Neck Pain with Movement Coordination Impairments
Neck sprain/strains can occur due to a variety of factors including posture, ergonomic set up, excessive loading, and trauma. If your patient complains of tightness or spasm in the neck region along with difficulty maintaining static postures, a neck sprain/strain could be the culprit! For more clinical findings click here!
Anatomy
Key Finding
The upper trapezius can often times be a tissue source in patients with a neck sprain/strain. Lengthening, contracting, and palpating the suspected muscle can help the clinician better rule in the likelihood of strain! Take a look at how to assess upper trapezius length. (Click image to watch 1-2 minute video)
Clinical Side Note 1: Considering that the upper trapezius and levator scapulae share similar locations, assessment of the levator scapulae may prove to be beneficial as well.
Treatment
Often times the upper trapezius (or levator scapulae for that matter) becomes irritated, not necessarily due to overactivity in a shortened position, but due to overactivity in a lengthened position secondary to variables such as poor posture. This forced activation in a lengthened position can eventually result in irritation of the tissue over time. The purpose of the post isometric relaxation technique is not to stretch the muscle, but to help relax it. Take a look at how its done! (Click image to watch 1-2 minute video)
Therapeutic Exercise
As mentioned previously, the middle trapezius is one of the muscles that is often under-active in individuals with a neck sprain/strain. Strengthening of the scapulothoracic musculature can assist with supporting the strained tissues and further reduce the amount of strain over time! (Click image to watch 1-2 minute video)
Clinical Side Note 2: Postural impairments tend to be present in these individuals. Do not forget to address posture and ergonomics. Make a functional change in something they are doing daily!
Clinical Side Note 3: Research also supports the use of thoracic spine manipulation (if deemed appropriate) in individuals with neck pain! If thoracic spine hypomobility is considered to be an associated impairment, consider adding this to the treatment plan!