What Might Help: Neck, Shoulder & Upper Back Care

For students who are safe to practice, we summarize considerations into these categories:

  1. Releasing Tension
  2. Increasing Awareness
  3. Correcting Imbalances
  4. More Considerations

1) Releasing Tension

  • Practicing passive relaxation
  • Practicing calming breath practices
  • Moving gently with the breath
  • Using gentle stretches to release tension in upper chest (that pulls the shoulders forward), shoulders and neck

2) Increasing Awareness

  • Learning postural awareness for incorporation in daily life
  • Increasing awareness of breath, tension and movement patterns
  • Moving patiently and with inner awareness
  • Ensuring proper shoulder and neck alignment
  • Modifying practices to avoid pain or aggravation
  • Originating movement of the arm from the shoulder blade
  • If practicing weight-bearing poses and inversions, being cautious to align shoulder joint carefully

Originate Arm Movement from the Shoulder Blade

The first thing to remember is that the arm does not function in isolation… When the shoulder blade doesn’t move much, it is not supporting the shoulder joint. So whatever arm movement you do, try to pay attention to what your shoulder blade is doing and emphasize that movement. This is where we want the arm movement to ORIGINATE FROM, with the arm just following the movement of the shoulder blade. Whenever I work with a student with shoulder issues, the first thing I check is how much awareness/mobility she has in her shoulder blades. – Olga Kabel

3) Correcting Imbalances

Correcting imbalance means to stretch tight, shortened muscles and strengthen muscles that have overstretched and weakened.

  • Countering effects of forward head posture through such practices as releasing tension in the chest and regaining upper back mobility
  • Lengthening the spine to address excessive upper back curve
  • Safely* strengthening muscles that have overstretched and weakened, including the serratus anterior muscles
  • Considering twists for strengthening and stretching muscles that twist upper back to right and left
* IMPORTANT: Mindful, Safe Progression in Strengthening Shoulders
  • Protecting and healing the shoulder girdle involves activating and strengthening shoulder muscles. But while Downward Facing Dog and Handstand work these muscles, the weight-bearing in such poses puts the shoulders in a vulnerable position.
  • It’s important to first mindfully build strength and mobility in shoulders before being weight.
  • Therefore, it is much safer to utilize preparatory poses where the shoulders are more stable. (See examples in Poses to Consider below.)
  • Experts describe here how the first step is teaching the student to bring the shoulders back and pull the shoulder blades toward each other. And then, once this healthy position can be held in Mountain Pose, then the next step is to keep proper form “while supporting a modest amount of weight (in poses like tabletop and sphinx).” From there, gradually increase the load on the shoulders to such poses as Plank and Chaturanga Dandasana.

4) More Considerations

Trapezius Muscles

  • In a pose such as Upward Salute where the arms reach up, the shoulder blades must be allowed to lift but the upper trapezius muscles (which attach at the base of the skull) should release so there is “no congestion near the base of the neck, and the sides of the neck are free to lengthen.” (Marla Apt)
  • Move arms with neck when addressing neck pain or stiffness; that is, whenever head is raised, lowered or rotated, arms move correspondingly. (A.G. & Indra Mohan)
  • Work neck by adjusting relationship between head and shoulders; either stabilize shoulders while turning head or turn shoulders in one way and head in other (Gary Kraftsow, Yoga for Wellness 1999, pg 144)
  • In weight-bearing activities, “pressing through the elbow when the arm is weight-bearing activates the deeper muscles—latissimus dorsi, subscapularis, and teres major—that pull the head of the arm bone down and back, away from the acromion process; this prevents the pinching of the supraspinatus.” (Doug Keller)
  • Ray Long MD notes that studies show having a strong core can improve the efficiency of the rotator cuff which leads to improved stability of the shoulder girdle.
  • Massage upper chest muscles. (Doug Keller)
  • With Frozen Shoulder Syndrome, “you actually have to move into far enough into stretch that it is painful. This is in contrast to physical therapy for rotator cuff injuries, where you would not go to the point of pain.” (Baxter Bell)

Figure Out What Is Happening

Often it is NOT the shoulder joint itself that’s the problem. The shoulder often ends up on the receiving end of what’s happening elsewhere in the body; namely the chest, upper and middle back. So we need to stop stretching the shoulder with intricate Cow Face-like maneuvers and stop trying to strengthen it with challenging weight-bearing poses. When we intend to work with the shoulder discomfort we usually have three main objectives: 1) Figure out what is causing the problem, 2) Stretch and strengthen the muscles that bind the shoulder girdle to the spine and ribcage, and 3) Mobilize the shoulder. – Olga Kabel