Craniocervical "tucking", a biomechanical fallacy and common cause of extracranial IJV stenosis
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- Опубликовано: 4 фев 2025
- Biomechanical, extracranial stenosis of the internal jugular vein (IJV) is an increasingly commonly recognized problem (Larsen 2018c, Gweon 2011, Dashti 2012, Higgins 2015, 2017). It frequently occurs between the atlas and styloid process, and may occur as a sequela of forward atlantal subluxation (Larsen 2018c) as well as due to intermittent, positional obstruction (treningogrehab.no/atlas).
Continuous neck tucking will cause the styloid process to translate down and backwards, narrowing the atlantostyloid interval (ASI) which the neurovascular bundle (IJV + CN9-12) transmit through. Compression of these structures may cause intracranial hypertension, chronic fatigue, orthostatic disorders, vision impairment, audiovestibular disorders, and more (Jayaraman 2012, Higgins 2015, 2017, Larsen 2018c).
Thus we do NOT want to tuck the chin fully , and especially not in tandem with craniocervical extension as this may further narrow the ASI. We want to "elongate" the neck (Osar 2012, Larsen 2018c) without overly extending nor flexing the craniocervical junction (head), to maintain/promote a broad ASI.
Intracranial hypertension may often remain occult. It has been shown that many may have this problem despite normal lumbar punctures and cerebral MRI scans (Higgins 2015, 2017, Larsen 2018c). The subsequent chronic venous congestion may burden the dural membrane to such extent that it perforates, resulting in CSF leakage and intracranial HYPOtension. This may cause depression, severe fatigue, orthostatic headaches and tachycardia, etc.
Habitual cervical hinging and chin tucking is detrimental and should not be done.
Chin tucks are promoted by so many physical therapists. I had significant Neuro symptoms and occipital pain as a result. You are presenting essential bio- mechanical information that is ignored or unknown by the many McKenzie chin tuck promoters on RUclips. Thank you so so much for sharing your knowledge and EXPERTISE with us.
Hi have you recovered from the occipital pain ?? Can you help me ,,even I have occipital pain and neuro symptoms.
@@dhineshkumars1991 It sounds like you may have some degree of cranial-cervical instability. All of the nerves and blood supply to and from the brain passes through your cervical spine. If there is cranial/ spinal misalignment, it causes compression on these nerves. For example the nerves that travel within the carotid sheath are the vagus, hypoglossal, and accessory cranial nerves, as well as branches of the ansa cervicalis and sympathetic nerves. Genetic predisposition, head/upper spinal trauma, chronic poor posture, chronic neck hinging/ bracing, etc can esp over time cause pain and dysfunction. I would suggest you get a C-spine MRI to rule out anything more serious. What has helped me the most is getting rid of slumping/ head forward posture and strengthening muscles that pull head up and back as well as upper thoracic spine. It takes time, effort and consistency to change your posture, and subsequently relive pressure and compression on important structures in head neck area. I can give you some exercises that have helped me the most.
@@dhineshkumars1991 Looking at a side view of yourself, would you say that you have some forward head position?
Our front muscles are all intrinsically stronger and pull harder than our back muscles. Plus most of what we do is down and in front of us. All of those muscles are dominating and pulling us forward. That includes pulling your cranium and cervical spine forward. This causes spine dystructure. It is hard work to strength muscles that pull you back and upright, establishing more of a balance. Look at pictures of poor spine posture vs normal. Look at your posture in side view. When relaxed does your ear, shoulder and hip all line up? That is the goal. At first it is hard. But over time if you strengthen the right muscles and change poor habits, straight upright posture will become easier and feel more natural.
The Superman exercise strengthens all posterior muscles and stretches front muscles. You can start out with a few reps and eventually increase to 60. Correct form is everything with this exercise. For example when yo lift up, make sure your head and neck is in a straight neutral position, your nose facing the floor. Do not tip your head up, ONLY pull mid to lower head back. It is a similar muscle activation to this:
Lie on your bed flat facing the ceiling. Chest out and push the mid lower back part of your head gently into the mattress.... face square with the ceiling. DONT tilt head up or down... maintain neutral head/ neck. The mattress contact point should be only the mid occipital portion of the skull. While pushing your head back if you feel muscle activation in the lower portion of your skull to where it joins the neck, that’s correct. Those muscles are very weak and neglected in most people.
