DAWM, Thomas E, Pope DP, et al. Occupational risk factors for shoulder pain: a systematic review. Occupational and Environmental Medicine 2000;57:433-442.
Cramer, H., Klose, P., Brinkhaus, B., Michalsen, A., & Dobos, G. (2017). Effects of yoga on chronic neck pain: a systematic review and meta-analysis. Clinical rehabilitation, 31(11), 1457–1465. https://doi.org/10.1177/0269215517698735.
Vallath N. (2010). Perspectives on yoga inputs in the management of chronic pain. Indian journal of palliative care, 16(1), 1–7. https://doi.org/10.4103/0973-1075.63127.
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