Don’t Neglect The Neck

Dr. Westcott

A few years ago, we conducted a research study with elderly residents of a large nursing home in Orange City, Florida. The 20 study subjects averaged almost 90 years of age, and spent most of their waking hours in wheelchairs. Their major problem was physical frailty, which we sought to address through a basic and brief program of regular strength training. Our major challenge was to get them out of their wheelchairs, and we selected four weightstack machine exercises that effectively served this purpose. However, our fifth exercise was the neck machine to strengthen the muscles that were supposed to hold their heads erect.

We included the neck machine because these frail older adults were almost incapable of lifting their chins off their chest. Due to incredibly weak neck muscle that could no longer hold their heads erect, these seniors had more difficulty breathing, eating, drinking and looking forward, as well as considerable discomfort in their neck/shoulder area.

After 14 weeks of strength training (1 set of 8 to 12 repetitions of the 5 exercises twice a week), the subjects added 4 pounds of muscle, lost 3 pounds of fat, increased their leg strength by 80 percent, increased their upper body strength by 40 percent, improved their functional capacity (FIM score) by 14 percent, and spent much less time (if any) in their wheelchairs. However, in our opinion, the most impressive outcome of the study was the renewed ability of the participants to hold their heads erect. In their opinion, the best result of the strength training program was the reduced discomfort in their necks and backs (we also included the low back machine in the five exercise training protocol).

Because an average-sized head weighs between 12 and 15 pounds, the neck muscles are extremely important for maintaining proper head position whether we are walking, standing or sitting. Strong neck muscles are our basic defense against the force of gravity that constantly works to pull our heads downward and forward. When our heads spend too much time in the downward/forward position, we typically experience a variety of undesirable degenerative problems (and discomfort) in our musculoskeletal system.

In addition to reducing the risk of chronic neck problems, strong neck muscles help protect us from traumatic neck injuries, such as severe whiplash from rear-end car accidents. Athletes who play contact sports, such as football, basketball, soccer, lacrosse, hockey, rugby and baseball are also at a greater risk for neck injuries. So are sports participants who have a higher probability of falling, including gymnasts, skaters, skiers, rock climbers, horseback riders and cyclists.

Even people who are completely sedentary can benefit from strong neck muscles, because muscle condition and bone condition are closely related. With progressive resistance exercise, neck muscles add myoproteins to become stronger. The same training stress is transmitted through the tendons to the bones, which likewise add collagen proteins to become stronger and more resistant to osteoporosis and other degenerative processes.

Unfortunately, most people pay no attention to neck strengthening exercises. Their necks gradually become weaker and weaker, and the cervical vertebrae inevitably do the same. How sad to see so many middle-aged women (and men) with an uncomfortably curved neck, forward head, and humped shoulders.

Although perhaps not as serious, unconditioned necks are typically unattractive. They seam weak, frail, and barely able to support the head in an upright position. Whether they appear too thin or too fat, poorly conditioned necks are hard to hide as this part of the anatomy is exposed even when wearing a suit or dress.

Obviously, weak neck muscles fatigue sooner than strong neck muscles. As a result many office workers feel like putting their heads on their desks to rest their necks during the afternoon hours.
A few years ago we tested several executives for neck extensor strength before work (9:00 a.m.) and after work (5:00 p.m.). Although they spent their entire work day sitting at a desk, their neck extensor strength decreased by over 30 percent during those eight hours. Even when sitting still, their neck muscles were working (and fatiguing) hour after hour. Of course, persons with well-conditioned neck muscles will also become weaker as the day progresses, but they may still be stronger at 5:00 p.m. than most people are at 9:00 a.m. Most likely, they will also be more productive at their job, as their task attentiveness is not reduced by neck fatigue and discomfort.

Maintaining strong neck muscles is important for a variety of other reasons. For example, riding a 10-speed bicycle places considerable tension on the neck extensor muscles to keep the head in road-viewing position. Weakness in these muscles leads to premature fatigue as well as an uncomfortable cycling experience.

Swimming uses a lot of neck movement to turn or lift the head for breathing purposes. Well-conditioned neck muscles are especially important for the butterfly and breast strokes, but contribute to successful swimming in the other strokes as well.

Strong neck muscles are also associated with performance ability in striking skills such as driving a golf ball, serving a tennis ball and hitting a baseball. To accurately strike a ball, it is important to keep the head as still and stable as possible so the eyes can focus clearly on its center.

In my opinion the neck and lower back muscles represent the two most important areas of the body from a conditioning perspective. Because the neck muscles control head movements, they are essential for normal and athletic functions. Because the neck muscles protect the cervical vertebrae and spinal nerve trunk, they are critically important for injury prevention. For these reasons, I strongly recommend that fitness instructors, personal trainers and strength coaches include neck strengthening exercises in their clients’/athletes’ exercise programs.

The safest approach to overall neck strengthening is a four-way neck machine, although it is not necessary to perform all four movements. Neck extension is the most important training exercise as these muscles (upper trapezius, levator scapulae and splenius) hold the head erect against the force of gravity. Neck flexion is second in importance, and actually uses the same muscles (sternocleidomastoids) working together that function independently to move the head laterally (left side or right side).

Generally speaking, one set of neck extensions and neck flexions should be sufficient, performed twice a week. I recommend 10 to 15 slow and controlled repetitions of each neck exercise, performed through a comfortable range of movement. When 15 repetitions can be completed with excellent technique (no momentum or body movements), the resistance should be increased by five percent (or less).

Of course, due to the possibility of previous injuries, pre-existing conditions, or other contraindications, clients should have physician approval prior to performing neck strengthening exercises. On the other hand, we are unaware of any injuries in our facilities over the past 20 years resulting from use of our neck machines. In fact, most of our members, program participants, and research subjects would agree that they have experienced more benefit from the neck and back exercises than from any of the other strength training components.

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Written by Wayne L. Westcott PhD

Explore Wellness in 2021