Posts by Mark

the forward head posture-dont be a neanderthal!

If you are waking up in the morning with a stiff neck you can pretty much bet it’s your pillow that’s at fault. There are a multitude of pillows on the market and you could lose sleep just thinking about which one to buy.

One of the most important things to think about is whether the pillow that you currently are using is the correct height for you. This is the key to having a pain free neck at night time and of course, when you wake up. Your neck needs to be well supported and in a neutral position when you are sleeping.

So the first question you need to ask yourself is whether you sleep on your side, back or turn a lot. These will impact the height you are going to need for your pillow.

Having your neck in a neutral position means that your head is neither pushed forwards, backwards or hangs sideways. If you are laying on your back you head should be nicely level. On of the problems with the foam pillows are that they can be too stiff and your head doesn’t sink into them which leaves your head thrust forward. This is a surefire way to get a stiff neck and compress the upper cervical vertebrae. Also if you use a feather pillow your head can end up sinking too far into it which puts your head into extension and aggravates your joints again. The same thing happens if you are lying on your side so for this reason I don’t recommend either of these pillows. However, having said that, it may be possible to but a foam pillow that is not too thick and supports your head in a neutral position none the less.

Find that the contour pillows are by far the best. It’s worth spending the extra money on these types of pillows simply because they are extremely good and help the vast majority of neck pain sufferers. You can also see these studies if you put ‘memory foam pillows studies’ into Google and you will find the research done.

Another cheap way to see if a contour pillow will help is to use your pillow and roll up a towel to the thickness of about one and a half to two inches thick and place it under your neck for support. This will give your neck the needed support and if you have the level correct, it will also have your neck placed in a neutral position. You have pretty much made yourself a cheap version of a contour pillow and it is a good way to feel the extra support that this type of pillow gives.

If you are still having pain when you wake up you may need to address other factors that may be aggravating your neck. The most common reason for neck pain and neck related headaches are poor posture. If you sit in a slouched position at your computer for hours on end this will most definitely aggravate your neck. It is the most common cause!

Cortisone can be a ‘magic pill’ for some people but be very careful.

I was speaking to a good friend of mine who was in a great deal of pain. I asked him what had happened and he told me that a rather small problem that he had had was now a big problem. He explained to me that he had had been suffering from pain in his Achilles tendon. The doctor didn’t seem to know why he had this pain so he recommended that he get a series of cortisone injections to ‘see how that went’. After the first one he felt a bit better, then the next he felt better again and a few days before he was scheduled for his third injection he felt ‘like someone hit him in the back of the calf’ and now he had severe bruising in and around his Achilles tendon and ankle and was no longer able to walk without the aid of crutches. The doctor took a look at him and couldn’t understand what had happened so sent him off to get some physiotherapy for his ankle. This is where he should have gone to in the first place

So what is wrong with this picture?

Why don’t we first take a look at cortisone injections themselves? They have been around since the 1950s and are used to decrease tissue inflammation so that the area can then heal. This is the theory. But why is the area inflamed? This is the number one priority-getting to the cause of the problem not just treating the symptoms. Let’s take a look at another example.

I will use and example of a new client who came to see me last week. This person was suffering from neck pain and had tried everything from prolotherapy to acupuncture to chiropractic to Rolfing. However, his pain still existed. The whole time he was speaking to me he was sitting in a slouched forward head posture. I could see by his posture that this was his major problem and would be our first area to look at. The thing about poor posture and particularly a forward head posture is that it affects the upper back, neck, shoulders, lower back and so on and so forth. A forward head posture has a huge knock-on effect throughout the rest of the body. In other words, many of your problems will be caused (and fixed) by addressing this first.

I knew by looking at him that his shoulders were also forward and internally rotated which will impinged the shoulder joint and set him up for shoulder problems. I asked him if he had had shoulder problems in the past and he said ‘oh sure, I have had 3 cortisone injections in the left shoulder and 2 in the right but they didn’t really work’.

Of course they ‘didn’t really work’ because the cortisone injections will never fix the cause of the problem which is known as ‘upper crossed syndrome’ or ’rounded shoulders’ or ‘shoulders that are too far forward and internally rotated which lessen the space in the shoulder joint and cause impingement or better put, constant mashing of the soft tissues.’ The cortisone may have had a temporary effect as it reduced the inflammation and impingement but the cause of the problem was never addressed (i.e. shoulders too far forward and internally rotated causing pain and inflammation) and therefore after a short while the pain returned.

