Body Wellness Blog

In our blog we will teach you the basics of posture, movement and exercise to help you move through life more fluidly and with less pain.

Optimal Head and Neck Position to Avoid Neck and Shoulder Injuries

By Patricia A. Staszak, PT

The STOTT PILATES five basic principles for posture and alignment are:

Over the last few months, we have examined the first four of these principles in the context of "what is your best neutral alignment?"  This month, we discuss head and neck position.

Neutral Head and Neck Position
When you are sitting or standing, your head should be balanced directly between your shoulders. Your chin should be level and, generally, the gaze of your eyes should be forward. There should be no tension in the muscles around your neck, and your neck should hold its neutral position with a gentle anterior curve, called a lordosis.

Neutral Head


Before we go on, we need to review the two parts of the neck (cervical spine).

o    The upper cervical spine describes the joints between the base of the skull and the top two vertebrae.
o    The lower cervical spine comprises the joints between the second and seventh cervical vertebrae

It is the lower cervical spine that stays in neutral as your body moves, but the upper cervical spine moves into slight flexion before your head is lifted off the ground. I know it is confusing, but stay with me here. The slight flexion at this joint is described as a head nod and is pictured below. By performing a head nod first, you are putting your head in a safe position before moving it.

STOTT PILATES Head Nod

Head Nod Exercise

 
Start position: As above. Eyes gazing at ceiling.

Inhale: Using your gaze to guide you, and your ear as an axis, gently nod your head to lengthen the back of the neck. Do not lift your head. There should be no tension in your neck.
Exhale: Return to your start position.

(Comprehensive Matwork 13).


Common Modification: For individuals with a forward head, a foam pad should be placed under the head to keep the neck in neutral. This will reduce tension in the muscles, and compression in the joints of the neck that would normally occur with this position.  You can determine if your head is forward by having someone looking at you from the side to see if your ear is forward of your shoulder.  The shoulder should be in the same vertical line.

Head Movement
When moving, your head should follow the line of the ribs and thoracic spine while your neck stays in a neutral position. Therefore, if you are lifting your body off the ground when lying on either your stomach or back, your thoracic spine and ribs should initiate the motion.

Then, while keeping that gentle nod, your head should follow. There should be enough room between your chin and your chest for a small fist; your chin should not be jammed into your chest. There should be no tension in your upper neck, and you should be able to talk (Comprehensive Matwork 12). This is illustrated well in the Ab Prep exercise below.

STOTT PILATES Ab Prep (Modification)

Ab Prep Exercise

 
Start position: As above. Eyes gazing at ceiling.

Inhale: Using your gaze to guide you, and your ear as an axis, gently nod your head to lengthen the back of your neck.
Exhale: Maintain length through the back of your neck and a neutral pelvis position. Stabilize your scapula and contract your abdominals to slide your rib cage toward your pelvis and flex your thoracic spine, reaching arms off the mat, level with your shoulders.
Inhale: Stay.
Exhale: Roll your upper body down to the mat, allowing your cervical spine to return to neutral once your head is on the mat.

(Comprehensive Matwork 13).


So the above paragraphs describe perfect head and neck movement. But even with careful attention to form, this is a difficult exercise. To do it properly, we have to be well aligned and stable in the joints below, and strong at the neck.
 
Next month, we will once again review the five basic principles of STOTT PILATES, but we will discuss them more globally - integrating all the principles to teach you to better understand how to get into and how to move in your best neutral alignment.

Works Cited

 

Comprehensive Matwork. Toronto: Stott Pilates, 2001. Print.