@@jeanine219 so have your symptoms resolved? I think the muscle you are talking about is the suboccital. I also feel mine is very week and infact when i lay down on my back my symptoms and neck pain gets worst as it feels like the neck contact with the bed/pillow is making it weaker.
@@snbrains9341 My headaches, neck pain and neuro symptoms are so much better from these strengthening exercises. At first the exercises made things a bit worse. But within a month or so I started feeling better. The suboccipital muscles are tiny muscles that stableize the connection between your head and upper cervical spine....so important that these muscles are not neglected, weak and tight. Your head is use to forward position, so when you lie flat on bed (no pillow), it feels awkward, painful and perhaps dizziness etc. Face ceiling and don’t tilt head up up or down. You will feel contact of part of skull behind your ears with the mattress. Just gently at first, press head into mattress. Make sure at the same time your upper shoulders are touching the mattress and your chest is out. These are all of the muscles you need to strengthen, that are currently weak and stretched forward. Expect it to feel awkward and uncomfortable at first. If you sleep on your back, do so without a pillow, as the pillow just reinforces that head forward position. A small towel roll under your neck is ok. Superman exercise will help your entire spine because even lower spine misalignments can translate to forward head position.
This video has helped me immensely. Every therapist I worked with taught me the wrong way to do chin tucks. And they had me doing it wrong 100x/day and then blamed me for not doing enough reps! Your advice was a game changer
have you found any more videos similar to him? I would like to see 2nd opinions, etc.
He's saying that chin tucks are evil and make you shit your pants or something.
Can show video of the right way please? 5 years of pain here
?did you see good results
Great video! I only had a styloid on my right side from a childhood whiplash injury. I have had chronic vascular and neurogenic symptoms for the past 46 years and my symptoms always got worse with posture correcting therapies. I just had my styloid removed in February 2023 and finally getting relief. Just the cognition increase and end of brain fog has already been amazing.
I just flared my symptoms doing some gentle chin tucking. What was your experience?
This is me to a T.... years and years of doctors no relief and diagnosed with the Thoracic outlet syndrome neurogenic arterial and venous all combined:/
I get these episodes as I call them where I can’t think straight dizziness headache off-balance visual disturbances overall just a horrible feeling when I do chain taxes I have been advised by every physical therapy I have ever seen for forward head carriage! Would always leave there feeling so horrible could barely drive home-i’ve actually gone to the emergency room several times in bed and Medicaid with doctors thinking I was having a stroke-super scary! I am making an appointment for a consult with you because I honestly think you ARE the only person who understands any of this the proper way so many of us have been injured and harmed by different doctors across the entire gamut!
God bless you can’t wait for my consult!!
Sorry...typo...NOT CHAIN TUXS meant “CHIN TUCKS!”
@@user-eq1cj8pi5r how r u now?
Szyszak hi there! He is awesome! I had a consult with him and he was very helpful! I’ve been BAD about doing the exercises he recommended so I am in a mild episode now! He is very knowledgeable with this topic
Sam hey how are you now? And what were your symptoms?
This same thing has happened to me about six times. It's terrifying. I have an appointment with an orthopedist in a few days. I'm scared to be alone until then. Did things ever get better for you? Stay safe. ✌
Excellent video Kjetil, hope that you are keeping well. Under the spotlight of the establishment at the moment, so have been bolted down. When this is all over I still want to come up and visit you. Hope all well, Mike
What do you think of the chin tuck Dr Mike? Because you recomended the chintuck exercise in one of your videos. Thanks appreciatie all the effort
Hope to see you soon, Mike.
@@michielbancken1884 haven't understood he said that we should avoid chin tucks ? i'm not native speaker
@@minaalgeria5688 Kjetil said dont do chintucks(with a very covincing explanation) while Dr Mike the chintuck exercise recomended. I used to do them untill i saw Kjetils Video about it. Its good to see how two very genius experts meet eachother. Cheers
Please make a collab video on this subject, I'm sure it would be incredibly enlightening to see both of your perspectives on this topic in the one video.
you sir might've literally saved many lives including mine with this video. i can't thank you enough !
That´s a really interesting discovery. I´ve experienced just that. Fatigue, dizzyness and high tension in the suprahyoid muscles when sitting a lot at my computer. Will definitely try to change that and see what happens. Great info Kjetil.
Dude, finally someone who understands this and can explain it thoroughly (with a solution)!!!!!
