What kind of exercise program can I do with neck pain off and on?

Q: I've been watching the Olympics and thinking maybe I should get back into some kind of exercise program. But I've had neck pain off and on (especially when I do try to exercise). What can I do about this?

A: Neck pain is a common problem among all age groups and often for different reasons. Women seem to be affected more than men. High-level athletes, weekend warriors, stay-at-home moms can all experience neck stiffness, pain, dizziness, and loss of muscle control. There doesn't have to be a major injury to bring about symptoms of this type. Even minor injuries, sprains, strains, and soft tissue contusions can result in chronic pain and dysfunction.

So your question about what can be done is a good one. The neck is a sensitive area so starting simple and going slowly in progressing the program is always advised. As you have discovered, it's easy to flare your symptoms when trying to exercise. It might be best to seek the advice and guidance of a physiotherapist. They are specifically trained to evaluate symptoms, anatomy and movement patterns and then prescribe patient-specific (even sport-specific) exercises.

The therapist will "titrate" the exercises to achieve the desired results without side effects. This means the intensity, number of repetitions, and frequency of each exercise is carefully set and then progressed slowly over time. You may even be advised at first to do some exercises through partial (rather than full) neck motion.

Other areas must be assessed and addressed, too. For example, shoulder and trunk muscles might be involved requiring attention. Weakness in the muscles of these structures can contribute to neck pain. In some cases, people with neck pain hold the head at an angle without even realizing it. They may have lost the natural function referred to as head/neck repositioning acuity. There are exercises to improve these deficits as well.

Anyone with neck pain (whether a top athlete, weekend warrior, or nonathlete) can benefit from specific exercises to address the problems they are facing. Pain, stiffness, loss of motor control, poor muscle contraction, and even dizziness can be addressed with exercises to improve repositioning acuity and postural stability. But don't try to do this on your own to get started. A carefully prescribed and supervised program of exercise can get you on the right track and stay there to meet your intended goals and desires.

Reference: Christopher J. Durall, PT, DPT, MS, SCS, LAT, CSCS. Therapeutic Exercise for Athletes with Nonspecific Neck Pain: A Current Concepts Review. In Sports Health. July/August 2012. Vol. 44. No. 1. Pp. 293-301.