The large exercise balls have become popular at rehabilitation centers, gyms, and in peoples homes and offices. There are so many great exercises that can be done for the core, back, arms, and legs. It’s also a great tool to use for strengthening the neck muscles.

Unlike some of the other muscles in the body, you really can’t lift weights or use resistance bands for the neck. You can, however, use the ball (and gravity) in various positions to help strengthen the muscles in the front, back, and both sides of the neck.

To strengthen the front of the neck, you can perform any exercise where you lie on the ball on your back with the head unsupported. This requires the muscles on the front of the neck to work to support the weight of the head against gravity. An example of such an exercise is lying on your back and doing a chest press with the head off the ball. If this is too difficult, you can start out by sitting on the ball and slowly reclining back as far as you can, and gently returning to an upright position. This will allow the muscles to gradually develop strength without over-stressing them.

To strengthen the back of the neck, you can perform any exercises where you lay on your belly on the ball with the head unsupported. Doing back strengthening, such as rowing in this position is an excellent example of a way to strengthen the back of the neck as well as upper back muscles. In this position be sure to keep the neck in a neutral position, so you’re not straining to look up at the ceiling or down to the floor.

The side muscles of the neck can be targeted by doing exercises on the right and left side lying positions on the ball. For example, you could lie on your side with the head unsupported and perform side leg lifts to tone the outer thighs and train the side neck muscles at the same time. If it’s difficult to balance on your side, position your feet at a wall for added stability and safety.

The neck, as with any region of the body, is more susceptible to injury when there is an imbalance in terms of strength and flexibility. Finding creative ways to strengthen the neck can help with prevention as well as rehabilitation of neck injuries.

So we decided for the first time this year to forgo the flu shot. I’ve done it in years past when I worked in hospitals and then with young children we always opted for it. My kids are 4 and 5 this year and out of the high risk age range, so we skipped it since we’re generally healthy and I was feeling optimistic.

Well, live and learn. We got the flu (and I say this diagnosis with confidence because the pediatrician did a nasal swab on my daughter to confirm that it was in fact the flu) not once, but twice. Yes, we got two different strains of the virus this year, and it hit hard. High fevers, stomach upset, and a cough that was unlike any I’ve ever experienced. And this is how my injury came to be.

From my frequent, violent, coughing fits, I managed to send my entire neck into painful spasm, to the point where I couldn’t even turn my head. It was so excruciating and every time I coughed I had to brace myself and support my neck in anticipation of the pain.

Now, I’m an advocate of early access to treatment, so after unsuccessfully trying to treat myself (and actually making myself worse by trying to stretch the joints and muscles of my neck and upper back), I went to see a chiropractor and then a massage therapist. My pain gradually decreased as my motion also improved. I have regained almost full motion, and only have pain when I cough (which has lasted over 2 weeks now) and at the extremes of motion. Had I not sought immediate treatment, I don’t believe I would be feeling as well as I am today.

I can’t stress enough the importance of early access to treatment for any type of musculoskeletal pain. It helps to restore function and prevent secondary effects from stiffness and immobilization. Although waiting it out to see what happens is sometimes OK, in many cases, you will speed your recovery time and healing process by seeking out professional care from a doctor, chiropractor, physical therapist, and/or massage therapist within the first three days.

As I sat in the waiting room at my daughter’s yoga class, I watched as some of the mom’s read magazines with their heads down, the magazine on their lap. This position with the head down in a flexed position for a sustained period can be very taxing on the neck. It should be avoided during activities such as reading and when using a computer.

Try to keep your chin level, so the neck remains in it’s neutral, upright position. In order to do this, you may need to prop something on your lap to rest the book or magazine on, so the book is more upright and the eyes can gaze forward or slightly down without straining the neck.

If you look down at your laptop screen, you could invest in a lap tray that would raise the height of your computer allowing the eyes and head to stay more level. If you find you’re always looking down at a keyboard, you could consider taking a typing class so you are able to type comfortably and accurately without looking down. If you look down at papers while working at a computer, a document holder could be an excellent investment for the health of your neck. It brings your work closer to eye level and reduces the pull on the muscles and ligaments of the neck.

So remember, whether reading, writing, working, or playing, the more neutral you align your spine, the less likely you will develop muscle imbalances and pain.

Today’s abcnews.com has a great article, titled “Headaches: What a Pain in the Neck.” It explains in a very reader friendly way how posture, muscle weakness and tightness, and bad habits can contribute to neck pain and eventually headaches.

Cervicogenic headaches, as they’re called, are headaches that stem from some type of dysfunction of the cervical spine. It can be caused by a malalignment of the cervical vertebrae, tightness in the muscles at the back of the neck near the skull as well as along the sides of the neck, or due to poor posture. In any case, they are different from migraines or tension headaches. (Consult with a health care provider to determine if your headaches may be originating in the cervical spine.)

