The Head to Toe of Injury Prevention for Grapplers: Part 2- The Neck

So let’s talk about the neck a bit, but first, a warning from our legal team.*

While I am an exercise professional, I am not a doctor, nor am I a qualified medical professional of any kind, although I did once correctly guess that a friend had crabs from the way he was walking. Perform all exercise at your own risk and remember that if you have current, existing neck or back pain, you really shouldn’t be looking for a solution on the internet. Get thee to a professional and get a diagnosis. This article is for healthy people who want to stay healthy. So if you’re in pain, off you go. If you are not, read on.

Next, a bit of background. I am writing this from a standpoint of bitter, painful experience, a lack of due care and attention to my injury in the past, thousands of euro spent on medical care and pain medicine, many, many false dawns and false starts and the intense frustrations of being off the mat, not doing my sport, for far too many sessions. All over what was initially a niggle.

I can’t recall one incident in particular that hurt my neck. There are many situations in the sports I play that involve trauma to this region. I just recall a growing sensation behind my scapula on my left hand side (I can still vaguely feel it sitting here typing this) that eventually grew into a full blown, headache inducing pain that travelled up and down my left arm. I took some pain medication for a few days and took a rest from training and it went away, though not fully. A month or so later, it was back, and I attributed it to tightness and went to a sports masseur, which gave me some relief. This pattern continued for about 18 months, which seems like a long time to have an injury without seeing a professional, but you have to understand that there’s something unique about back pain. Occasionally it’s bad, but mostly, it’s just there. If you injure your leg, it becomes difficult to walk, injure your elbow and it becomes difficult to write or throw, but when you injure your back, your body finds methods of adapting your posture to relieve the pain, which can often go unnoticed by you until one day it rears its head and leaves you no choice. That day for me came when I was slicing a block of cheese- yes really- and something was obstructing me from pushing the knife all the way down to the bottom. When I pushed harder I finally felt that the obstruction was my little finger. Fortunately I was slicing, not carving, so I barely broke the skin and kept my finger intact, but I was in the physiotherapist’s office the next morning and was soon diagnosed with a bulging disc between T1 and C7. This was causing a loss of sensation in my left arm, referred pain in my neck, back and elbow, weakness in my back and triceps, and if left unattended could deteriorate to the point of requiring surgery. Back surgery is no joke, so finally, I took this one seriously. This article is entirely based on my experience in rehabilitating this injury, the professional advice I received from physiotherapists, and research I undertook on my own behalf to ensure I was doing everything I could within the boundaries set for me by my physiotherapist. In other words, this is written from experience, and the next guy’s experience may be different.

Henry Rollins- nothing to do with this article other than he has a notable neck

So, with that established, we’re ready to begin. First let’s look at the problem area. When we are discussing the neck, we are mainly talking about the 7 cervical vertebrae, which run from the base of your skull to the top of your back, in and around the mid point of the scapulae, at which point the thoracic spine begins. (The T-spine will form part of this article later, so remember the name) Between these vertebrae are your disks, rubbery tissues that assist in movement and shock absorption. Into these gaps run the cervical nerves, and it is by and large compression of these nerves that cause what I’ll term “Grappler’s Neck”. I just made that term up right this minute. Let’s see if it catches on. So why do we need to protect the cervical spine? Well, first of all, injury to the cervical spine is potentially fatal at the top end of the scale, and as we progress down that scale the news isn’t really much better. My injury is down at the very bottom, and on your way there from death you’ll pass by quadriplegia, paraplegia, life altering loss of movement and… well, I think that’s enough. You get the point I’m sure. The cervical spine’s position in the neck makes it the most vulnerable point of the spine. It’s a design flaw, the sort of soft spot that the heroes eventually discover aliens have in science fiction movies. At this point in the body, the spine is protected only by the musculature of the neck and the mobility of the rest of the body around that point. These are the two things you require to limit your chances of injury- strength and movement.

