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Neck Range Of Motion Exercises, Neck Exercises

One very powerful way of controlling your neck pain is to do daily range of motion exercises, putting your neck through full movement several times a day. This prevents stiffness developing and stretches all the attached muscles, making them less vulnerable to sudden demands. Please note that exercises can make your pain worse as well as better so please consult the simple exercise guidance before getting on with them. If you have any doubts, please consult your physio, other manual therapist or medical practitioner. These exercises are meant to maintain range of motion or regain loss of movement in the neck region and to help control pain. Regular performance of movements can help with pain problems. They are simple and not magical in any way. If you have long term neck pain with some disability these exercises may help mobility or allow you to tolerate more activity but may not be very effective against pain. Do each movement slowly five times, resting a short time in between each set of movements. Do two or three times a day although more often can be useful. Work out how much you should do by slowly increasing the frequency until you are doing enough or start to have problems.

Neck flexion
This is the movement of bringing the head forward so that the chin hits the chest and your face is staring straight down at the floor. Do slowly five times. This exercise stretches the structures at the back of the cervical spine, which are often kept in a tight position in normal day to day postures. They can then become shortened and stop the neck moving naturally. To make this more difficult you can retract the neck slightly to start with (see below) and then flex the head forward, increasing the stretch on the neck.

Neck extension
This is the movement of allowing the head to go back until the face is looking directly at the ceiling. Dont do this movement fast or forcefully as it forces all the small joints at the back of the neck into an extreme position. This wont do them any harm but might increase your pain. Allow your neck to ease back steadily as you do this, leaving your neck at the end of the movement for a few seconds.

NB If you feel dizzy when you do this leave it out. Dizziness, especially if you are older, might indicate that the blood vessels in your neck are being squeezed by the position.

Rotation
Turn your head slowly round to one side until it cannot easily go any further. Once you have done five to one side do the other. Do not go from one side to the other in the individual movements or roll your neck about. Hold your neck at the end of the movement for a few seconds as this is the most valuable part of the movement to maintain or increase your movement. NB If you feel dizzy when you do this leave it out. Dizziness, especially if you are older, might indicate that the blood vessels in your neck are being squeezed by the position.

Side flexions
Keep your head facing straight forward and try and tip your ear down towards the same shoulder. Its difficult to do this well and without rotating to one side. Shes doing pretty well in the picture, just lifting her chin up a little more than ideal. This movement is quite severe on the neck joints so dont go hard at the exercise. Dont move from side to side in the movement as that stops you getting to the ends of the neck range and may aggravate your joints.

Neck Retraction (Chicken Tuck)


This is one of the most useful neck movements as it counteracts the tendency we all have of allowing our heads to poke forwards in a poor posture. Shes showing the extreme position of poking chin here. When we sit, which many of us do a lot of the time, we tend to slump and to keep our heads up so our eyes are horizontal we arch our necks backwards slightly This gives a continual flexion (bending) posture to the lower neck and an extension (arching) posture to the upper neck. Over time the tissues can shorten and give us stiffness and pain. Typical pains are in the neck, upper shoulders, but this posture can also give you headaches. Heres the end point of the movement. Keep your face straight on during the whole movement, drawing the head back and the chin down slightly.

If you get it right, you will look funny, rather like a sergeant-major in an exaggerated military neck posture. If you do it in public people will either laugh or give you funny looks! The whole movement is like the forward and back movement that chickens make. Hold the movement at the extreme of the backward posture for a few seconds.

Upper Neck Nodding


This movement particularly moves the upper cervical joints. In our bad postural habits we tend to poke our chins forward which puts our upper neck joints into extension (arching). The nodding movement flexes these joints and can help with upper neck pain and headaches of joint origin. This is the neutral starting position for the movement. Lying flat on your back for this movement is the easiest way to start this movement. You can be flat on the surface like she is in the picture or have a pillow if you dont like your head down flat on a surface. This is the end position of the exercise. Think of your head as a bowling ball which you rotate forward to rock the neck. You should not lift the head off the surface at all. You may feel a pull in the upper neck which is often tight. This exercise should be done with caution as you could increase your pain if you push it too hard. When you get good at the movement you can do it standing up or sitting but it is harder to get the pure joint movement than in lying down.

Related movements which may be useful


When we have neck problems it is rarely just the neck which is the problem, the pain usually involves the thoracic spine and the shoulder girdle. It is good to do shoulder girdle exercises as well to loosen up this area. 1. Shoulder shrugs Shrug your shoulders as far up as you easily can then downwards further than normal. 2. Shoulder bracing (retraction) Bring your shoulders to the front as if you are trying to get them to meet at the middle then brace them right back, pulling your shoulder blades together. Make it a large, slow, repeated movement.