The story doesn’t end there. Not only do cortisone injections hurt but they have a corrosive effect on the cartilage and soft tissues. This, I don’t need to tell you, is NOT GOOD!

This brings me back to my friend with the Achilles tendon problem.

The major cause of prolonged pain and dysfunction from injuries is from lack of appropriate rehabilitative exercises. If you have an injury you MUST do stretching and strengthening exercises as soon as possible. (After the initial 48 hour inflammatory phase).

So my friend has, in my opinion, been getting treatment in ‘backwards- forwards land.’ He has come to see the doctor and instead of getting treatment for it such as physical therapy, which means stretching and strengthening exercises and soft tissue/joint therapies he was given cortisone injections. Here was a person who needed to strengthen his tendon and stretch it out to recover it to full function but what he got instead was something that masked the problem. He should have been getting therapy to allow the fibers to knit into a strong and flexible repair so that he could regain his strength in the soft tissues. However, instead he was now walking and running around with a torn tendon but now he could apply more pressure through the tendon thanks to the analgesic properties of the cortisone. Now, he could walk harder and faster which enabled him to damage his tendon further. Every pain free step would enable him to tear those tiny fibers more and more until finally something had to give- and it did. His tendon, thanks to the deadening effects of the cortisone and the added benefits of the corrosive properties of the cortisone pushed his Achilles tendon past breaking point and it snapped. Where is my friend now? He is getting physiotherapy 3 times a week to try to heal the area which is now much worse than the original problem.

So my advice to you is this. Just because your doctor or therapist doesn’t know why you have pain is no reason to jump into a series of cortisone injections. They are not good for your body, they are a corticosteroid. There is no reason to start putting more chemicals into your body when you may not have to. Seek another opinion. More than that, make sure that the cause is being addressed not just the symptoms. Are your shoulders painful because of major muscular and structural imbalances? Can you stop your osteoarthritis getting worse simply by postural and structural modifications?

If a person has sciatica and back pain because they have disc bulges in their lower back and need surgery I would want to see first why they have disc bulges in the first place. Is it because they sit slouched at their desk all day and night? Is it because they lift things poorly? If this is the case, and they elect to have surgery and do not stop these bad habits, what is stopping the next weakest links above and below the fusion from doing the same thing? Nothing. If you have blown your L5-S1 disc because of these very reasons and then after surgery( all going well) you feel better but continue to sit, stand and lift poorly you will put these same forces on your discs AGAIN and the problems will still be there. You are still causing your discs to be pushed backwards, straining your ligaments and soft tissues. Likewise, a cortisone shot will not fix your back pain from bad lifting techniques if you continue to lift badly

Your neck is no different. You MUST remove the cause of your neck pain.

Have you suffered from a Whiplash injury and still have neck pain?

Here is some very good news.

It could be simply because of one very simple thing that you are doing that is causing your pain. Over the Past twenty years I have seen hundreds of people who have had whiplash injuries and they had pretty much given up all hope of removing their neck pain and suffering. However, after I showed them how to reduce the strains on their necks which would allow their necks to heal completely-their symptoms disappeared. That is, their neck pain that they had been suffering from for so long was no more. It is not a magic trick, as you will see; it’s just simple body mechanics.

I won’t bore you with the basic facts in regards to a whiplash injury because if you have it I am sure you have read volumes on the internet about ‘acceleration-decceleration’injuries. Of course, the most common reason people have whiplash injuries is from car accidents and the forces generated can be as much as 15 G forces through the neck. This amount of force can damage the capsules, ligaments and other soft tissues and even the vertebrae and discs. Then after time the neck should heal. However, many people put enormous forces on their necks all day every day which causes their neck pain. Remember, over 80% of neck pain is postural. I put that estimate at a very conservative level because many people with neck pain who have been diagnosed with pain from whiplash or arthritis can still have pain from their posture, not their arthritis!

