Why is my neck tight all the time?!

Recently, I took a refresher virtual course on mobilizing the vagus nerves through the Institute of Physical Art (IPA). I last covered this material during the COVID lockdown in 2020 so it was wonderful to go through it again. In this course, the instructor Gregg Johnson mentioned an article called, "Is cervical region tightness related to vagal function and stomach symptoms?". I loved the ideas around this article because they make perfect sense.

The vagus nerves travel from our skull down both sides of our neck. They then take a dive to our heart and our organs. Information is sent between our organs and our brain via the vagus nerves (as well as the enteric nervous system but that's for a different post). The vagus nerves also get the spotlight for our parasympathetic tone (rest, digest, heal). If our neck muscles and fascia are restricted, the vagus nerves are one of the many parts of our cervical spine anatomy that aren't able to slide and glide through this area. With decreased mobility, they become less efficient at doing their job. Cue the potential for poor sleep, increased heart rate, increased blood pressure, poor digestion, and anxiety. Due to this aforementioned article, I was moved to discuss what leads to neck tightness and tips you can do to address this.

Here are some common causes for neck tightness and what you can do about it. Click each idea to learn more:

Your shoulders are shrugged when you are on your computer or driving in your car.

The Deal: Desk and car set up if everything if spend a lot of time there. Shoulders are shrugged at the desk or car if the keyboard or steering wheel are too high, the chair height is too low, or shoulders are up and forward when there is stress.

What To Do: The ideal position is to have your elbows next to your sides with support on an arm rest or some folded pillows. Ideally the elbows are bent around 90 degrees to use the keyboard. Yes, this usually means getting a bluetooth keyboard if you're on a laptop so you have more options of where to put it. Personally, having my bluetooth keyboard on a book on my lap is the most comfortable when I'm on my laptop. The screen needs to be at eye level. This is a similar set up for the car. As for the upper shoulder and neck tension from stress, this is where awareness is huge. Checking in with your body periodically is the first step in recognizing if you're "holding" or "posturing" there. Set yourself a timer to remind yourself throughout the work day. Doing a quick meditation (when you're not driving!) can also do wonders.

You breathe using your neck muscles.

The Deal: Diaphragmatic breathing is boss. It helps pump blood in our bodies, it helps our parasympathetic system thrive, it helps us digest, it helps our pelvic floor relax, and it helps our back feel better. When you are not breathing with your diaphragm moving to it's full potential, you are probably using neck muscles too much. Place your hands around the bottom of your ribcage and breathe. Do you feel your hands expand in a 360 degree direction when you inhale? If not, you may be a "chest breather". To find out, you can place your hand on your sternum (breast bone) and feel if there is a tendency for it to rise towards your chin as you inhale. Chest breathing means you are using your neck muscles to raise your upper chest towards your chin because this area of our ribcage isn't great at expanding. The only direction to go is up! Our neck muscles are used when we are breathing hard during a sprint or hard physical work, but at rest, they should be relatively quiet. You can even look at your neck in the mirror while you breathe. If you see your neck muscles contracting or popping out while you inhale, you've got some diaphragm work to do.

What To Do: The easiest position to start training your body to breathe with your diaphragm is lying on your back with your knees bent and feet flat. Place your hands on your belly and monitor for the belly to rise or expand with each inhale. When the diaphragm moves down during an inhale, pressure is increased in the belly area which means the belly expands. You can even place one hand on your belly and one hand on your chest to see if your belly expands while your chest does not rise towards your chin. Now place your hands on the sides of your lower ribcage with your fingers facing forwards and thumbs facing back. With each inhale, you should feel your fingers expand outwards and forwards and thumb expand outwards and backwards. Breathing with expansion into the back of our body (which you would detect under your thumb) is very hard for a lot of people, especially those that have back pain. The ultimate skill would be to breathe like this while sitting, then standing, and then while you do just about anything!

Your pillow isn't the right fit.

The Deal: I know finding the right pillow is such a pain. I struggle with it myself. If you are lying on your side, the goal is for your head and neck to be in the same trajectory as your spine. If the pillow is too flat, your head will look like it's falling off a cliff. If the pillow is too thick, your head and neck will side bend towards the shoulder on top. If you prefer sleeping on your back, same rules apply in that you don't want your head too far forward in front of your sternum. If you sleep on your tummy, I'm not even going to go there because I hope you stop!

What To Do: The best pillows are the ones we can mold to us, not us to them. This means a down pillow or like-wise material that can easily be adjusted with some pushing around is ideal. First make sure the pillow is tucked into the very bottom of your neck, where it meets your shoulder. This is to ensure your entire neck is supported. Then, lie down in whichever position you prefer and take a photo of yourself. Are you able to draw a straight line from your spine through the top of your head? Also, did you know pillows wear out just like shoes and mattresses?

You shrug your shoulders whenever you are picking up, pushing, or pulling.

The Deal: I used to be very guilty of this. I would do manual therapy all day with a giant shrug in both shoulders. Your shoulders don't really need to shrug unless the arms are reaching above the head. Often times, if shrugging is the preferred movement strategy, there's weakness in the lower scapular muscles.

What To Do: If you are unsure if you are shrugging to get your upper body power, perform movements while looking in the mirror. If you are picking up, pushing, or pulling a weight that is appropriate for you, you should be able to accomplish it with appropriate form of minimal shrugging. Unless your arms are overhead, in which case it is important that the shoulders shrug while reaching at the tippy top.

The core muscles in your neck are weak.

The Deal: You know the core of your neck is weak if your head feels heavy and/or you often put your head in your hand with your elbow on a nearby surface. If the core of our neck isn't stabilizing our cervical spine, other muscles on the periphery will try to do it instead and they aren't good at it.

What To Do: Keeping your ears in line with your shoulders is key. "Forward head posture", where your ears are in front of your shoulders, gives the core muscles of your neck zero chances of supporting the spine. Keeping your tongue on the roof of your mouth also helps bring in the stabilizing muscles. An exercise to perform to directly strengthen the core of your neck is to lie on your back, tongue on the roof of your mouth, lengthen the back of your neck and settle your chin down. You should feel some good stretching in the back of your skull, neck, or even between your shoulder blades. While maintaining this lengthened position with a slight chin tuck, imagine you're going to lift your head off the floor only enough for an ant to crawl underneath your head. If you already feel muscle shaking, that's great! Hold it! If you don't, you can also play with actually lifting your head off the floor and holding it but do not lose the chin tuck position.

Some others...

• You hold the phone between your ear and shoulder.

• You carry a bag on one shoulder and your shoulder shrugs in response to that.

I hope these are helpful! Please reach out with questions or comments!