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Cervical Exercises
Forward Bend Isometrics Extension Isometrics Side Bending Isometrics Rotation Isometrics Neck Curls Reverse Neck Curls Lateral Flexion Curls Prone Chin Retractions Tubing Resisted Cervical Strengthening: Forward Bend/Backward Bend Side Bends Rotations Cervical Active Range of Motion Exercises:

Forward Bend/Backward Bend Lateral Flexion Rotation Nodding Neck Rolls Supine/Sitting Chin Retractions Supine and Sitting Retraction/Extension Progression Series Neck and Upper Back Stretching Scalene Stretch Upper Trapezius Stretch Levator Scapulae Stretch Neck Rotation Stretch Sternocleidomastoid Stretch Standing Cervical Retraction Stretch Postural Exercises Deep Breathing Shoulder Girdle Range of Motion Chin Retractions Pectoral Stretching Rhomboid Pole Stretch Shoulder Punches Arm and Chest Lift Middle Trapezius Strengthening Facelying Overhead Lifts Postural Wall Sits Prone Extension-Rowing-Horizontal Abd Prone Flexion-D2-Military Press Prone Dribbling Helpful Hints for Neck Care Postural Positions Neck Movement Neck Positioning in Sitting/Standing

Cervical Stretching Exercise


To perform the cervical stretch sit or stand with a straight back. Lock your hands behind your head. Slowly bring your elbows in front and then pull your elbows back.

SHOULDER SHRU G

This is a great neck and upper back exercise. It can even be done at work.

Just stand against the wall and shrug your shoulders up and down. For a variation rotate the shoulders in a circular motion.
About Arthritis
Arthritis means inflammation of the joints. Most people with arthritis will experience pain and difficulty moving around. Over nine million people in the UK have arthritis and, like them, you can take control of your symptoms and continue to have a good quality of life.

Getting a diagnosis
If you have any pain, stiffness or swelling in your joints, it is important that you visit a GP as soon as possible. It is possible that your GP will be able to diagnose

you right away, but, in some instances, they may need to refer you to a rheumatologist or orthopaedic surgeon at your local hospital. A diagnosis will be made on the basis of your symptoms, a physical examination and medical tests. Some things to bear in mind when you visit your GP:

be ready to give a full description of any pain, stiffness or other problems you will be working together with your GP to manage your condition so dont be afraid to ask questions. Make a list before the appointment so that you dont forget anything or take a family member/friend with you

Testing for osteoarthritis (OA)


Your GP will:

check for any bony swellings and creaking joints, as well as testing for any restricted movement, joint tenderness or instability test your blood to rule out other kinds of arthritis perform X-rays to confirm OA and to see how much damage has occurred

If you are diagnosed with OA, your GP will be your main contact for managing your condition. They may also refer you to a physiotherapist for advice on keeping your joints mobile. If your arthritis is severe, the GP can refer you to a rheumatologist, orthopaedic surgeon or pain specialist. Living with Osteoarthritis will tell you more about what to expect when you visit your GP.

Testing for rheumatoid arthritis (RA)


Your GP will:

examine your joints and skin, and test your muscle strength carry out blood tests looking for inflammation do X-rays to find early signs of damage to joints and bones.

If you are diagnosed with RA, your GP will refer you to other healthcare professionals including a rheumatologist and physiotherapist. You will also be prescribed drugs to control the disease and reduce the inflammation. See Drugs and Complementary Therapies for more information. The booklet Living with Rheumatoid Arthritis will tell you more about managing your condition. See Just Diagnosed for more information on dealing with being diagnosed with arthritis.

The Arthritis Care Helpline is available to answer any specific questions you may have

How joints work

A joint is where one bone moves on another. The two bones are held together by ligaments. Ligaments are like elastic bands: they keep the bones in place while muscles lengthen and shorten to make the joint move. A coating of cartilage covering the bone surface stops the bones from rubbing directly against each other. This helps the joint to work smoothly. The joint is surrounded by a capsule and the space within the joint (joint cavity) contains synovial fluid. This fluid, which provides nutrients to the joint and cartilage, is produced by the synovial membrane (or synovium) which lines the joint cavity. What goes wrong with joints varies from one kind of arthritis to another.

How will it affect me?