I never had neck pain for my entire life up until a few years ago when my dad shared a chin tucking exercise from a physical therapist, which I started doing quite forcefully and often. My neck started getting tighter and tighter and then I finally strained it severely. I'm just now recovering from it after realizing what you're talking about here in this video. But your video helps me a lot because it confirms what I've learned from experience and is a wise and important reminder to change my habits, relax and let go of the tension I've been holding.
Thanks so much for sharing. You might the very best therapeutic trainer I've found yet and your videos are up to date and very helpful. Thanks!
Hi
Did you have any forehead prominent veins😊?
bro I love you lol. its good to finally see someone with just straight up critical thinking skills instead of someone just taking from a textbook and regurgitating it.
Love this guy!! I keep referring back to his videos over the years he’s the only one I trust!
This makes so much sense! I would leave my therapist with the worst headaches!!!
Alexander technique teaches the position as cue
Head forward and up. The hard part is learning the new feeling of the corrected position getting used to it and also trying not to force the position rather let your body do it
But that's difficult because your body thinks the incorrect position is correct 😆
Great video!
Where can i find the Alexander technique ?
Huge thanks. I struggle with hypermobility especially in the cervical spine. This video has been super helpful. 🙏
Are you better
Finally I found someone explaining what this. I've had it confused with forward head posture for a long time.
Altough some muscles like longus colli needs to be strenghten in both cases.
It's hard to identify when you're using the correct muscles and not cheating, atleast for me.
I would really like to see some more videos on this topic, this is the only video I found.
Keep up the good work!
Yes, it is hard, unfortunately. But not impossible.
How is it for you now?
It's good to see this finally being talked about as it is waaaay over-prescribed. Particularly by McKenzie credentialed therapists.
yes!!!!!!! It made me get visual snow ;(
@@karlinhahf what do you mean?? you did the mckenzie exercises for neck and u got visual snow ???
@@GreenAlexPower yes
How are you now?
@@karlinhahf Was this the only thing that changed in your life? I have visual snow and never heard of this being a cause. I suppose it's possible but med changes or drugs more likely
I watched these videos while I worked on my posture this summer, but even though I avoided the chin tucks I still think I developed this!
great video i love this stuff ive been researching everything on facia and muscles and congestion for a few years now and the way you described how you sat and the feeling you got was easy to understand and to the point not confusing loved it!
My god, your videos are simply top quality! Thank you!
thanks bro
Thank you, man. This is exactly what is going on with me. I've experienced ICP about six times to the point I thought I was going to pass out and had to call someone to come watch me because it literally felt like I was going to die. Without this information, I would be in danger. 🙏
(I only just learned about Intracranial Pressure through my own research a couple of days ago or I would have gone to the ER.)
Hey man, how are you doing now
another gold mine from you my friend this is another problem I have been having. Super intercranial pressure. alot of balance issues. I was overtucking the chin per my physical therapist and other advice given like pull your shoulders back and keep them there has really caused major issues. but you have really hit home on clenching and these issues.
What about doing the chin tucks as a repeated exercise to correct neck posture, but not holding that position throughout the day, and not holding it while performing the exercise?
Dude, you're an absolute genius! Your videos have changed my painful daily life and I'm in shock. I'm thanking the Lord for you! Thank you!
Lmao its rare to find an orthopedist who isn't a moron
I think you have just saved my life no joke I've had vision impairment for years now and no real understanding as to why I'm an electrician and I tend to do a lot of things with my head in this posture as I'm always doing this with my hands on top of that I had a fear when I was young of people thinking I was looking down my nose at them very strange I know i also used to do Calathenics which emphasizes the chin tuck I've had a problem with my voice also for a very long time this was in no particular order the point to my message is to say thank you so much!
HI am clinician x 35 yrs and have TMD. I was confused by this, and intrigued (language, not familiar). Would love a summary at end with visual: so what I am hearing is: sit up straight, neck up, chin neutral with ? neutral spine. Where is rib cage placement? shoulder? eyes? when looking at PC, and core? engaged/not engaged. Would love more alignment tips (total alignment), as to align whole upper body with ?neutral chin slight tuck. Feeling more pointers , more demos, more visual with less descriptions. Agree: too many chin tucks, was told x 10 yrs : chin tucks after 2 whiplash accidents (hit from behind while i was stopped) and can you talk: Dowager hump x chin placment. Love that your here!