Let’s start with the latter. Mobility of the neck isn’t really what we’re after here, although a healthy neck should have good movement in several planes that a qualified physio can test, you’re not really going to be going gung ho on stretching the neck muscles, the function of which is to ensure adequate stability. Instead, the shoulders and scapulae, and facet joints and musculature of the thoracic spine should be mobile enough to alleviate the possibility of your neck having to do the movements they were designed to do. Ensure that you have full range of motion through your shoulders and that you can rotate through your mid back. Other than that, you may be relying on your cervical spine to take up the slack. Imagine for example being thrown into a forward roll position, or being twisted into a bow and arrow choke. If your t spine can’t bend to alleviate impact or pressure, then your C spine might flex a centimetre too far to make up for that. There are many exercises for each of these movements, but let’s focus on two which I have also used as benchmarks for people who I train.

The Shoulder Dislocate- When this series moves on to the shoulders next, we’ll see these again. Hold a resistance band, towel, or belt between your two hands. The distance in your grip should be approximately from your fingertip to the shoulder of your other arm. I prefer to use bands for this as they allow the athlete to stretch the band outwards to overcome any tightness, rather than bending the arms which is necessary when using a non-flexible item like a towel. Hold the band in front of your waist with your arms straight. Now using a slow, controlled motion, while trying to keep your shoulders from rising up, move the band backwards over your head with straight arms until it has travelled all the way around to touch your backside. Repeat forwards. If you are using something that can’t stretch, you may have to bend your arms during a part of the movement. This is a good sign you’re not flexible enough. This exercise works as both a stretch and a test for your shoulders.

The Trunk Twist- This one twists your trunk, there’s a clue in the name. The idea here is to loosen out the thoracic region of your back- the facet joints and associated musculature. Lie on your side with your bottom leg straight and your top leg bent 90 degrees at the hip and knee. Place both of your hands straight out in front of you, palm to palm. Surprise author fact! I sleep in this very position! With your top knee remaining in contact with the ground, you are going to bring your top hand in a wide arc all the way over your body, rotating through your mid back, until you can go no further. It’s unlikely you’ll be able to touch the back of your hand off the floor, but if you do, make sure that you have kept your top knee on the ground throughout. Most people will find that they will be able to go further on one side than on the other. This is typical, but is a symptom of imbalance from one side of the body to the other which is obviously something we want to avoid. If you want to use this as a benchmark stretch, have a friend record the distance from your hand to the floor on both sides at maximum stretch, or video yourself performing the exercise.

Self massage, massage or foam rolling is also an excellent way of ensuring that the areas that should be moving, are moving. Foam rolling is a whole other article, but I’ll deal with it briefly now. I use the foam roller to ensure flexibility of my rib cage (an amazing structure we’ll deal with another time), my thoracic spine, and to help with tissue quality in my rhomboids and traps. Getting a sports massage once in a while is also a very good idea for ensuring everything is moving the way it should.

Next up let’s look at some strength work. And for this I really must once again ask you to sit back and pay attention as your cabin crew take you through the safety features of this article. If you feel any pain, discomfort, or even if your Spidey Sense is tingling, stop right away. You may just be doing the exercise incorrectly, or you may have a pre-existing injury you don’t yet know about. Always consult a professional, this is just a guide, on the internet, written by a stranger.

A lot of traditional exercises for neck strength are pretty good, but many of the most common ones are pretty advanced and may serve only to exacerbate the problem or even cause an injury themselves. I’ve seen guys perform neck deadlifts with head harnesses that made me want to ring an ambulance in advance, and many of the bodyweight bridges  performed by wrestlers are really best left to those who have a massive training history. That is to say, many advanced level wrestlers have been doing these exercises since they were children. You may not be that fortunate. As such, every single professional I have ever spoken to has always recommended starting with very light resistance, and just as importantly, limiting yourself to isometric exercises when embarking on a neck strength programme. This probably seems odd to most people since it runs contrary to people’s standard perception of strengthening. After all, if you want stronger arms you don’t stand around holding heavy weights, you move them. However let’s hark back to the primary function of the neck muscles- stability. Their first job is to ensure the area is stable, we can make it much stronger once we achieve that, and that’s what the first exercises will help with.