Having arthritis will mean something different for each person, but how severely and for how long you are affected will depend on the type of arthritis you have. You may also find that there are some good days and some bad days. Generally most people will feel a level of:

discomfort pain stiffness fatigue

Some people may feel frustrated as these symptoms can lead to a loss of strength and grip, making it harder to move around. This does not mean you need to give up having an active lifestyle, but you may need to make some changes to your way of life.

Taking control of your arthritis


Although there is no known cure for arthritis at present, there are ways in which you can relieve the pain, stiffness and inflammation. Arthritis pain can take many forms you may get a persistent pain, sharp stabbing pains or a mixture of aches and pains. For further information on Coping with Pain refer to the Arthritis Care booklet. Gentle exercise is one way of tackling the loss of strength, grip and mobility associated with arthritis. See Exercise and Arthritis and Keeping Active There is a lot you can do to take control of your condition to whatever extent it affects you. See Living with Arthritis for tips on how to manage your life and Conditions for information about own particular form of arthritis. The Arthritis Care Helpline is available to answer any specific questions you

Conditions
There are over 200 kinds of rheumatic diseases or conditions often referred to as arthritis or musculoskeletal diseases. Arthritis affects around nine million people in the UK one in five of the adult population and 12,000 children. This section gives a brief outline of some of the more common kinds of arthritis. If you do not see your type of arthritis, you can contact our helpline to get more information.

Osteoarthritis Secondary arthritis Rheumatoid arthritis Reactive arthritis Ankylosing spondylitis Fibromyalgia Gout Polymyalgia rheumatica Psoriatic arthritis Systemic lupus erythematosis Page Last Modified

Physiotherapy

Physiotherapy plays an important role in managing arthritis. It can help people to maintain independence through improved mobility, strength and flexibility. Used in conjunction with medication it can help minimise pain and encourage independence.

Simple exercise plan


A physiotherapists specialty is in understanding the body and movement. They work with people with limited mobility from injury, arthritis or another condition providing advice, guided exercises and referral to other services. Exercise is especially important for people with arthritis. It can help to reduce pain and increase mobility. Physiotherapists can devise simple exercise programmes that you can practice at home to help you build your strength and flexibility.

How do I get to see a physio?


Physiotherapists are often based in hospital departments, but some work in health centres. They may work alone, or sometimes as part of a multi-disciplinary team. You can be referred by your GP or rheumatologist, although some people choose to pay to see a physiotherapist privately.

What happens?
In an assessment, the physiotherapist will examine your posture, gait and muscles, and ask you questions about what kinds of activities cause you pain. They will offer you advice, and design a personalised treatment plan, which may include:

exercise posture hydrotherapy massage pain relief techniques, such as electrotherapy,TENS

Treatment of Arthritis and Other Rheumatic Diseases


Rheumatic diseases are characterized by inflammation (signs are redness and/or heat, swelling, and pain) and loss of function. Common symptoms of rheumatic diseases include pain, swelling, and stiffness. They especially affect joints, tendons, ligaments, bones, and muscles, although some rheumatic diseases can also involve internal organs. An estimated 43 million people in the United States have arthritis or other rheumatic conditions; they are the leading cause of disability among adults age 65 and older. Many people use the word "arthritis" to refer to all rheumatic diseases. However, the word literally means joint inflammation. There are more than 100 rheumatic diseases, and the many different kinds of arthritis are just a portion of the rheumatic diseases. Osteoarthritis is the most common type of arthritis, affecting an estimated 21 million adults in the United States. When people talk about "arthritis," they are usually referring osteoarthritis. Osteoarthritis primarily affects cartilage, which is the tissue that cushions the ends of bones within the joint. The cartilage begins to fray and may entirely wear away. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips). Causes of Rheumatic Disease Scientists are studying risk factors that increase the likelihood of developing a rheumatic disease. Some of these factors have been identified. For example, in osteoarthritis, inherited cartilage weakness or excessive stress on the joint from repeated injury may play a role. In other types of arthritis, a combination of genetic factors and environmental triggers are believed to be important. Gender is another factor in some rheumatic diseases. Arthritis Symptoms Different types of arthritis have different symptoms. In general, people who have arthritis feel pain and stiffness in the joints. Some of the more common symptoms include:

Swelling in one or more joints Stiffness around the joints that lasts for at least 1 hour in the early morning Constant or recurring pain or tenderness in a joint Difficulty using or moving a joint normally Warmth and redness in a joint

Early diagnosis and treatment help decrease further joint damage and help control symptoms of arthritis and many other rheumatic diseases. Diagnosing Rheumatic Diseases Diagnosing rheumatic diseases can be difficult because some symptoms and signs are common to many different diseases. A general practitioner or family doctor may be

Exercise And Arthritis: Why Exercise?