I also don’t understand at all what I am suppose to do
@@marijadejanova549yo estoy igual no entendí porque no hablo inglés y no vi nada visual que ayudara
Me neither 🙄
I have cervical dystonia- it is very complex neurologically and symptomatically biomechanically complex. Your videos are helping me making sense of it in a way my Neurologist and Neurophysiotherapist haven’t. Thankyou. If you have seen any Dystonia patients I would be really interested in your views. Particularly for post-injection physio and exercise. Right now my head twists left and into extension slightly so the main neurotoxin injected into the contralateral (right) sternocleidomastoid and right splenius capitus and sometimes the trapezius (bilaterally). It’s very hard to find exercises given the amount of muscle atrophy that work while the Botox is acting on those motor nerves. To help with ROM and stability especially
THANK YOU SO MUCH! I was over correcting my forward resting head position.. I knew it had to be somewhere in between because I couldn't breath when in over corrected tuck position..but still want to fix my fhp!!! Thanks, man! YOU are bright!
Thank you so much for this information! I have had concerns about chin tucks and but have been unsure how to move forward with my patients. This was a very helpful video, thank you!
i think you just saved me a lot of problems. considering unsubscribing from a certain youtuber insisting that's the only way to fix forward head posture. thanks so much
We need some people like you in France ...
Omg so that's the problem i was having then! I recently started having numbness in my arms and pain on my neck, spine area but i didn't know why. I had started neck tuck and some other exercises for correcting my posture and i was about to fix the bulging on my neck. Unfortunately it was getting worse everyday, i thought i was doing the exercises right. But after this video i immediately stop doing those and tell you what? All those problems massively reduced.. it seems there is not just one solution for everybody. I am glad i discover your channel and really thankful of this. No other videos on youtube seem to tell this. It is even better to do nothing rather than doing those ridiculous "neck tucks" . At least on my case.You literally helped and saved lots of people's health.. thank you!
Thank you, great video! I literally can feel my brain tingling and sinuses draining when I do that. Now to exercising more...
Interesting observation of yourself experiencing chronic fatigue syndrome symptoms after holding that poor head posture! I never thought a head posture could cause those symptoms.
Your videos have really helped me understand more about why I have had dizziness, nausea and almost passing out at times, I definitely had a hinge around C6-C7, I had trouble achieving a long neck until I noticed I had too much curve in my thoracic spine meaning T1 was coming in on a steeper angle, I am now working on my thoracic kyphosis and I’m able to achieve a long neck without a hinge. If you have any videos on the thoracic/cervical connection I would love more information, great work man👍
I think I already described "the connection" here, so I don't know what more you want
@@MSKNeurology thanks again man, your other video explains more,
ruclips.net/video/JAqtfOmSKIs/видео.html
really appreciate all of your videos they have helped a lot.
Great video, I think I have this problem (I've had TMJD for a few years now at 23 years of age). Are there any good exercises I can actively do to fix this?
Hi how are u now
Great video and points, I have definitely done this! Also noticed that even just breathing is much easier in the correct position 👍
Great information! I'm wondering what would be the best sleep position to avoid this issue.
Hello, following a false movement to stretch on my bed with my head on the pillow, I put my neck in hyperextension and tilted my chin to the sky, I heard a crack towards the occiput and a sensation of something sliding forward, since then I have pain in this area as well as a feeling of stiffness, something blocked that needs to be put back in place, sometimes tingling in the skull and face. Do you think my C1 could have shifted slightly forward? What can I do to remedy this?
Dear Sir, I have a couple of questions: Are you saying avoid chin tucks altogether? Or just do them but only lightly? Also, should we extend the neck like you have showed at 4:40 as an alternative excercise? If so, for How long should we hold that position for?
So glad I'm not the only one who wasn't clear on the message.
@@Tsugimoto1I am not sure what he is trying to say either
@@matchpoint14yo tampoco entendí no hablo inglés y no entendí nada :(
I was having numbness in my thumbs, and everything I searched about it online went to carpel tunnel syndrome. I knew it wasn't that, and that it had something to do with my shoulders/neck area, but I couldn't figure it out. This video confirms the problem I had. I was trying to prevent the neck hinge by tucking my chin down when performing exercises and when running. When I stop tucking my chin and instead bring my chest up, the numbness is gone.
Fascinating!! I need to pay attention to my posture because I'm guilty of the chin tuck.