If your headaches are caused by tightness in the cervical musculature at the base of the neck, using a Ma roller or still point inducer may be of benefit. (I have a Ma roller that I use any time I feel tension, tightness, or malalignment anywhere along my spine with immediate relief most of the time…I couldn’t live without mine.) Another simple technique to try is to roll a tennis ball along the base of the neck to help relieve tightness. Performing simple neck exercises will also be of help for cervicogenic headaches.

If you have neck pain and headaches, there is a chance that they are directly related. Speak to your health care provider and understand there are many non-invasive, non-chemical treatment options that can help you.

Congratulations…you did it! You survived pregnancy, successfully delivered your baby, and are getting to know this very special little person. Like many mothers, you may be sleep-deprived or overwhelmed, and feel a great sense of accomplishment if you can get showered and dressed before noon. You certainly don’t have the time or energy to let back pain interfere with your busy life.

Back pain? But wasn’t that only supposed to be a problem during pregnancy? Although most women believe that to be the case, many women develop upper back and neck pain post-partum. This can often be attributed to the new positions you assume while caring for your newborn. You tend to look down at your adorable child, and this repetitive forward bending of the neck and upper back can be straining. Awareness of posture and movement when you feed, carry, diaper, lift, and play with your baby can make a significant difference in how you feel and reduce your risk of injury. In general, take care when performing the following activities:

• Feeding: Sit in a comfortable, supportive chair that allows you to rest with your back straight and your head and neck upright. You may benefit from placing a pillow in the small of your back to help you sit taller. If breastfeeding, you can use a specially designed nursing pillow to support the baby and your arms, or you can cradle the baby keeping your arms supported on the armrests of the chair or pillows. If bottle-feeding, place a pillow under your elbow for support. Your shoulders should be relaxed, not shrugging up towards the ears.

• Carrying: Keep your baby centered along your midline to avoid unnecessary twisting and bending of the spine. Newborns can be held with both of your arms cradling them against your belly. Try not to look down excessively to minimize neck and upper back strain. If you carry your newborn in a car seat carrier, try to hold it with both hands in front of your body for short distances. Consider leaving the car seat in the car or connecting it into the stroller if you are walking more than a few feet. Front wearing baby carriers may be another comfortable way to carry your little one. As your baby gets older, it’s very common to carry her on one hip, which creates uneven forces on the spine. If you do this (and we all do), alternate on which hip you carry her.

• Diapering: When changing your baby, try to bend your knees (rather than bending at your waist) and keep your spine straight as you work over him. Although it may feel awkward, eliminating this slight amount of bending can significantly alleviate pain.

• Lifting: Try to always keep your back straight, hold your baby very close to your body, and lift with your legs. When lifting your baby in and out of the crib, lower the crib rail.

• Playing: Play at eye level with your baby. When he has tummy time, lay on your belly facing him. When she plays in her baby seat or learns to sit, sit on the floor in front of her. If baby lies on his back, play on all 4’s over him. Playing at eye level varies your posture, allows you to maintain better spinal alignment, and allows baby to enjoying looking at her favorite face in the whole world.

A regular exercise program is also helpful for reducing post partum pain. If you typically don’t exercise, this is a great opportunity to start incorporating regular exercise into your life so you will be able to keep up with your child who will be running around before long. You should discuss any pain you are experiencing with your health care provider, who may refer you to a specialist for an individualized treatment program.

Perhaps you’ve heard of fascia. It’s a layer of connective tissue throughout the body that lies over and between the muscles and skin and surrounds the internal organs. (It’s the stuff on raw chicken that looks like clear saran wrap). The fascia moves as the tissues do, and restrictions of the fascia can contribute to various painful conditions, including back pain, neck pain, foot pain, and shoulder pain among many others. It is also a contributor to myofascial pain syndrome and some cases of fibromyalgia.

You can visualize a restriction of the fascia like taking part of a saran wrap coating and shrink wrapping it. That area gets adhered, doesn’t move, and in the case of human fascia causes problems for the surrounding skin, muscle, and organs.
There are a few things I find helpful for fascial restrictions and pain.

1. Work with a physical or massage therapist trained in myofascial release. It’s a gentle hands on technique that helps release the fascia in its various planes. To learn more about myofascial release click here.

2. Work with a Rolfer. Rolfing is a manual therapy technique that uses more firm/deep pressure to release the fascia throughout the body. Often done as a series of 12 visits, Rolfing is a way to restore fascial mobility and reduce pain. To learn more about Rolfing visit www.rolf.org.

