Physio Blog

How does an active neck pain recovery using exercises work?

In this, the second part of our 2-part blog about ‘How to recover from neck pain by staying physically active’, we will explain how you can use ‘exercise as medicine’ to recover from neck pain.

In Part One of the blog, we showed you how to stay physically active and gave a detailed explanation of how you can train around neck pain as a part of your recovery. In this part, we will show you how you can use specific neck exercises within your recovery to build a strong, mobile and pain-free neck.

How do neck exercises work for recovery?

Research shows that neck exercises have a number of physiological benefits, including increased neck strength and mobility. It is also well established that these exercises improve function, decrease neck pain and can reduce headaches, although it is important to remember that all pain (including neck pain) is multifactorial and not only affected by physiological stressors but also psychological and emotional factors, beliefs and expectations about pain, along with lots of other things.

With that in mind, being active and exercising the neck is a great way to actively confront your pain - empowering you to feel in control of your recovery and helping to reinforce a belief of your neck as being robust, adaptable and able to handle the physical stress you place on it.

For some people, when they experience pain or injury it may be associated with anxiety and catastrophizing about the pain, like for example whether or not it will ever go away and if it will get worse if they move too much. In turn, some become fearful of exercising and being active (known as ‘fear avoidance behaviour' and 'kinesiophobia') and might rely solely on passive treatment and resting, which can have some adverse effects and may lead to decreased function and a lower load threshold which could result in more pain. As you can imagine, with this approach a vicious circle is created which can sometimes be very difficult to break.

For people with neck pain who might have been told they have “wear and tear”, “a worn out neck” and perhaps even have had imaging on the neck to show this, it is hugely important to know that degenerative changes are very normal, are very poorly related to pain and are also found in a great number of people who do not suffer with neck pain.

Diagram of findings taken from study of asymptomatic individuals

Remember this and the fact that your body is very adaptable and has the capacity to handle a large amount of load and physical stress. Move and don’t be afraid that you might hurt something - your body is strong and pain does not always equal harm or damage - in fact, your spine alone is able to withstand more than 2000 lbs of load! If you are unsure about how much you can do and where to start, find a good physiotherapist with an evidence-based and active approach and mindset, who can help you with finding the right activities and exercises in the amount that will get you recovered.

Okay, I get it - being physically active and doing neck exercises is good for my pain, but how long will it take to have an effect?

Physical activity and exercise can have an immediate effect of pain relief on your body. Exercise itself can have what is called an hypoanalgesic effect, meaning that it acts in the same way as painkillers, but without the side-effects. However, not everyone will experience pain relief immediately from doing exercise as part of their recovery and it is important to know that this is not a requirement for the recovery to work.

Sometimes it can take a while for pain reduction to occur and you might even feel some mild pain when you first start exercises, but this is often because the body has to adapt to a new stimulus. As long as the pain is mild and it gradually gets better when doing the same activity or exercises after a few sessions, this is fine and just a normal part of recovery.

Usually studies investigating the effectiveness of exercises for the neck, use interventions of 6-8 weeks, so at that point you should really be experiencing a noticeable improvement in the level of pain you have and an improved level of function.

Remember that adaptation, strengthening and increasing both physiological and psychological stress tolerance  takes time, but it is worth the effort and if you follow it through, you’ll be more resilient and have a lower risk of the pain recurring, than if you chose a passive treatment approach only.

Where do I start?

A good place to start is to use a qualified physio or physio service to help find the right exercises for you and prescribe the right amount of load, volume and frequency depending on your specific neck problem.

Most of the time, it’s not a matter of fixing any movement dysfunction, imbalances or asymmetries, but simply finding the level you’re currently at and making sure that the exercises are challenging enough, without being too challenging and then instructing you on how to do each exercise properly.

The difficult part is usually creating a habit of doing the exercises regularly within an already busy schedule, but if you can nail this, you’ll be on your way to recovery in no time! Mark Twain once wrote:

“The secret of getting ahead is getting started. The secret of getting started is breaking your complex, overwhelming tasks into small manageable tasks, then starting on the first one.”

One way to develop a new behavior is to implement it alongside something that you already have a regular habit of doing. Take one of your physio-prescribed exercises that doesn’t require any equipment and can be done while standing and then for example, do just one set of it every time you brush your teeth or every time you’re in the shower. If you’re more used to exercising, perhaps you could implement a neck exercise as a part of the warm up, during or after a run or a gym training session. Once you’ve successfully created the habit of doing one exercise, you can gradually add another exercise or multiple sets  (i.e. 2-3 sets) of the exercise you already do.

Eventually, the exercises themselves will hold enough importance in your schedule that you can start doing them as a stand-alone activity or during your normal training or within a break at work. That said, life is still busy, so try setting reminders on your phone to make sure you don’t miss a beat. You can also read how some of our users build their routines - like Veronica, who prefers to do her exercises as soon as she wakes up.

From there, it’s all about gradually building up capacity. Be consistent by doing your exercises regularly and the physio should help you with motivation and by progressing the level and load of your exercises as you adapt, to help you continue to build up strength and recover!

Wrapping up

So there you have it, remember that when you are suffering from neck pain, you should try to stay active, do your normal activities and training that you like and that motivate you. A good rule of thumb here is, “Whatever your body is able to do, it is allowed to do!”

Just remember when needed, if something is painful and the pain is not improving over time, make the necessary modifications to your training and your everyday activity. Use a physio to help you find the exercises that are at the correct level for you and make slow but steady progressions to them.

If you’re suffering from pain and want help with getting rid of neck pain and back to where it was, and even higher, then check our Reach Physio App. Here we supply you with a tailored exercise program, guide and motivate you throughout your recovery journey while you are able to track your progress.

Here’s to your active best!

Andreas Hessner


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