I'm not a native I can't understand he means we should avoid chin tucks?
@@minaalgeria5688 yes
Thank you so much for your videos and information. I've been battling a hunch back with shoulders and horrible mid cervical hinge for years now. I saw an incredible specialist and received my prescribed corrective exercise regimen but for whatever reason I couldn't perform the deep neck flexor exercises properly. I thought I tried everything until I just simply lifted my head like you showed.. I think the distinction or the KEY in this scenario is not to enter flexion, that is not a correct chin tuck. The correct way to activate DNFs is to sit/stand nice and straight comfortably, look straight ahead and simply push the tongue up to the roof of the mouth you will feel the relief instantly if you engage them correctly. I hope this helps others struggling with a shit cervical posture!
would love if you could explain this more, in depth. Curious. I push tongue to roof of mouth and muscles in cheek get exhausted instantly, must be doing it wrong, welcome more details, thanks so much!
Wow... I have had trouble engaging dnf as well. So if I'm getting this correctly, the way you train your dnf is just to hold the position you described, with tongue on the roof of the mouth, rinse and repeat? I'm still not sure if what I feel is dnf
Can you please make a photo at least of the correct position, it was really hard to follow and understand as you switch from position to position too fast
So how did you end up fixing your issue exactly? Besides positioning different at the computer etc, what exercises did you do to retrain your neck muscles to hold your neck correctly since the chin tuck isn’t helpful
Dr. Larsen, very good presentation of correct mechanics in this video. I am a bit confused on one thing thought that is external to this video. It would seem to me that you are advocating for a “military neck posture”, because this is exactly how we were supposed to stand at attention in the military, hence the nickname. Is this the case? Otherwise, how would this correct posture look on a x-Ray? Would there be a reverse C curve, or would it be more straight like military neck?
OMG this is exactly my problem! Thank you. I get so nauseated and it feels like my head will explode. I was told to do chin tucks but must have been doing them wrong
Thanks for the summary at the end, I needed that to confirm that I understood. Great information.
I didn't even know I was doing this and it was definitely contributing to my pain, thank you!
Great info. Thanks. If when a person tried chin tucks to fix the dreaded hinge and their neck got stuck for a couple of days. What might that suggest to rule out?
Thank you Kjetil ! Finally a voice of reason!
Great Doctor! Many GPs need to have some training
I started doing chin tucks to fix my forward head,but it only gives me tensions around my neck,which were never before.
Because you're working out your neck muscles..
@@TehUltimateSnake so is that a good thing ? Or am I doing something wrong?
So I'm assuming the chin tuck and double chin exercises that are prescribed by nearly every physiologist on the planet are to be avoided completely? You are such a progressive visionary. Keep turning the industry in it's ear.
I have used the chin tuck exercise to loosen the suboccipitals and therefore reduce headaches...but I always felt that they were doing damage simultaneously.
What do you suggest for management of suboccipital tension, forward head posture and exaggerated neck curvature, (with or without hinging)? I dont have evidence of hinging but have been told that my neck curvature is very exaggerated and suspected to be the result of tight SCMs.
I would have a look at his blog post Robert. Well more of an article than a blog post!
I love Kjetil's articles.
Where do I find his blog Ciaran?
same question! i was told by my pt to do chin tucks for my cervicogenic vertigo but feel dizzy while doing them now.
You'll have to click the English button on the top right - then go to articles.
www.trainingandrehabilitation.com
this the best explanation for my neck issue. I need help
I have blurry vision. Sore heads.
Static vison and have really bad posture.forward head posture is something I have pretty bad. Aswell as pretty bad hunch back. How do I sort it ?
How does this sort of resting position translate to the longus colli and capitus exercise. Would the exercise have to be modified or would the increased strength of the muscles make it easier to obtain this sort of resting position? Thank you
I could cry rn. Thank you so much
Hi
My C1 is touching skull, have terrible variety of symptoms . Have straightning of curve .Can you pls suggest some exercise.
Thank you
So do tucks? Just the right way? Or just avoid them? 5 years of doibg double chins here. In pain still
Wow, such an excellent video. Thank you 👍
I personally attest to the fact that after I started doing McKenzie chin tucks and keeping chin tucked during the day, I started to have dizziness and pressure in the back of my head. Neck hinging in the back was adding to my problems. Very harmful exercises promoted by almost all so called experts. Big thanks to Kjetil for his work.