Isometric Band Holds- Using a light resistance band, we’re going to work in just 2 planes, the frontal and sagittal. The aim here is to use the neck muscles to resist flexion or motion in these planes. You will need a resistance band for this, although there is a method of doing this using a partner but with that there is no real way of knowing if the resistance is constant. Loop or tie the band on to a stable rack or pillar at head height. Loop the other end of the band around the top of your head. Face the pillar, retract your shoulders and brace your neck. Step back into a half-lunging position, enough so that the band is trying to pull your head forward. Hold for 5 seconds, then release, rest for a moment, then start again. Repeat this while facing away from the pillar, then with your left ear facing the pillar, and finally your right. Overall, you want to do 5 sets of 5 second holds per direction, and then you stop. That’s a neck workout for day 1. Gradually, you can increase the length of each hold to 8 seconds or so, or increase to a higher tension band. After you have reached a point of comfort with isometrics, you can move on to more difficult exercises such as neck deadlifts or (slightly) more dynamic movements on the same planes.

Bent over or bench supported Shrugs- Most people are familiar with the standard bodybuilder shrug, which usually involves the athlete standing upright and shrugging the shoulders upwards toward the ears. We’re going to shrug differently, since our goal is to protect the neck and an upright shrug does tend to promote internal rotation of the shoulders. (imagine your shoulders rolling forward towards your chest) For this exercise you will need a barbell or dumbbells, and again you will not be going to heavy, too soon. To perform this exercise, grasp the weights in your hands and tilt forward as though you are moving towards performing a barbell row, keeping your spine in a neutral position until your chest is parallel with the ground. Keep your arms straight and shrug your shoulders backwards and think about getting them down into your back as much as possible. Our goal here is to have the scapulae retract fully during the motion, so concentrate on squeezing the mid back at the top section of the lift, and on preventing your shoulders from rising towards your ears. If you’re lucky enough to have a bench row (and not many people are) then you can support your chest on it in the prone position. You can also use many of the seated row or cable machines found in commercial gyms.

A word here on traditional shrugs. Traditional, upright shrugs were contraindicated for me during my rehabilitation since they tend to activate the upper traps in addition to causing internal rotation. In a perfect world, your trapezius muscles operate equally on both sides and the work these massive muscles do is distributed equally throughout their mass. This is rarely so in reality, and the upper traps tend to be far more active, often causing back discomfort and imbalances on their own, and creating tension in the neck. This is why we’re shrugging in the rowing position as opposed to the upright one, since I know that many people immediately think of the standing variation when it comes to building a bigger neck.

So let’s finish with a synopsis of sorts.

• Consult a qualified professional if you have any existing pain
• Ensure good mobility and soft tissue quality in your chest, shoulders and thoracic spine through massage, stretching and mobility work
• Begin strength work with light isometric work such as the one recommended above
• Only move on to dynamic or heavier work in small increments once stability has been achieved
• Be wary of exercises that place direct compressive force on the upper spine such as wrestler’s bridges

Finally, in many cases, neck injuries don’t really go away, they just get well enough to be managed which is the stage I am at. If I allow myself a few weeks off strengthening and traction exercises I will inevitably feel some additional loss of sensation or pain. This is true for many people I know who have had more or less severe versions of my injury, so I am very careful to ensure I remain strong and mobile in my upper back through a comprehensive strength, mobility, and flexibility routine. Doing these once in a blue moon, or whenever an injury flares up is not a good idea. Instead think of these as checking the tyre pressure or filling your car with oil; essential maintenance that has to be carried out.

That’s all for this time. I’m going to move on to the shoulders and arms next week.

*there is no legal team, it’s just me speaking like a lawyer