Last month, we looked at the VERY important deep neck flexor muscles. As promised, this month, we will cover exercises to work the deep neck extensors.

Since the 1990s, the deep neck flexors have been getting most of the attention as being the “missing link” in rehab of the neck after whiplash. As important as the deep neck flexors are, the deep neck extensors cannot be ignored. In fact, BOTH the deep neck flexors and extensors have to work in concert to control segmental movement! A 2013 study reported the deep neck extensors can become quite de-conditioned and weak in patients with neck pain. Recent studies confirm that neck pain patients typically display reduced activation AND a less defined activation pattern in the deep neck extensors, and the amount of weakness and poor activation is proportional to the amount of pain present (i.e., the higher the pain level, the worse the activity response).

PROCEDURE 3 (Prone Neck Extensors): Lying on your stomach, arms at your sides, palms facing outwards, tuck in the chin without looking down. Lift you head and chest off the floor and hold the position for ten seconds or as long as can be tolerated. Remember, stay within “reasonable boundaries of pain” (that only YOU can define) and gradually add repetitions over time.

PROCEDURE 4 (Neck Extensor Isometrics): Sitting or standing, tuck in your chin without looking down. Extend the head back slightly and place one hand behind the head. Slowly push the head back into your fingers at about 10% of maximum force and gradually use a greater amount of force over time. Once you feel you have good motor control and are tolerating the exercise well, vary the amount of resistance from 10% to 90%, gradually increasing then decreasing the resistance SLOWLY (crescendo and decrescendo the resistance)!

PROCEDURE 5 (Neck Extensor Isotonics): Same as above but this time the head moves while applying a steady light (10-25% of max.) resistance from full extension into full flexion. Repeat this for three to five slow repetitions through the full range. Keep your chin tucked while moving the head into your hand. The object is to SMOOTHLY move your head into and out of flexion/extension SLOWLY through as much of the range as possible (remember you define the pain boundaries)!