Let me explain. If you have arthritis or a whiplash injury that is now chronic and you continue to sit with poor posture, namely the ‘forward head posture’ how will you ever know if your whiplash or arthritis pain is coming from your whiplash or arthritis? If over 80% of people have neck pain from their posture( look around your office or workplace, bus stops, your home and nearly everyone who uses a computer and you will see people who are slouching with their heads in a forward head posture.) it is endemic in our society and is getting worse! Now with teenagers sending text messages all day and when they are not doing that they tend to be slumped over their laptops for hours on end the problem in the next ten years will escalate enormously. A year ago in December in the United States, Americans sent 48 billion text messages- in the month of December alone! Last December, it increased to 110 billion. That means a lot of happy telecom companies, physical therapists, massage therapists etc and a lot of unhappy people with neck pain.

The mayo clinic state that the forward head posture leads to long term muscle strain, disc herniations and pinched nerves. So here you are with an already injured neck and injuring it further, or at the very least- not allowing it to heal- because you are constantly straining the soft and hard tissues.

A forward head posture is what produces over 80% of neck pain. It is THE cause. Don’t believe me? Go back to Google and check out the major cause if neck pain and you will see that it is postural. What does postural mean? A forward head posture. So, if you spend most of your day sitting and standing like this, how will you ever know if your pain is simply coming from your posture? You won’t until you fix it. You must fix the cause to remove the symptom-pain.

This is how I have helped hundreds of people who felt that they had to live with their pain forever. People with arthritis who were simply sitting poorly and compressing their joint capsules and facet joints became pain free almost instantly. People with whiplash injuries who addressed their posture day in and day out saw their pain subside and leave them permanently.

As I said, this is not a magic trick or some ‘new fabulous wonder technique’. It is basic mechanics. This is the exact reason why millions of people suffer from neck pain daily. This is the exact reason why the mayo clinic state that it leads to ‘long term muscle strains, disc herniations and pinched nerves’ and the exact reason why you too can become pain free.

If you suffer from neck pain or perhaps even pinched nerves I suggest that you read this.

A very common scenario:

You spend all day slouched in front of a computer, slouched watching television, sew, write, eat and drink with poor posture and even drive with your head protracted forwards. You also ‘mysteriously’ suffer from neck pain. You are completely unaware that this ‘forward head posture’ not only causes neck pain, (and is in fact the major cause of neck pain) but also causes great strains on your discs. Then one day your disc finally can no longer resist the tremendous forces being applied by your prolonged poor posture, gives way and herniates(bulges) and then presses on a nerve. This then causes you immense pain and or weakness and or numbness in your arm and or hand.

You go to a surgeon and he tells you to take some muscle relaxants and some painkillers. You do this and it gives you some temporary relief however you continue to slouch at your computer, whilst driving your car and when you read your favorite book in bed at night. Unbeknownst to you, the discs are still continually being forced backwards towards the nerve again. It is only the anti-inflammatory effects of the drugs that you are taking that is keeping the nerve from being pinched severely once again.

After your ten day course of drugs from the surgeon you feel a bit better (if you’re lucky) but another week goes by and your problem comes back again. Why? because you continued to slouch and sit and stand with a forward head posture and thus continued to exacerbate your problem. You never once removed the cause of your problem. Just like having a sore thumb from hitting it with a brick, its not until you stop hitting your thumb with the brick and remove the cause of your pain will you be pain free and allow the area to heal.

However, you are not told that the forward head posture is the cause of your disc protrusions and pinched nerve. You are scheduled for surgery because the numbness has become worse and the pain is now also much worse. Your sleep is also badly affected. You buy pillows to help your neck but of course it is nothing more than a bandaid because the majority of damage is being done during the day because of your poor posture. You spend thousands of dollars on chiropractic, massage and acupuncture treatments and never get anything more than temporary relief at best. Why? The cause has still not been addressed.

You finally commit to surgery. However, even after surgery you have not been told that the forward head posture is the main cause of neck pain. You, if you are lucky, are told that you should sit at your computer in good posture but it is nothing you really spend much time thinking about. After all, you have just had your neck fixed from the surgeon right? (At this point, lets assume that the operation was successful-meaning you are not paralysed and/or the pain is not worse or the same as it was before).

You have your surgery, you do your rehab and then go about your daily life again. The area where you had your problem is OK now( as such) because it is fixed by titanium. However, you go back to your slouching at the computer again, spending long hours reading and writing your books, sewing, driving, and doing crosswords all with a forward head posture once again. Now, the strains are being put back onto your neck once again. This time its on the areas above and below your vertebrae that were operated on. Are you headed on exactly the same course as you were before?

Absolutely! Your neck pain, disc bulges and pinched nerves due to the forward head posture are completely avoidable.