What you should know when you have stiff shoulders or cannot turn your neck
There is something important to know when you have stiff shoulders or cannot turn your neck. The neck is a vulnerable area that is easily affected by the lower back and legs, even though they are far away from it. That is why, when trying to solve neck and shoulder problems, it is important to check whether the cause may actually be somewhere else in the body.
There are many different situations in which the neck will not turn.
・Cases where you suddenly cannot turn your neck when you wake up in the morning (a crick in the neck)
・Cases where you suddenly cannot turn your neck after looking behind you (an acute neck strain)
・Cases where your neck does not turn well on a regular basis
The severity and triggers vary, but many people who cannot turn their neck or who develop a crick in the neck have one thing in common: the cause is often not actually in the neck itself.
The human spine runs from the neck down to the pelvis, but the bones in the neck are thinner than the bones in the lower back and pelvis.
This is because the neck became more mobile in exchange for having slimmer bones. The neck also has less muscle mass.
However, because the neck has an unstable structure, it is easily pulled by stronger muscles. So where are those powerful muscles located?
This illustration shows a test to see whether loosening the muscles in the lower body improves how far the neck can turn.
The patient is asked to turn the neck while the hips are bent. Sometimes, a neck that would not move before starts to turn.
What this hip-flexion test tells us is that the muscles causing the neck problem were actually in the lower body.
Lack of exercise and smartphone use have a major effect on the neck and shoulders, but it is rare for only the neck and shoulders to be affected. More often, the effects spreading into the lower back and legs make neck and shoulder problems worse.
You may already have tried many things, such as consciously moving your shoulders or stretching your armpits. Even so, the reason you still have not felt fully better may be the order in which the muscles were loosened. If stronger muscles than those in the neck and shoulders are allowed to keep throwing the body out of balance, the discomfort can continue indefinitely.
To solve problems such as stiff shoulders or an immobile neck, it is important to find which parts of the body are not moving well, and then stretch the muscles that are restricting movement, starting with the larger muscles first.
- Have already reviewed their chair or pillow
- Practice yoga or stretching
- Have received massage or similar treatment
The key to solving this problem is understanding your body’s habits
We have seen that the problem often lies in muscles other than those of the neck and shoulders, but how can we identify the exact cause?
There are about 400 muscles that support the body’s framework. With so many muscles involved, it can be difficult to tell which one is actually causing the problem. That is where testing becomes useful.
This illustration shows a test of the back muscles. The reason for checking this area is that the muscles supporting the back are very strong and have a major influence on the neck.
Ideally, you should be able to rotate your body equally well to both sides. If the muscles on the left and right sides of the back are used unevenly, a difference will appear in how easily you can turn.
One reason for this left-right difference in back muscle use is scoliosis, which is a curvature of the spine. Many people have a slight degree of scoliosis that does not require medical treatment.
In some cases, the tilt of the spine is caused by the abdominal muscles. For people who have problems with this test, neck and shoulder pain will improve only after the abdominal muscles are also relaxed.
Treatment record
Let us look at a treatment record to see how symptoms such as not being able to turn the neck, along with stiff shoulders, can improve step by step.
- Symptoms: Cannot turn the neck. Stiff shoulders. Occasional headaches.
- Age: In their 20s
- Job: Desk work
- Things tried so far: seitai, yoga
If we put the events so far in chronological order, the course has been as follows:
- They developed frozen shoulder while in high school.
- They had no shoulder stiffness while at university because they exercised regularly.
- After starting work, stiffness developed in the neck and shoulders due to desk work.
- At a seitai clinic, they were told that the pelvis was misaligned.
- They practiced yoga for a while.
- The pelvis seems to be part of the problem, but the neck and shoulder issues still have not been resolved.
A variety of tests are carried out to identify the cause. Every part of the body has a natural range of movement. If a part cannot move as it should, or if movement is harder in one direction than another, that area may be contributing to the pain.
Test results
The examination showed that factors contributing to a rounded posture were hidden across a wide area, including the legs, chest, and neck.
Here, the patient turns the head to the left and right to check neck movement.
Ideally, the neck should rotate about 60° to each side, but when turning left, it stops partway through the motion.
Problems like this do not affect only the neck. When the neck cannot turn far enough, the chest and lower back compensate by rotating instead, but over time the strain builds up and may eventually lead to lower back pain.
When it is difficult to turn left, the left shoulder blade is often not in the correct position. Since the frozen shoulder in the past was on the left side, it is likely that the left shoulder blade has had problems for quite a long time.
Next, the shoulder blades were checked.
Although the patient complains of pain in the neck and shoulders, I do not touch those areas from the beginning. There are two reasons for this.
