Cervical Spondylosis and where to stretch?

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cagritosun
Posts: 9
Joined: Sat Mar 25, 2017 11:55 pm

Cervical Spondylosis and where to stretch?

Post by cagritosun »

Hi Bernie,

Recently I was diagnosed with Cervical Spondylosis by my doctor and she prescribed me with exercises which basically stretches my neck muscles on my back and SCM and trapezius.

It makes sense that neck muscles on my back are shortened and I have to stretch them. However considering the curve of the spine, it seems logical that I should drop my head back like in Matsyasana to increase the curve.

What is your idea about this seemingly contradictory views?

Thanks in advance,
Cagri
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Post by Bernie »

Hi Cagri

Sorry to hear about your neck problems. If your doctor is suggesting stretching your neck muscles (flexion), that’s probably a very good idea. Whether you should go in the other direction and extend the neck may or may not be a good idea. It depends upon the degree of your spondylosis. (For those who don’t know what spondylosis is, here is my definition: “An acquired defect in the pars interarticularis due to fatigue fracture. This can occur in the lumbar or the cervical spine. Often this defect is filled in with scar tissue, fibers and free nerve endings, but this does not mean it is necessarily painful.”. By acquired, I mean it wasn’t something you were born with but something that developed, possibly through an accident or lots of gymnasts when you were young or other causes.)

There are 2 kinds of stresses that we subject our spine to: compression and shear. Compression is an axial stress that pushes the spine into itself. Shear is a stress that tries to slide one vertebra over another. In spondylosis, shear is the main worry: the vertebrae have facets that normally prevent shear sliding, but in spondylosis the part of the bone around the facet is weakened and could fracture completely creating a slipage of one vertebra off its lower neighbour (this is called Spondylolisthesis).

In your case, what we worry about is shear stress, and extending the neck could lead to too much shear. Extending the neck (dropping the head backwards) could put too much pressure on the bone and fracture it. That would not be so great. On the other hand, not stressing the bone at all could lead to osteoporosis. So, you may be “damned if you do and damned if you don’t.” My own personal philosophy is that all tissues need stress, even damaged tissues, but when tissues are damaged, the amount of stress that they can tolerate is very little. So, do a little. Matsyasana (Fish Pose) is too much: that is a deep backbend for the neck. And if you are resting your head on the floor in Fish pose, you are increasing the compression stress as well as the shear stress. Start with easier extensions: have your head hang off the edge of a pillow under your shoulders, allowing the head to rest on the floor: this should give some extension to the neck without a lot of weight on it. Work up to more pillows, more extension. But, maybe even better than working on extension, work on strengthening all the muscles and fascia around the neck.

But, before doing any of this, check back with your doctor and go over the plan with him/her. The idea is to start slow with some gentle extension and with no load on the neck, and build up over time to more load and more extension. Along the way, continue to strengthen as well as mobilize.

Good luck!
Bernie
cagritosun
Posts: 9
Joined: Sat Mar 25, 2017 11:55 pm

Post by cagritosun »

Thanks Bernie.

What if I don't have spondylosis but just I lose the curve on my neck (lose the lordosis)? Would you suggest the same?

Cheers,
Cagri
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Post by Bernie »

My suggestion would still be to talk to your doctor about doing extension exercises to regain your lordosis. However! Please be aware that not everyone has a cervical lordosis! The fact that your neck is straight may not be a pathology needing fixing. It just may be the way you are.

The average amount of cervical lordosis is 18.2° but the normal range is from -8-45°. I am currently working on my next book Your Spine, Your Yoga which will talk about this a lot more. [see Serkan ERkAN et al “The influence of sagittal cervical profile, gender and age on the thoracic kyphosis” in Acta Orthop. Belg., 2010, 76, 675-680. They used a “posterior tangent technique originally described by Albers and Gore et al“. They studied 228 subjects with an average age of 38.7.]

Cheers
Bernie
cagritosun
Posts: 9
Joined: Sat Mar 25, 2017 11:55 pm

Post by cagritosun »

I will talk to my doctor and let you know.
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