Exercise is essential for people with arthritis. As for anyone, exercise:

increases energy levels, helps develop a better sleep pattern, helps with weight control, maintains a healthy heart,increases bone and muscle strength decreases depression and fatigue serves to improve self-esteem and self-confidence

For people with arthritis, exercise is especially advantageous in regard to the joints. Moving the joints daily helps to keep them fully mobile. Added joint support is achieved by strengthening the surrounding muscles. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects the ends of the bones.

Exercise And Arthritis: Types of Exercise


Range-of-motion Exercises Range-of-motion exercises are gentle stretching exercises which move each joint as far as possible in all directions. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities. ROM (range-of-motion) exercises are especially important for arthritis patients, who because of intense inflammatory pain tend not to want to move painful joints. It is the notion of some people that normal daily activities take joints through their full range-of-motion but this is not the case. Normal daily activities, such as housework, dressing, bathing, and cooking, are not a substitute for ROM exercises. Strengthening Exercises Strengthening exercises help increase muscle strength. Strong muscles help to support the joints, making the joints more stable, and helping a person move more easily and with less pain. The two types of strengthening exercises are isometric and isotonic. Isometric exercises involve tightening the muscles, without moving the joints. These exercises are especially useful when joint motion is impaired. Isotonic exercises involve strengthening the muscles by moving the joints. Endurance Exercises Endurance exercises are physical activities that bring your heart rate up to your optimal target level for at least twenty to thirty minutes. The target heart rate is computed based on age and physical condition. These exercises, by raising the heart rate, improve cardiovascular fitness. These exercises should be performed at least three times a week to enhance effectiveness. Many arthritis patients who do endurance exercises:

increase physical strength develop a better mental attitude improve arthritis symptoms

Not all arthritis patients are able to perform endurance exercises however. For example, patients with long-term rheumatoid arthritis and left with functional limitations will be unable to do this type of activity. Endurance exercises for arthritis patients need to be chosen carefully to avoid joint injury.

Exercise Choices
People with arthritis should always discuss their exercise plans with a doctor. There may be many exercises that are off-limits for people with a particular type of arthritis or when joints are swollen and inflamed. The amount and form of exercise recommended for each individual will vary depending on:

type of arthritis joints involved levels of inflammation stability of joints joint replacements other limitations

Exercise choices for people with arthritis may include: Walking - Walking can be an excellent exercise choice. Walking helps build strength and maintain joint flexibility, aids in bone health and reduces the risk of osteoporosis. Tai Chi - The practice of Tai Chi is a gentle martial arts exercise with origins in ancient China. While performing fluid and flowing circular movements, those with arthritis can relax, maintain mobility and improve range of motion. Yoga - Yoga can provide pain relief, relax stiff muscles and ease sore joints. Yoga with it's controlled movements, pressures, stretches and deep breathing relaxation, can also provide needed range of motion exercise. Use caution when disease activity is flaring and avoid excess torque or pressure on the joints. Water exercises / Swimming - Warm water exercise is an excellent way for those with arthritis to build up strength, ease stiff joints and relax sore muscles. The water helps support the body while the joints are moved through the full range-of-motion. The buoyancy of the water places less stress on the hips, knees and spine. Bicycling / Cycling - Cycling, both indoor and outdoor, may provide a good low impact exercise option. Cycling as an exercise, can be either freestanding or stationary. Cycling equipment can be adjusted and adapted for many of the limitations imposed by arthritis. Running / Jogging - Running may still be good exercise for those with arthritis if they run on softer surfaces. Walking or more gentle forms of exercise may be a better option for people with arthritis in their lower extremities. Research indicates, contrary to popular belief, that running does not cause To obtain the maximum benefit from an exercise program: Be consistent. Exercise should be performed daily. In order to see results and obtain full benefits from exercise, it cannot be done sporadically. Build up gradually. The best exercise program is one which begins at a low intensity and builds up gradually as symptoms permit. Too much exercise, especially initially, can worsen symptoms. Exercise when symptoms are least distressing. The best time to exercise is when pain and stiffness are at a minimum. Some patients feel the best time is after morning stiffness subsides. Other patients dislike the afternoon because they are fatigued by that time of day. Do not overdo. Many strengthening and range-of-motion exercise programs suggest performing the exercises in sets of three to ten repetitions, with each set repeated one to four times.osteoarthritis in

those with normal, uninjured knees.