Chronic neck pain is commonly due to neck muscles being either neurologically underactive or overactive. However, as each neurological dysfunction will inevitably cause the same symptom presentation (muscles shorten and tighten), it is essential to individually test each neck muscle to determine the dysfunction (underactivity or overactivity) before treating the neck accordingly.
Many therapists commonly attribute neck pain to bad posture, and it is true that many people with bad posture have neck pain, but it is equally true that many people with bad posture do not have neck pain. Believe it or not, that older person walking down the street stooped forward, back bent in a curve with their head jutted out in front of them does not necessarily have neck or back pain. The body and brain are highly adaptable, the notion that poor posture causes pain has been inappropriately postulated for too long by therapists without sufficient evidence to back this up.
In SensoriMotor Repatterning (SMR), I do analyze clients’ posture, but by no means does it govern how I treat neck pain. The big take away from my years of treating chronic neck pain is that some people’s necks have a tendency to become overactive (up-regulated) and some underactive (down-regulated) and I need to determine which before I resolve the pain.
An inhibited group of neck muscles will cause the nervous system to feel unstable; thus, it will shorten and tighten the neck muscles to gain stability. The nervous system will always give up mobility to achieve stability. On the other hand, an overactive group of neck muscles is always engaged; thus, they become tight and short as a result of excessive usage. Hence we have two completely different mechanisms that end up with the same outcome: short and tight neck muscles and chronic neck pain.
Knowing which mechanism has caused neck dysfunction allows SMR to reverse the process and get people out of chronic pain.
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References:
https://www.bettermovement.org/blog/2014/does-bad-posture-cause-back-pain
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