Are cervical extension exercises okay? Do they contribute to cervical hinge?
Are cervical flexion exercises (particularly the neck curl) okay? Do they contribute to compression of cervical artery?
Are lateral cervical flexion exercises okay?
Are neck exercises in general necessary for a strong and muscular neck, or will simply having proper posture be enough for a strong and muscular neck?
Does having a muscular/thick neck contribute to sleep apnea?
I have issues with migraines and a lump on my throat right under the jawline. I notice the lump get smaller when I sit the way you describe we should here, and when I sit the way you say we should not sit, it grows.
My doctors have not found a issue with my issues. Is it dangerous when I started to get a lump?
WOW! I booked with you already. All these exercises and learning of how to be aware are not as easy as they seem:-)
How'd it go?
Update?
Please help i keep hinging/pinching the back of my neck when I sleep. When I wake up I feel a pins and needles feeling in my head and blood rushing to my head. Anything I can do to stop or help this
Are you suggesting to sit with neck extended forward? Isn’t that just forward head posture. Why not just keep it neutral? I sit for 8+ hours per day without much discomfort.
You're missing the point completely. And no, it's not.
How do you strengthen the craniocervical flexors and longus colli without tucking the chin?
Good question
Very informative. I have terrible episodes when I get back from the gym after using elliptical. Should I use a neck brace while working out? Going to a neurologist. Please help.💙
what do you think one can do to address recessed maxilla? or is that something the mews would have more information on?
Thanksm
Can Too much chin tucking lead to military neck? ( lack of lordosis in cervical spine )
Nah , military neck occurs after an accident or genetic
Military neck happens from crap posture and neck clenching. There's probably a genetic component as well. That said, chin tucking sucks and shouldn't be done.
This is interesting. So I'm 31 and have worked out and kept relatively good nutrition since my teens. I started a desk job about 6 years ago and have had major issues ever since. I've had 3 ischemic strokes and frequent migraine with auras. Every test and scan always says I'm healthy as a horse. I know for sure I've been obsessive on trying to "correct" my posture because I've had breathing issues and felt like crap. Is it possible most of those stem from what is presented in this video? No Dr. Or Neurologist has been able to explain thus far.
I have a quite straight cervical spine due to an injury and I was told by physicians to do the chin tuck and all it does it cause teeth pain after. I immediately stopped of course, but it still left behind consequences for doing it.
I have this neck tuck posture and also intracranial hypertension. But I think there is an issue with my back somewhere down the chain. I have severe iliopsoas injuries
How do i check if i have jugular compression or decreased blood flow
I assume if we correct the neck position and posture should this help with Thoracic Outlet Syndrome? I have read that neck tucks should be done for TOS, obviously I won't be doing these anymore since seeing this, but i thought the more head forward position is the issue with closing off the brachial plexus bundle?
Great information. Though using the chin as a reference for patients with micrognathia may be problematic as chin is not where it’s supposed to be. Can use the nose or brow line to help these patients correct head position with respect to level/plumb.
Meh
Lol, thanks for your brevity : ) Another thought is learning to use proprioception to better align the head over the spine. If the head is levered over its support, it feels heavier. I’ve been using biofeedback as well (similar to blood pressure cuff) and I’ve had some success. Thanks for your work - haven’t seen anyone putting things together in such a comprehensive and common sense way.
Im confused. Chin tucks are meant to activate the internal neck extendors? And thus maybe assist in repairing a reverse curve or try create a normal ' curve? The uk n h s is atrocious literally, not just unfit for purpose... And i try work on my own on this earth maybe. Anyway, After ''physio exercises ''... I do feel guessed venal congestion symptoms...but i just felt like it was a price to maybe assist very apparently mylopthy,
Can a combined hinge and craniocervical tuck, as seen at 1:25, also cause tautening of weak scalenes continuously throughout the day, contributing to TOS CVH?
Neck extension in general tautens the scalenes, so yes it can contribute. Hinging, though, doesn't really extend the lower neck just the upper, so it does not always cause scalenus tightening. I have had many patients, eg., migraine patients (TOS), WORSEN with proper neck posture initially because it causes tautening. So we had to go very gradual.
@@MSKNeurology With those patients, how did they manage to untauten the scalenes in proper posture? Was it more a matter of proprioception ie learning to lift the head up and flex the neck without involving the scalenes, or waiting until the scalenes were strong enough through isolation exercise to then be able to go into proper posture without them tautening?
