How to safely do yoga when dealing with neck pain (Part 1)

Danh NgoYoga + PilatesLeave a Comment


yoga for neck painThe medical community is recognizing the power of yoga as a medium to enhance mobility and muscle flexibility.   Consumer Report magazine recently endorsed yoga as a proven alternative to back pain relief.  When it comes to neck pain relief,  as a Spine and Sports Medicine Physical Therapy clinic in Long Beach, we realize that our medical colleagues and doctors are slow to understand how to help use yoga and exercise for neck pain relief.


If you are waking up with kinks or working with nagging muscle spasm, you have to understand why stretching your neck consistently may not be the best option for long-term neck health.  As a Holistic Spine Doctor in Physical Therapy, we will explain how your neck is more connected than you think.



There are tons of muscles in your cervical spine (fancy word for the neck) that connects to your cervical vertebrae.  Your muscles respond to what you believe you need to do to bend, look up, or turn your neck.  The key word is “what you believe”.  These movements cause your cervical spine to load or stress enough, not enough, or more than enough on parts weight on your individual neck vertebrae.  If you believe you need to power through a pose, then you have a group of “power” muscles that will over-dominate your cervical spine vertebrae.  When you go to a yoga class or follow a yoga video and your mind is distracted with a list of work and home tasks, your coordination of muscles will be as chaotic as your mind’s current beliefs.  If your muscles cannot guide you or support your desired activities, your cervical vertebrae will take up more stress too.

A perfect example is when you start out on all fours to perform the downward dog pose (Adho Mukha Svanasana), you need sufficient upper body strength and coordination with your trunk muscles to get you into this safe yoga pose.  This pose is one of our most recommended exercise that will unwind many nagging issues.  If you do not have good shoulder strength, then your neck muscles and joints will bear more weight.  Your cervical spine does not like this so your neck muscles called your Upper Trapezius and Levator Scapulae will work harder to contract.  The contraction will feed into the vicious cycle of placing more stress on your neck joints.


Weakness  in upper body strength plus lack of coordination will increase pressure to your joints and spine .  Your neck tightens and spasm.  Muscles become more weak and less coordination since it cannot fullly function.  You try hard to bear weight with exercise, which will lead to a vicious cycle that will not get to the root cause, leading to you to come to the conclusion that yoga is not for you.

Quick Tests to see if your neck is over-reacting and there is “issues within the (muscle) tissues”

Trigger points are great for a clinician and you to see if there are dysfunction in within a muscle.  The problem is that it does not say why the muscles are dysfunctional.  You may not have neck pain, but if you have trigger points to your neck muscles than there is an underlying problem.

Here are the big three muscles that are designed to help you over-compensate or demonstrate that you are trying to over-power your yoga pose.   They are the Sternocleidomastoid, Levator Scapulae, and Upper Trapezius Muscles.  These are three muscles that help with turning your head and commonly becomes dysfunctional when you wake up with that dreaded kink.

Upper Trapezius Muscles



Note where the “x” spots are within the muscle diagram.  Press on the spot and if it hurts, you have a trigger point with the Upper Trapezius Muscle.

The red shaded areas are pain referral that is part of the Upper Trapezius Muscle dysfunction.


Levator Scapulae


Note where the “x” spots are within the muscle diagram.  Press on the spot and if it hurts then you have a trigger point with the Levator Scapulae Muscle.

The red shaded area is pain referral that is part of the Levator Scapulae Muscle dysfunction.






Sternocleidomastoid muscles


Note where the “x” spots are within the muscle diagram.  Press on the spot and if it hurts then you have a trigger point with the Sternocleidomastoid Muscle.

The red shaded area is pain referral that is part of the Sternocleidomastoid Muscle dysfunction.



If you have 3 out 3 muscles with trigger point and you are serious about doing yoga, but worried because of any nagging injuries, you can get your first TELE-HEALTH phone or skype consultation by clicking on the blue button.

What are common pitfalls when starting Yoga that increases your risk of hurting your neck?

1.Your upper body strength is weak and joining a class will speed the stress to an already weak region.

When we use the word strength, we are focusing on the ability of your body to turn on, match the power based on the yoga pose, and shut down unimportant muscles.  If a key muscle cannot turn on, then you cannot be stable at your joints and spine itself.  When your body cannot sense how much to turn on and off and there is a mismatch in intensity, your joints will have to juggle this imbalance.

2. You have a history of low back pain and have not completely addressed the physical capacity of your lower back.  Our holistic theory of neck pain is that non-traumatic neck pain is a victim of a weakness or lack of coordination within the lower back and pelvic region.  We are not talking about the appearance or the ability to perform amazing lower body feats.  You are only as stable as your foundational base.


Here are three tests that you can do to test if you have sufficient Lower Back Physical Capacity.  Click on the video.  Dr Stuart McGill is a researcher and Doctor of Physical Therapy and spent his whole career looking at the mechanics and inner working of the spine.  He recommends these 3 tests and exercises that everyone should be doing.

ABDOMINAL CURL UP: support your lower back, knee bent, head up. Hold 30 seconds.

SIDE PLANKS: lay on side, pick up your upper body and pelvis. Hold 30 seconds.

BIRD-DOG: get on all 4’s and pick up opposite arm and leg.  Hold 10 seconds. Switch.




3. One of your legs has better balance than the other.  

Assuming we have good balance to both legs since we are walking without issues is a big mistake.  Single limb balance asymmetry has been shown as an injury risk factor but one cannot say why.  We can go into the chicken or the egg question of which one is compensating, but it is better to be better balanced altogether.

The gold standard of testing for optimal single leg balance is when you stand on one leg with your other knee up at hip height.  If you feel comfortable, close your eyes.  A healthy leg balance time that will not sacrifice your muscle and joints is 30 seconds with your eyes closed.


Now that you know you have an underlying neck dysfunction with the trigger point assessment and able to test the common 3 mistakes people make that will place their neck more at risk, read our follow-up article “How to safely do yoga when dealing with neck pain (Part 2)“.  This article will dive into strategies to address the common 3 mistakes and 3 yoga poses that you can start doing today.

If you prefer a Medical Holistic Spine and Sports Medicine Physical Therapist to assess and guide you during this process as a security blanket, you can click on the blue button below to schedule your special time on our schedule.  We welcome you to our ReVITALize Rehab Club  HQ – Physical Therapy Division to learn more about how to keep you active, mobile and independent.


Looking forward to hearing from you,


Dr Danh Ngo

ReVITALize Rehab Club



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