As trainers, we hear clients talk about their tension and tight muscles in the neck and shoulders. Further, because we’re professionals, we should know what might be causing this and how to fix it (assuming no medical conditions exist). Several things can lead to tight muscles in the neck and shoulders (upper back pain and dysfunction), which are widespread in today’s culture. These dysfunctions often result in pain, sleep loss, weakness, inability to do daily tasks, and an overall decrease in quality of life. Luckily, it’s easily manageable if you retrain and correct what’s going on in those areas.
Before we start, it’s important to remember how hard it can be to get people to do exercises, even to feel better! In fact, I have many stories of close friends being resistant to recommendations I offer. But, as with anything else, once they try it, they’re hooked. Experiencing a correction is a fantastic way to get people interested in doing what’s best for their body.
Let’s look at what causes tight neck and shoulder muscles, how it affects quality of life, and how you can help clients asking about it. It usually starts in the thoracic spine and can be a result of poor posture or irritation of the back and shoulder muscles like strain or spasms.
Clients who have upper back dysfunction usually show any of the following symptoms:
Pain/numbness/tingling radiating into the arms
Muscle spasms or knots
Shoulder or arm weakness
Loss of sleep
Decreased quality of life
As you can see, it can take clients away from their everyday lives and make simple tasks seem difficult. Clients with these symptoms will usually try their own stretches, change their workouts, take medications, or receive medical treatment, which doesn’t always address the core problem. All of these “solutions” can lead to, in extreme cases, chronic pain, drug dependency, surgery, or depression.
Upper back problems can result from lack of education or awareness on correct posture, a sedentary lifestyle, occupational demands, joint stiffness, decreased conditioning, muscle weakness, poor core stability, or poor ergonomic workstations. The problems you should prioritize are poor posture, prior injuries, and poor technique.
Today’s culture crumbles good posture from things such as:
Hunching at a desk job 5-6 days a week
Mobile phone use and reading
Carrying heavy or asymmetrical items
Using a computer mouse
Technological convenience (online shopping, food delivery, etc.)
Most people aren’t aware of their body when doing these activities, which puts them in uncomfortable positions for extended periods without a break. This, in turn, strains the muscles and tendons of the upper body. And, over time will cause the muscles and vertebrae to become fixated and restricted, resulting in uncomfortable muscle tension. These simple yet repeated actions are significant contributing factors for upper back problems.
Prior injuries can also cause tight muscles in the neck and shoulders. Even injuries 10+ years old can amplify current problems. Upper back discomfort can intensify from untreated trauma to the:
Other soft tissues
Regardless of whether an injury was from a car accident or an athletic sport, the body responds the same way: muscles get strained and vertebrae become restricted, and you wind up with upper back and neck problems.
This isn’t just during training; poor technique can happen during any motion you have to perform each day. This can include lifting kids, getting in and out of a car, putting things away, and any other total body, functional movement. Day-to-day activities like these, with even the slightest bit of bad form, can put a strain on the shoulders and neck. Pain from improper movement develops over time based on the continued muscle memory of your upper body.
Interestingly, all three of these tend to go hand in hand. Injuries can happen from poor technique that develops from poor form. Or, in reverse, injuries can cause poor technique and result in regularly bad posture. If you are unaware that you’re moving incorrectly, then you’re at risk for injury.
These factors and others cause us to compensate when we move, leading to excessive movement in areas like the lower neck and shoulder girdle. Further, it causes muscle tension of the rhomboids, scapular stabilizers, rotator cuff and neck musculature. This can snowball into more aggressive injuries like:
Rotator cuff tears
Retraining the body is crucial, so the condition doesn’t worsen. This can reduce nerve tension and joint stress. The goal is to have proper movements ingrained into muscle memory to keep good posture.
Corrective training, in the form of exercise prescription, is important for the recovery process. The exercises here can be part of a daily program. Each exercise has a different level of difficulty and progresses to become more complex as the list goes on. You can share the instructions for these exercises with your clients at the end of the article.