@@jackprot351 You are overthinking this. Obviously if the patient had crap postsure for years and then completely changes their position, some muscles will get tighter and some will get looser. Some will activate more, etc. The key will be to go gradual, along with correcting the underlying issues cf. my tos article
@@MSKNeurology Thank you. Makes sense.
Hi Kjetil, thank you for this video. It seems I have this condition and so far doctors have been treating me only on the cervical hinge part, not the craniocervical tuck part. I have the symptoms - protruded trachea, chronic fatique, dizziness and so on. Probably has been caused by few of my habits - looking down on laptop and phone, reading on stomach etc. The cues you have shown are so far helping me, I just wonder, can you overdo the part of putting the head forward and keeping long neck (going too far forward on atlanto-occipital joint for example)? Or will it just get "fixed" there in correct position by surrounding muscles? Don't want to go too far, if it's possible...
Yes, easy to do wrong.
@@MSKNeurology Alright, will be careful then. Thanks for answer!
How is it now
@@snbrains9341 Still about the same, thanks for asking
@@axagra815 did you get to know what is wrong exactly
Would you still recommend cervical neck flexion exercises (but not as a postural habit)? While I still have debilitating neck pain, I've found the actual exercises alone seem to at least help stretch out my neck extensors, providing temporary pain relief.
Hi Daniel,
I don’t know the answer and I’m not qualified to give a professional opinion, but I’m passionate about biomechanics and I’ve been doing my own homework for years to help with my own joint issues so I’ll share my opinion and if anyone wants to speak on it then great, I’m here to learn.
I had a physical therapist once tell me of the importance of learning how to use and train my muscles when they are elongated and how important this is. I do think most physical therapists would tell you the importance of activating and strengthening your deep cervical flexors, but what I think this guy is saying and what I believe to be true is that traditional chin tuck exercises only train how to use your cervical flexors in a shortened position which is impractical and according to this guy harmful. What’s brilliant about this video is that I think his cues can help train your deep cervical flexors when they are elongated. For example, if you place your arm straight out palm down, slightly extend your wrist and hold this posture for a bit, I imagine after holding this position you would feel your extensor muscles (back of forearm) working. Another way to hold this same position would be to place the energy on your palm side and find stability through your wrist flexion muscles. This would be training your wrist flexion muscles when they are elongated. Finding a proper and efficient balance is the key and I think that’s what this guy is trying to say. I’ve been practicing his cues but then trying to find my deep cervical flexors to help with stability. An incredibly small, relaxed, and slow chin tuck, like no more than a centimeter seems to help me. When I do this my whole head shakes because I sense my cervical flexors are incredibly weak when they are in this elongated position. Hope this helps.
I’m trying to use the Ledwitz-Rigby paper that you mention in this video, and cite in your vestibular impairment article on your website, however I cannot find the actual paper anywhere on the internet. Would you mind seeing if you have access to it and point me in the right direction? All the best, thank you 🙏
Legende. Man får så mye dyr- og ikke minst feil behandling i Norge.
I am trying to learn how to do this. I can’t even feel the back of my head to elongate my neck though. That’s been the greatest challenge for me.
Hi, I did a chin tuck and at the same time I leaned my head to the right and back, and now i hear pulsating hiss of blood flow in right ear, do you know what could be?
He means we should avoid chin tucks plz answer i m not native speaker
I have that too. Did you find out what it was?
@@ImpulsoCreativo9322 no not yet, it is very slowly getting better though
@@rocfella which exercises are helping you?? I get the hiss pulsating of blood flow when I go from laying down to standing. On my right side, which has the right scm always
@@ImpulsoCreativo9322 no exercises, just leave neck alone for some time, neurologist told me that
Oh gosh this is impossible to do for hours at a time, maybe if we stand at the computer desk it can be easier? I woke up today with neck pain on the right side and tight TMJ and clogged ears...not really painful just discomfort and lots of clicking, warm towels and Tylenol helped but I can feel its still there. Been like this for 6 weeks on and off. Took antibiotics for 7 days thinking I had an ear infection and surprisingly it went away for a week and now today I am with it again. Why did the 500mg of Amoxicillin twice a day help if its the skeleton?
i think
sound recording has problem ??
or
my ears are not good.???
