Last week I had a lady call me who was at her wit’s end. About a week earlier, she’d woken up with severe neck discomfort. She’d had a good workout the evening before at a local San Diego gym, GFit South Park without any mishaps whatsoever — no pops, pulls, or tweaks. Nevertheless, she woke up and her neck muscles felt tight and the bones of her upper thoracic spine and cervical spine felt like they were grinding against each other.
She’d already been to her chiropractor twice, but adjustments were making no difference at all. Massage also had not seemed to make any difference. Her neck hurt lying in bed, standing, sitting, and especially when turning her head to check her blind spots while driving.
Whenever I hear about neck irritation, my eyes immediately start looking at the shoulders. Often one or both shoulders will often be pulled well out of place, much too far forward and away from the spine. This can get the affected levator scapula working overtime, making the levator scapula pissed off and forcing all the muscles of the neck to work asymmetrically to essentially keep your cervical vertebrae from getting pulled out of whack.
But this woman’s shoulders didn’t really look that off — just very, very slightly. She did have a little slouch that gave her a little shoulder rounding, but it wasn’t that dramatic.
After having her do a few tests with her shoulders retracted, it seemed like there was something very, very different going on from what I normally see.
We went straight to the table where I began doing some neck work, feeling for anything overly tight in the front of the neck, back of the neck, and side of the neck. We relaxed the traps and pecs, pulled the spinal erectors toward the midline to extend the spine a bit, all in an attempt to get the shoulders and head to sit better, then had her retest her range of motion.
The good news was the muscular discomfort was gone and she had more range to comfortably check her blind spots, but the sensation of bones rubbing together was still there.
This was when I started to really question what was going on. “Does lying down on your side, back, or front make any difference?” I asked.
She said not that she’d noticed.
“Did you experience any kind of twinge at all while working out? You just woke up with the neck pain?”
“Yeah. It’s so weird. I didn’t get hurt at all during the workout. It just felt terrible when I woke up.”
“What about lying down?”
“Oh, it’s still there.”
“On your back, stomach, and side?”
“Well, I’m not sure. I definitely feel it now.”
“Okay, go ahead and turn face down,” I said.
She flipped over and put her face in the cradle of the table. “It’s gone.”
“What’s gone?” I asked.
“The neck discomfort is gone.”
“Okay…” I said. “Turn face up for me.”
Even when lying face up, she still had a slouch. It was as if she was constantly doing half of an abdominal crunch. Her ribs were being pulled toward her pubic bone by some extremely strong and shortened muscles. I poked around her abdomen a bit to see just how tight things felt. Forget a quarter — I could’ve bounced a bar of gold off her abs.
“Wow,” I said. “You’ve got some strong abs.”
“Oh yeah,” she said. “I’ve had super strong abs since high school. It’s always been that way.”
I spent about ten minutes working along the ribs, along the rectus abdominis, and all over the obliques to encourage the muscles to soften up a little and release their death grip on the pelvis and ribs. The benefit was immediate and was a welcome confirmation of my suspicion.
“Wow, it’s gone. You figured it out!”
This was not the first time I’d seen someone with abs that were way too strong and shortened. Usually the rib cage gets pulled down and you start to see shoulder problems (can’t raise your arms all the way out to the side, impingement, bursitis, etc. ad nauseum). This, however, was the first time I’d seen someone’s abs get so shortened that it clearly caused this kind of a pain in the neck.
So can you do too many sit ups? Yup. As with anything, balance is the key.
If you’re doing a lot of ab work, make sure you keep your abs stretched out and your back erectors strong enough to keep things in balance. A yoga stretch like the cobra on your forearms can be a really simple, easy way to stretch out your abs. For those who are already pretty comfortable using weights, Romanian Deadlifts and regular Deadlifts (DONE PROPERLY) will help get your erectors working really, really well. For those who aren’t quite ready for that stage — and also for those who think they have great erectors but actually are stuck in c-curves — you can try this Egoscue exercise known as Sitting Floor (video below) and see how your mid and upper back feel as you do this.