Past research has demonstrated that combining spinal manipulative therapy (SMT) with exercise yields the best long-term results for individuals with neck pain. So what exercises should we consider when neck pain rears its ugly head?

In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM).

The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!

You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.

Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.

Studies also show that weakness of the deep neck flexor muscles is very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.

Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.