Author: Dr. Shannon Russell, DPT, CSCS, USAW-1
In today’s world of technology and working from home, posture has become a buzzword with a largely negative reputation. We are constantly surrounded by messages about what makes posture good or bad and why it is supposedly the root cause of all aches and pains.
You have probably heard it all. Pull your shoulders back. Stand up tall. Stop looking down at your phone. Or the personal favorite, posture correctors that promise to fix everything by doing the work of your muscles for you. Have neck or back pain? It must be your posture. Fix your posture and the problem goes away.
With so much information floating around, it can be difficult to separate what actually helps from what does not. You can spend hours researching neck pain and still walk away without a clear solution. The truth is that the body is far more complex than finding one perfect posture to solve every issue. We are built to move, adapt, and function dynamically. Everything in the body is designed to work together.
Because of that, the solution to neck pain is rarely as simple as just having better posture.
Take a look at picture 1 above. Every time you move your shoulder, your shoulder blade, also known as the scapula, must move as well. If we look at the muscles that surround the scapula, particularly the levator scapulae and upper trapezius, we can see that they attach on one end to the scapula and on the other end to the cervical spine.
This means that every time you move your shoulders and use these muscles, you are also influencing your neck.
If you are dealing with neck pain, pause for a moment and consider a few questions. Do you feel stressed and notice that you hold tension by keeping your shoulders shrugged? Do you spend hours typing at a keyboard that is positioned too high, forcing your shoulders upward all day? Do you feel limited when trying to reach overhead or behind your back?
If any of this sounds familiar, the true contributor to your neck pain may be the position of your shoulders and the constant tension in those surrounding muscles.
The second picture above shows the muscles of the neck from the front. This includes the sternocleidomastoid muscles, the scalene muscles, and again the upper trapezius. In addition to helping move your neck, these muscles also assist with breathing.
Before diving deeper into this, it is important to understand what normal breathing should look like.
Ideally, during an inhale, the rib cage should move outward and upward. During an exhale, it should move downward and inward. When breathing with the diaphragm, there should be noticeable rib cage movement with each breath.
Sometimes this breathing pattern becomes inefficient. The rib cage no longer moves as it should, and the diaphragm is not used effectively. When this happens, the body often relies on the neck accessory muscles to help drive breathing instead.
These muscles are relatively small and not designed to handle high demand. If they are asked to assist with roughly twenty two thousand breaths per day, they will struggle to keep up. Over time, this leads to increased tension in the neck and upper shoulder region and eventually pain.
While bad posture is an easy explanation for neck pain, it is often an incomplete one. The body is far more interconnected than posture alone. Many muscles attach different regions of the body together, meaning dysfunction in one area can show up as pain somewhere else.
Understanding this makes it clear why neck pain is rarely as simple as it is often presented. If you are dealing with chronic neck pain, it is important to zoom out and look beyond posture alone.
You may listen to the advice to pull your shoulders back, but if your rib cage mechanics or breathing patterns are contributing to your pain, that solution will fall short. If this sounds like you, consider being evaluated by a licensed professional who can assess how your entire body is moving and help identify the true root cause of your neck pain.
