An Easy Rehab Exercise Progression for Neck Pain

By djpope

February 26, 2017

cervical spine, deep neck extensors, deep neck flexors, neck, neck exercises, pain, physical therapy, progressions, protocol, Rehabilitation

There’s a plethora of research showing that training the neck and scapular musculature is beneficial for people with neck pain.  Protocols that involve motor control training, strength and endurance for the deep neck flexors and musculature like the serratus anterior, rhomboids and low / mid trapezius are generally helpful.  Here are a few of my favorite exercises to target these areas:

  1. Easiest: Top Left – Deep Neck Flexor Motor Control
  2. Moderate: Bottom Left – Deep Neck Flexor and Anterior Neck Strength and Endurance
  3. Advanced: Right – Partial Get-ups
    • Partial get-ups are great because they incorporate deep neck flexor training while working the scapular musculature simultaneously.  For most of my patients this step is imperative because they’re mostly all trying to get back to high level training (pressing things overhead, handstands, handstand pushups).  I think this is often a step we miss as therapists attempting to bridge the gap back to performance.

Potentially as important as training the deep neck flexors are the deep neck extensors.  Professor Gwen Jull talks extensively about this in this BJSM podcast if you want more information.   We can go through an easy progression for these muscles as well.

  1. Easiest: Top – Deep Cervical Extensors
    • This exercise I got directly from Gwen Jull.  The idea of this exercise is to keep your eyes on your hands throughout the movement.  This allows us to selectively train the deep neck extensors and minimize the more superficial extensors.
  2. Moderate: Bottom Right – Plank Variations
    • Once athletes are tolerating the first variation well I generally like to progress toward plank variations.  In this way we train the cervical extensors while simultaneously working the core and serratus anterior.
  3. Advanced: Bottom Left – Crawl Variations
    • Lastly are crawl variations.  Crawl variations are excellent because they simultaneously train the core, neck extensors, serratus anterior and posterior scapular musculature.  They’re also nice and challenging for athletes to perform.

I’ve always felt that there aren’t very good rehab progressions out there for people with neck pain trying to get back to high levels of fitness.  Here are some of my favorites.  Give them a shot and let me know what you think.

I Love Neck Pain,

Dan Pope DPT, OCS, CSCS, CF L1