Neck and Shoulders: How to ease the tension

MANY years ago, homo sapiens wandered the earth, creating communities and surviving by hunting and gathering. There were no laptops, desk jobs, PDAs or tablets. The head and shoulders of the average man sat squarely on his shoulders. Today, in an era of technology and sedentariness, the average man’s head sits a little too far forwards of his shoulders and that can cause a lot of issues.

Kyphotic spine lateral view in x-ray

Let’s consider some: persistent headaches; poor ’rounded’ posture; shoulder dysfunction; lower back pain; spine compression; dowager’s hump; and even man boobs (or just saggy lady boobs)!

Clients and participants often ask what we can do in Pilates to ‘work the neck and shoulders.’ The simple truth is, it’s complicated! When you spend up to 40 hours of each week sat in front of a computer, you need to consider incorporating daily training into your life to undo to ill effects of desk posture.

According to Kapandji (Physiology of the Joints, Volume III), for every inch your head moves forwards, it gains 10 pounds in weight, as far as the muscles in your upper back and neck are concerned (these muscles have to work that much harder to keep the chin upright).  This also forces the suboccipital muscles (the muscles that raise the chin) to work on over-drive. It’s this muscle tension and associated pressure on the nerves in the area which may cause headaches at the base of the skull. Pressure on the suboccipital nerves can also mimic sinus (frontal) headaches.

As well as headaches, rounding of the shoulders can make it difficult to breathe effectively, creating short, chest breaths, causing the shoulders to rise and fall. This can increase tension in the neck and shoulders . Plus there’s the associated weakness across the shoulder blades and the opposing tightness across the chest muscles. This can in turn cause shoulders to round and become mis-aligned, leading to pain and injury. And yet another common problem I see is winging through the shoulder blades. If the shoulder girdle does not sit and function as part of your core to maintain good posture, you can end up with over-use injuries like tennis elbow.


Our first course of action is always to stretch and mobilise. Something we spend a lot of time doing in Pilates classes. Consider how the head and shoulders have been pushed forwards, with the shoulders also often raised.

Here are a few mobility exercises to incorporate into your day or exercise routine:

Shoulder shrugs and rolls.

Alternate between lifting and relaxing shoulders as if you were trying to shake something off your shoulders. Then roll shoulders through a full range of motion, forwards and backwards up and down.

Standing chest opener.

Standing about 6 inches in front of a wall, with your bottom, ribs, shoulder blades and head all touching the wall, raise your arms so your elbows are touching the wall at shoulder height and your hands just above your head. Gently draw your chin in (but keep your eyes looking forwards). If you need more stretch slide your arms higher.

All fours spine mobility.

Kneeling on all fours raise one arm. Thread your arm under your body as if you were threading a needle and then open it up to the side as if you were trying to wave to someone.

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