When there is less flexibility in the upper torso, there will be excessive and destructive movement in the neck, shoulders, and lower back. This adds stress and opens the door to injuries; to help this, start your clients with the can opener exercise.
To perform can openers:
Lie on one side on the floor.
Extend your bottom arm out to the side, resting it on the ground.
Bend the top knee and hip to 90 degrees and let the inside of the knee touch the floor.
Keep the knee against the floor during the exercise.
Take your top arm and touch it to your bottom arm.
Take the top arm and rotate the other direction toward the opposite side of the body.
Turn your head and eyes to look where you're going and the arm is moving.
Keep the knee touching the floor the entire time as you repeat the motion
Perform 1-2 sets of 10-12 reps every day on each side.
Egyptian Turns help improve flexibility in the cervical spine from sitting and poor posture. The exercise aims to correct excessive and destructive movement in the neck, shoulders and lower back.
To perform this exercise:
Lie supine on the floor (on your back).
Have one arm extended out to your side and then bent upward at 90 degrees.
Keep the other arm down by the side.
Squeeze both the raised arm as well as the opposite arm into the floor.
Turn head and eyes to the direction of the raised arm.
Perform 1-2 sets of 10-12 reps every day on both sides.
It’s common for people who don’t activate their core and hips enough to compensate and add stress to their upper back. Therefore, you should have your clients perform double and single leg glute bridges.
Incorporate this hip exercise with the following reminders:
Lie flat on the floor and bend both knees, keeping the feet on the ground.
Lift one leg off the floor.
Pressing through foot on the floor, lift hips.
Don’t squeeze your face, neck, or upper back.
Use natural and comfortable breathing.
Perform 1-2 sets of 10-12 reps every day on both sides.
Decreased stability in the lateral core and shoulder girdle can contribute to dysfunction. Therefore, side planks are great to add into your client’s program to relieve tight muscles in the neck and shoulders.
Follow these recommendations:
Lie on your side, propping yourself up on one elbow.
Keep feet flexed.
Head and eyes look directly forward.
Keep hips neutral at all times, with a straight line between your knee and your ear.
Raise the hips up off the floor.
Perform the exercise in a repetitive manner, holding 2-4 seconds and repeating 10 times.
As endurance builds, hold the upward movement longer and decrease the repetitions, progress to the next level (bent knee, straight leg, then elevated top leg).
All exercises will take a few days before your client notices a difference. Corrective exercise prescriptions and strength training work hand in hand to realign the body and reduce dysfunction. When the body is misaligned there’s a lack of muscle strength because the muscles don’t contract properly. This leaves clients with unequal strength which should be realigned to reduce chances of injury. Combining these exercises in a total program will give your clients more flexibility, strength, and confidence in their fitness levels.
If you want to learn more about correcting movement dysfunctions and muscle imbalances, check out the ISSA’s comprehensive course on Corrective Exercise.
To learn more about Dr. Scott Hoar, visit www.Mobility-4Life.com
Ludewig P.M., Cook, T.M. (2000) Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical Therapy. 80 (3) 276-291
Inman, V. T., Saunders, D.M., and Abbott, L.C. (1944). Observations on the Function of the Shoulder
Joint. Journal of Bone and Joint Surgery, 26-A, 1-30
Reed D, Cathers I, Halaki M, Ginn KA. (2015). Does load influence shoulder muscle recruitment patterns during scapular plane abduction? Journal of Science and Medicine in Sport.
By now, most of the fitness world knows our society spends too much time sitting and the corresponding impacts on posture and movement. This article helps you break down how it happens and what you and your clients can do about it. Then, we give you a sharable resource you can give to your clients to help them set up their work space in a better way. Check out the latest from ISSA here.
The ISSA's Corrective Exercise Course will help you learn how to identify and correct the most common movement dysfunctions that you are likely to see in a wide range of clients.