As promised last time (see A Literal Pain in the Neck), I want to look at a more specific cause of neck pain today and talk about ways to approach it with your yoga practice. And as in “life imitates art,” I was on a red-eye flight last week, and despite my use of the neck pillow and good sleeping alignment, my four-hour plane nap left me with a very stiff and sore neck. In all likelihood, the source of my discomfort was my neck muscles suffering a mild strain from the unnatural immobility I placed them in. Muscle strain and spasm is probably the most common source of neck pain in all ages, young and old. But although it holds the number one spot, the good news is that it is also the one that is most likely to resolve quickly, especially if addressed appropriately. You can bet your bottom dollar I was doing some of the exercises described below the next day!
Now here comes an overarching principle that will likely apply to other causes of neck pain we will cover down the road: when your neck is hurting, avoid putting direct pressure on your skull and neck structures. That is, avoid poses like Shoulderstand, Headstand, Plow pose, Rabbit pose and the like while you are hurting. Especially in the case of muscle-related neck pain, you should be able to return to these poses when your muscles return to working order. I also have a secondary caution for certain standing poses, in which your neck is hanging out in space and your muscles are fighting gravity to keep your head in the requested alignment of the pose. The two examples of basic poses include Triangle and Extended Side Angle poses, which can then be extrapolated to Half Moon, Revolved Half Moon, Revolved Triangle and Revolved Side Angle. To keep your head in the traditional position in these poses you need to work multiple muscle groups in harmony. Even Warrior 3 could be a challenge if the offending muscles are on the back surface of your neck. And in reality, you will need to carefully assess all of your asana that requires significant contraction or stretch of the neck muscles.
So now that you have a few cautions to consider, what can you do when you get a muscle spasm or strain the muscles in your neck? On way to assess and to begin to encourage gentle movement in your neck is to lie down in Constructive Rest position (lying on your back with your knees bent and feet on the floor).
Another way to influence your neck somewhat indirectly, or maybe less obviously, is to work on arm movements that involve neck muscles. So, from Constructive Rest, inhale your right arm up and overhead to floor behind you, and then exhale your arm back down to your side. Repeat with your left arm. Keep your arm straight, creating an even arc of movement in what is referred to as, in anatomical terms, flexion and extension at the shoulder joint. Do this about six or so rounds. When you finish, pause for a few moments and see how your neck is feeling. If things are quiet, proceed to the next exploration, which combines the two previous exercises.
Still in Constructive Rest position, inhale your left arm up and overhead, and as you do so, gently roll your head to the right shoulder. As you exhale, bring your head and arm back to the starting position. Repeat on the second side, doing a minimum of six rounds. Upon completion, pause and re-assess. If you are doing fine at this juncture, move on to Dynamic Bridge pose, as way of assessing your neck’s ability to safely bring your chin to your chest, or to flex your cervical spine. From Constructive Rest, move your heels about four inches from your hips, with your arms resting at your sides. On an inhalation, lift your hips up just two to three inches off the floor. On your exhalation, lower down. Repeat for six rounds, gradually lifting up a bit higher each round as your neck permits. When dealing with an injury like this, check in with your neck after completing each series of movements before moving on.
To assess and work with the opposite action, extension of your head and neck (the movement you use to look up to the sky), try a low Cobra pose. Flip over onto your belly and rest your forehead or chin on the floor, depending on which action feels better your neck. Place your hands palms down on the floor beneath your shoulders, and as you inhale, gently lift your head, neck and chest up a few inches into low Cobra pose. In this low back bend, try to keep your head and neck in line with the gentle curve of your spine. Exhale and lower down. If that felt ok, on the next time up, let your chin lift up an inch higher, so your neck is taken into gentle extension. Repeat this process, you guessed it, six times, finding the most appropriate amount of extension of your neck and not going past that. Rest and assess before going further.
If all is well, I’d recommend you sit up in a comfortable seated position and follow the Prime Directive, that is, lift from your sitting bones through to crown of head. From here, repeat the gentle rotation movement you did lying down by inhaling as you rotate your head gently to the right and exhaling it back to center. Repeat to the left. Do six rounds. I call these Owl turns, for obvious reasons.
Curious Dog Tips are next. As you inhale, side bend your right ear towards your right shoulder, then exhale back to center. Repeat on your left side. It is helpful to do these in a mirror to make sure you are not adding in any rotation of the neck. Do six rounds and assess. This last movement stretches and contracts the scalene muscle group in the neck, which is a frequent culprit in muscular neck pain.
From here, you can start to explore some of your more basic poses. Two that I like for their gentle tractioning qualities on the neck are Standing Forward Bend (Uttanasana) and Downward-Facing Dog. In both cases I would encourage you to let your head dangle towards the floor so gravity can help to passively stretch your neck. If you feel okay in these positions, you might shoot for 90 seconds in order to give your muscles the maximal chance of lengthening.
Simply doing this complete group of explorations as an initial return to yoga for a while is a good way to start the healing process. Folks always want to know how often to do this routine, but this really needs to be individualized. However, having said that, I’d do it every other day for a week and see how you are progressing. I always find the following time periods helpful in assessing the safety and appropriateness of my plan:
• a few hours after the practice
• before bedtime the day of practice
• the next morning
• 24 hours after practice
The less pain at each of these intervals the better! If you are feeling your neck pain diminish, gradually add more poses in, saving the caution group for last. Many of these same exercises will be helpful for other causes of neck pain, but modifications will apply for situations such as arthritis of the neck, which we will take up next we visit neck pain and yoga.
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