Neck & Shoulder Strain

Aggravated tension and related complications involving the neck and shoulders is frequently raised as a primary concern by people from as diverse backgrounds as office workers to  athletes and across geographies as far reaching as the Americas and Southeast Asia.  The concern is real and growing, and there are simple solutions available.

Cause & Context

One of the key causes of shoulder and neck pain is the pattern of holding the head in front of the body.  While looking at a smartphone, for example, a person might roll their head forward and down deeply flexing the cervical spine of the neck.  Or alternately, one might reach their head toward a computer while simultaneously lifting the chin to maintain an eye level at height with the screen.  In both cases a tremendous amount of effort is required to restrain the weight of the head forward of the body’s center of gravity. 

“For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.’  The extensor muscles running from the base of the cranium along the spine to the sacrum bear this weight.  The further forward the head, the more deeply these muscles need to engage.  And as these muscles become fatigued, more muscles in the shoulder and neck are recruited to share in the work load.

Commonly, extension of the head in front of the body lends to a flattening of the cervical (neck) curvature and an increase in compressive force - when the head is lifted up to gaze forward - on the intervertebral discs.   The shoulders round forward and the musculature of the chest and clavicular region shorten as the body follows the head.  And, to stabilize agains this forward pull, the lordotic curve of the lower back compensates by flattening.

Solutions & Approaches

First and foremost, keep the head lifted and centered over the spine as thrusting the chin forward results in shortening (i.e. compression) in the first few cervical vertebrae.  There are many techniques to correct this alignment including, for example:  envisioning a string attached to the top of the head lifting lightly upward; and extending the base of the cranium (‘occiput’) away from the base of the neck while lying face up (‘supine’) on the floor.

Have close friends support indicate when the head is forward.  Consistent reminders, encouragement and guidance go a long way toward achieving better long-term alignment of the head atop the torso’s center of gravity.  

Build an exercise routine.  There are simple, easily learned movements which can return position and tone to the neck and shoulder structure.  Robin Mckenzie, a New Zealand physical therapist, developed a technique which came to be known as the ‘McKenzie Method’ in the ’50’s.  This technique has undergone clinical trials and is now widely used for rehabilitative purposes. 

Request work from a bodyworker.  Utilize this work to explore and maintain new length in the neck and alignment throughout the upper body.  One of the most effective treatment for reducing spinal tension and compression is to gather tissue from either side of the spine - just lateral to the extensor muscles - and coax it toward the spinal column.  This movement creates incremental slack in the musculature, hence length, reducing compressive pressures directed through the bony vertebra and the softer tissue of the intervertebral discs.  Effective forms of bodywork for strains of the neck and shoulders include:  Structural Integration (aka ‘Rolfing’) which supports better alignment by working with the body directly and through movement; and, Alexander technique which focuses on posture and movement education. 

Build strength and length through yoga asana.  Specifically, lengthen the musculature across the chest and front of the neck through asana’s such as ustrasana (‘camel’) and urdhva dhanurasana (‘wheel’).  Investigate this approach under the supervision of a capable yoga teacher to avoid strain or further injury.

Develop a self-treatment routine.  Lie supine with elbows bent and the fingers of either hand touching into the sides of the cervical vertebrae.  A wide and somewhat dense strip of tissue overlays these vertebra - from the occiput down to the 7th and final cervical vertebra - called the 'nuchal ligament'.  Ease several fingers into and just beneath the edge of this ligamentous strap.  Coaxing the tissue  centrally along its entire length can result in a huge difference in neck tension.  

Finally, it is interesting to note that tension in the neck can be caused by tension in the jaw and / or eyes.  Muscles providing fine motor control to actions such as swiveling the head are habitually synchronized with eye movements, and insert in close proximity to those of the jaw.  
Soften the jaw while doing the exercise above. Then, conceptually, let the eyes fall to the back of the skull while softening the gaze. 


One of the primary causes of neck and shoulder strain is an habitual extension of the head in front of the body.  The impact of this imbalance is heightened spinal curvatures, compression across impacted vertebral and disc segments, and tension and exhaustion in synergistic muscular systems.  The stress caused by these imbalances can be easily reduced by simple postural realignment of the head atop the body’s center line.  Support for positive change to redress this pattern is widely available - ask a friend for a reminder, spend some time in exploratory mode with the tissue bordering the cervical spine, or invite the help of therapeutic bodyworker. 

Research Articles of Significant Interest

‘Forward Head Posture - The 42 Pound Head’, Eric Dalton, Ph.D.
‘Cervical Injuries’, Ben E. Benjamin
‘Upper Crossed Syndrome (UCS)’, Vladimir Janda, general reference and overview



Mitchell Gold is an Advanced Practitioner of Structural Integration (aka ‘Rolfing’) and an Authorized (Level II) teacher of Ashtanga  To Vinyasa Yoga.  For more information about his trainings, or to write him directly, please go to:  http://www.structuralbody. And com.