So how should we sleep, my muscles at the back seem to be weak and I hinge a bit (long neck makes it 2x as bad), I can do this most of the day but how should we lay down then? If we actively hold the neck long while laying down it's impossible to relax and sleep
Lie on your side with your head a little forward, or if you lie on your back use a fairly large pillow. Don't worry too much about making small mistakes. THe most important corrective is daytime (upright) posture.
I'm trying to do this correct posture and I immediately have some pain on my upper-middle back (leveled with the lower ribs). Does this mean I'm doing it correctly?
Unlikely
Is this advisable to those who has weak muscles in neck? Ive been slouching for god knows how long and i did the chin tuck exercises but its making me uncomfortable. Then when i tried yours i felt my neck decompress but my shoulders and my hump at the base of my neck hurts but not much. Its like sore or not getting used to that position. Should i still continue doing yours, and is this continous posture even just doing normal activities? Please reply. Need help badly.
My physio has pescribed chin tucks but they have been giving me so much pain. Absolutely useless to be paying so much money
So, people who've had whiplash shouldn't do chin tuck exercises, right? (and people in general also shouldn't, right?)
I have a hard time understanding him because the accent and I am not very attentive. Can someone tell me what type of head posture is he promoting here? Forward head?
Wonder that as well
make sure your lumbar curve is used because it will be easier to have the correct neck/atlas position.
Please what exercises can I do to help this? I can’t afford sessions. This problem has made me unemployable.
Well, you might try what's being shown in the video. How about that?
Read his articles on his website
@@MSKNeurology but obviously many of us couldn’t capture, please be so kind and post a visual or summarize the position in a comment
@@marijadejanova549 Can't help the entire world
I agree with the chin tuck, it made things worse for me. One question: Do you think it's appropriate to try and restore the cervical curve with Dennerolls or other devices, or will it restore naturally over time if you work on your posture and strengthen neck? Thank you for all the information you provide!
Just work on your posture
@@MSKNeurology will continue that then, thanks.
So not a good idea to do chin tucks for strengthening deep neck flexors ?
As I said.
I screwed myself after shoulder injury by trying to fix my posture now i have shooting pain in the upper area under ear and i have severe tinnitus, i think it was the chin tucks, now that area gets stiff and i have all kinds of weird symtoms doctors in my country think i went crazy, but im sure that the tinnitus and ear pressure is caused my neck .
Thank you so much, i felt so lost and alone in this journey, every move i try to do only gets things worse but im hopeful i'll find something. could you please share with us ways on hoy to relax that area and remove the tension from it .
I'm confused. Are you suggesting the chin tuck EXERCISE is bad, or just that head position?
If so, what exercise should be done instead?
Bad. Why are you asking me what you're supposed to do when I literally show it in the video?
Probably because your accent is thicker than a cow paddy, and you're constantly info-dumping and bouncing from subject to subject.
Why do you give condescending non-answers for the layman, instead of being helpful?
I was just trying to clarify something that you didn't specify in your video, you literally could have just answered without being so terse.
@@MSKNeurology yeah…talking down to people is a great look…Or are you just trying to get people to pay for your services instead of actually helping, and taking advantage of people in the US because you know they don’t have good health insurance and you can charge whatever hell you want. You tell them that every single physical therapist is wrong so they are too afraid to go (therapy sessions that are less than half as expensive as yours without insurance, by the way). You’re a sheister, pal.
@@MermaidMakes No...many 'informed' people in the industry advise against chin tucks. It makes sense if you think about it...the chin coming forward is an adaptation, a symptom if you will. You have to address the root cause of WHY it is coming forward, you can't just force it back.
@@AM2K2 I’m positive there’s a lot of incorrect common medical knowledge out there that we will eventually find to be incorrect. It happens all the time, so even if I’m wrong in trusting PTs I’ll accept that I’m wrong. The one thing I cannot accept however, is how much of an unhelpful prick this guy is when people are asking genuine questions. If he wanted to really help people he wouldn’t be shilling his overpriced sessions in America where insurance usually doesn’t pay for this stuff and instead be answering these very basic and earnest questions. He’s been doing it to everyone who questions him.
Can you do the tuck for us. Too many different ones out there.
Yes, I'm a subscriber now, you take it that step furthr that often explains why although I thought I was doing the right thing, turns out i wasn't and proved by the results.
What can I do to get a rid of neck humo then😣