3. Practice Yin Yoga. Yin Yoga is a passive, quiet form of yoga. All of the postures are performed in a seated or reclined position with the muscles completely relaxed. The poses are held for 5-10 minutes in order to allow the fascia to release.

If you have pain that hasn’t resolved despite faithful stretching, strengthening, and work with a health care professional specializing in musculoskeletal injuries, maybe fascial restrictions in the body that haven’t been addressed are part of the problem.

Swimming is recognized as an excellent form of exercise, particularly for individuals with joint pain or musculoskeletal injuries. It has many benefits including the following:

• It’s a great cardiovascular workout, which can help lower blood pressure, cholesterol, and body weight, improving overall health and well-being.
• It works all the major muscle groups for a total body workout and toning.
  The hydrostatic pressure helps reduce inflammation and pain, allowing someone with a swollen knee, for example, to do gentle range of motion or even shallow water walking with less pain.
• The properties of buoyancy allow individuals with significant mobility loss, pain, or obesity to exercise with limited risk for injury.
• It’s non-weight bearing and non-impact so any conditions that are aggravated by weight bearing, such as certain cases of back, hip, knee, or foot/ankle pain, can benefit.
• The water helps promote range of motion. You don’t have to swim in the traditional sense of doing laps to use water to help encourage movement in the joints. Standing in shallow water and gently moving the affected area can be of great help.

• Various tools are available for use in the water, such as water weights and flippers that help increase resistance for additional strengthening. In addition, aqua joggers are buoyancy belts that keep you afloat and can be used to do deep water jogging for runners (and non-runners too) who are off the road due to pain with high impact activities.

If you are NOT a swimmer, meaning you don’t know how to swim the various traditional strokes (such as the crawl, freestyle, breast stroke, or backstroke) I don’t recommend swimming if you have back, neck, or shoulder pain. Faulty mechanics could actually cause more problems for you. If you’re unsure where to begin in the water, consult with a physical therapist who has experience with aquatic therapy. They can help you establish a safe program for your specific needs.

Whether at work on a computer or home in the kitchen making dinner…when the phone rings and it’s just so easy to cradle it between your ear and shoulder and continue on with the task at hand. Though convenient, doing this for even short periods can cause problems. Let’s consider, for example, that you cradle the phone between your right ear and shoulder. In this position, the neck and shoulder alignment are altered in the following ways:

1. The muscles on the right side of the neck (such as the upper trapezius) are shortened and the left side are stretched. The muscles on the right may eventually get tight, and those on the left will weaken from over-stretching.

2. The joints on the right side of the neck get compressed, and those on the left side are opened. This can cause joint mobility problems where the joints on the right don’t glide as well due to being stiff/compressed. In addition, the left neck joints can start to move too much due to excess mobility.

3. The right shoulder shrugs up, causing the muscles around the shoulder blade as well as the upper traps to work over-time. This can contribute to problems in the upper back, with the shoulder blade, as well as with the entire shoulder complex.

So, given all that, it’s best to keep the neck and shoulder in their neutral, upright position while using the phone. In order to multi-task, this can best be achieved using a phone headset/earpiece or speakerphone if available. These allow the hands to stay free and the body to maintain a more ideal alignment, reducing the risk for neck and shoulder injuries.

I used to be a stomach sleeper…really for as long as I can remember. Then about 6 years ago, my neck started to bother me. It started as a tightness on one side and some days felt like the joints were pinched and my muscles would spasm. I had a feeling it was probably from from my lopsided sleep habits, so I trained myself to sleep on my back or side.

When sleeping on your stomach, the head turns to one side, and for many people it almost always turns to the same side. This sustained position places stress on the muscles and joints of the neck and shoulder (that is either tucked underneath you or stretched out to the side) and can be a real source of neck problems. But when that’s the only comfortable position your body knows to sleep in, it can be difficult to change.

When I work with patients on changing their sleep position, I usually recommend that they use pillows to help with the adjustment process. For example, a contoured cervical pillow will provide nice support to the neck in a back or side lying position. In addition, a pillow or wedge under the knees (for back sleeping) or between the knees (for side sleeping) will help encourage you to maintain a new position. Of course, there will be nights and even many times in one night where you find yourself on your belly with pillows on the floor. When you are aware of it, change your position and return the pillows to a comfortable place for sleeping. Gradually, you will be able to retrain yourself to sleep in a way that allows the joints and muscles to be in a more neutral alignment.

My neck pain slowly resolved as I changed my habits, and I’ve worked with many patients who have seen dramatic improvement in pain levels by making these types of modifications. We do spend (hopefully) close to 8 hours a day sleeping, so the more comfort and support there is for the body during this time, the better we’ll probably feel upon waking.