Neck Strengthening Progression in 4 Point Kneeling – Part 3

Here we are at Body Works Sports Physiotherapy and now we’re going to look at a function progression for strengthening the deep neck flexors. This helps you improve better strength in your neck for day to day function, for better postural endurance and returning to sport.

In this position now we’ve brought Holly into a hands and knees position and we want her shoulders lined up over top of her hands and her hips over top of her knees and Holly’s natural position is to allow her chin to poke forward a little bit towards the floor, you can see a little bit of a forward sway through her neck so we’re going to cue her to find neutral position of her neck and her upper back. We’re thinking about nodding in your chin and lengthening the neck and a little bit of softness through the upper back. That’s our starting position and important that we can find it before we progress on to the next part of the exercise.

If this is too difficult then in the beginning we work on just finding this position and teaching the muscles to be able to hold the weight of the head against gravity before progressing onto the rest of the exercise. If you feel that this is okay and comfortable to do then we would work on functionally progressing this to control the movement one vertebrae at a time into a forward flexion. So thinking about the access of movement starting at the ears and slowly nodding in the chin bringing one vertebra at a time down towards the ground slowly with breathe usually. When you get to the bottom of this position it will feel like the head is quite heavy and there will be a little bit of softening through the upper back. Now on the way back up then we don’t want the head to initiate the motion we want to think about the motion being initiated first from the mid back so she’s going to be think about lifting through here and the next vertebrae coming up and slow lifting and the head comes last as the lift when we come back up, so slowly working one vertebrae at a time coming back to neutral.

This can be quite fatiguing so often in the beginning we only do a couple repetitions depending upon when you hit fatigue so fatigue is more important than repetitions here. So my advice to Holly would be to work until she starts to feel fatigue and if she cannot control the motion any longer then it is best for her to take a break and go again after a rest period.