① It can worsen inflammation and increase the number of visits needed
When you massage the shoulders, blood flow definitely improves for a moment, so it feels good temporarily. However, the muscles producing the pain are inflamed, and pressing on them can make the inflammation worse. If that happens, the pain can continue constantly, and during treatment it becomes impossible to tell whether the symptoms are actually improving or not.
In that situation, you cannot judge improvement on the spot, so it leads to comments such as, “That is all for today. Please see how it goes for a while,” and the result is more clinic visits. Increasing the burden on the patient is not desirable.
② The cause is often not in the place where the pain is felt
When pain appears in the neck or shoulders, the cause is often hidden somewhere farther away, such as the lower back or legs. Shoulder massage may feel pleasant, but it does not address the root cause.
In some cases, the painful muscles are actually muscles that should not be loosened. If that is the case, more treatment only makes things worse.
For these two reasons, even though the patient has pain in the neck and shoulders, I do not start by touching the neck or shoulders.
Treatment details
Here is an example of a treatment approach that is characteristic of seitai.
When people hear the word “seitai,” they often imagine correcting distortion, like a pelvic adjustment. In reality, however, we sometimes intentionally create more distortion first.
A body habit is the tendency to keep moving or leaning in the direction that feels easiest, even when that movement pattern is not ideal. By moving in a way that brings out that habit, we can guide the body back toward correct posture.
In this illustration, the patient performs a movement that intentionally increases the lower-back arch in order to correct an excessive arch. By adding the right amount of resistance, the tilt of the pelvis is guided back toward its proper position.
Because resistance is applied, this becomes a light form of strength training, so breaks were taken in between. It is a form of seitai that improves the body while leaving a pleasant sense of healthy fatigue.
The patient was asked once again to try the movements that had been painful during the examination before treatment. She confirmed for herself that there was no longer a problem with the neck movement that had concerned her most.
I suggested that she continue exercising, as she had done during her student years. From experience, she already knew that exercise could improve shoulder stiffness. However, when you exercise with a body that is not functioning properly, the muscles and joints that are easiest to move end up doing most of the work, which places too much strain on them. The yoga she had stopped doing is also an excellent form of exercise, so now that her muscles have regained their natural movement, she should be able to feel its benefits even more clearly.
We then teach exercises to reset the body’s movement habits, and the treatment is complete.
The neck sits at the very top of the body and is influenced by the whole body, which makes it a difficult area to treat. Here, I answer a common question that many people run into when trying to solve this problem.
You won't know unless you examine it.
I highly recommend you try stretching. Stretching can be extremely effective if you target the areas that need stretching. That's why there's a key point to keep in mind: how to identify the muscles that are causing the stretch and how to stretch them safely.
To achieve optimal results, follow these steps:
1. Check the background of the problem, such as what caused it and your lifestyle habits
2. Conduct an inspection to identify the contributing factors
3. Treatment
4. Retest to confirm that the expected results are achieved
One of the reasons for asking about the background of ① is that if there has been a major external influence such as an accident, the test results may be inconsistent. This is to prevent incorrect treatment.
The purpose of alternating between the examinations and treatments from ② to ④ is to constantly check whether the treatment plan is correct. It is the same idea as using a map and compass to check your direction to get to your destination.
Just like fingerprints, the condition of each person's neck is different, so it is extremely difficult to select a stretch that is "OK" without examining the individual. Therefore, there are risks involved in trying a stretch selected from the many available without a clear basis for its effectiveness.
The risk is that you may be loosening muscles that shouldn't be loosened. If you loosen the muscles that are pulling on your posture to prevent it from getting worse, it will only get worse. I once stretched the wrong muscles, which left me unable to walk and left me with a hunched back that I've never experienced before. This is why you should be careful when choosing stretches.
The answer to the question, "What stretches are good for stiff shoulders or stiff neck?" can only be found by seeing someone who is knowledgeable.
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Steps for solving the problem through seitai
The way we use our bodies, shaped by childhood play, sports, accidents, childbirth, and many other experiences, creates the physical condition we have today.
If you are feeling pain, it is simply your body telling you that there has been a problem with how you have been using it up to now.
The first stage of solving the problem is to stop the pain. Once the cause has been identified through examination and treatment has been given, the pain will lessen. Only after the pain has improved is the body ready to learn correct movement patterns.
The second stage is learning how to use the body correctly. This changes both the body and the brain so that you do not return to your old condition.
Because physical pain is often related to daily habits, stretching and exercise become necessary. Like brushing your teeth, steady repetition is important.
If you want to solve your pain, first stop the pain. Stretching and exercise come after that.
