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Featured, Winter 2022, Personal Wellbeing

Alleviating Neck Pain

Try these simple movements to strengthen underactive muscles in your neck and reduce your risk of work-related injuries.

Saleema LookmanRVT, CPT

Since entering the veterinary field in 2009, Saleema has held a variety of roles and positions. This diverse experience led to the discovery of her true passions for patient care, education, and mentoring. Saleema is currently part of the Boehringer Ingelheim Tech Champion team, delivering continuing education presentations to veterinary nurses, and practices in a high-caseload small animal practice. Saleema lives out her passion for fitness as a certified personal fitness trainer and group fitness instructor.

Alleviating Neck Pain

Has your job become, quite literally, a pain in the neck? If so, you’re not alone. Following animal attack injuries, sprains and strains are the next most common workplace injuries to affect veterinary nurses and assistants.1 Whatever your specific role as a veterinary nurse, the long hours and physical strain associated with the job likely take a toll on your body. 

Standing or sitting for significant periods, restraining patients in unusual positions, lifting heavy objects incorrectly, and staring at a low computer screen can lead to muscle imbalances and, consequently, injuries. But by strengthening and stretching the appropriate muscles, you can aid in avoiding this chronic pain in the neck and instead focus on providing optimal care for your patients. 

WHY DOES MY NECK HURT?

Several unique work-related scenarios can lead to neck discomfort. Injuries to cervical vertebrae, discs, ligaments, or nerves typically involve more complex solutions that your physician should facilitate.4 However, chronic muscular discomfort can be a result of poor posture or overuse. One of the most challenging cervical conditions to avoid, not just in the veterinary workplace but also in one’s everyday life, is often referred to as “tech neck” or “text neck syndrome.”5 Text or tech neck earned its catchy names from the action that causes it: peering down at one’s phone. But texting is not the only activity that can cause negative consequences. Veterinary nurses are at risk for similar neck flexion postures while performing occupational tasks, including looking down at a clipboard while recording vitals, peering over a patient in surgery for extended periods, or staring at a low computer screen. This repetitive and prolonged downward glancing motion puts unnecessary stress on the cervical supporting muscles.6 Fortunately, you can help protect your body from this common syndrome with intentional strengthening and stretching movements.7 


Watch Saleema demonstrate the stretches and exercises described in this article:


STRENGTH TRAINING EXERCISES

By strengthening the often-underactive muscles that support the head and neck, you can improve your alignment and reduce your risk of work-related neck injuries.8 Perform 1 or both of these movements daily. 

Always consult your physician before adding new exercises to your routine and seek medical attention if you experience pain during any of these movements. 

Chin Tuck

  • Sitting or standing with a neutral spine, place 1 to 2 fingers on your chin. 
  • Gently guide your chin directly backward, creating a “double chin” appearance. Pause when you feel slight tension in the back of your neck. 
  • Hold for 5 to 10 seconds and slowly return to the starting position. Repeat 5 to 10 times. 

Supine Head Lift

  • Begin by laying on your back with your shoulders and the base of your head in comfortable contact with the ground. 
  • Glance down toward your toes as you gently tuck your chin toward your neck/chest. 
  • Gently elevate your head off the floor—no more than ½ to 1 inch. 
  • Hold for 5 to 10 seconds and slowly release. Repeat 5 to 10 times. 

STRETCHING MOVEMENTS

Gentle stretching movements can help alleviate and prevent cervical discomfort and can even provide stress relief. Perform these stretches a few times daily, preferably before your workday, while standing in surgery, or anytime you need a moment of calm.

Be sure to avoid overextending the muscles involved by holding each static movement for no more than 15 to 30 seconds.9 If these stretches cause pain at any point, discontinue immediately and consult your physician.

Upper Trapezius Stretch

  • Begin by slightly extending your left arm to the side, creating a 15° to 30° angle with your body.
  • While looking ahead with your shoulders squared, allow your right ear to fall toward your right shoulder. Do so slowly and only until you feel a slight, gentle pull in the opposing side of your neck.
  • Hold for 15 to 30 seconds, then repeat on the other side.

Regression: Limit your range of motion or remove the arm extension.

Progression: To deepen the stretch, you may place your right hand on your head. Do not pull down with this hand; simply allow the weight of your hand to deepen the stretch.

Levator Scapulae Stretch

  • Start with squared, relaxed shoulders, staring directly ahead.
  • Extend your left arm slightly, creating a 15° to 30° angle with your body.
  • Allow your right ear to gently fall toward your right shoulder. Stop as soon as you feel a slight pull in the left side of your neck.
  • Then, slowly rotate your head and bring your nose toward your right armpit. Again, go only as far as your body will allow while feeling a gentle pull across your neck and shoulder.
  • Hold this position for 15 to 30 seconds, then complete on the other side.

Regression: Limit your range of motion or remove the arm extension.  

Progression: You can deepen this stretch by placing your right hand on the top of your head, allowing the weight of your hand to deepen the stretch without pulling on your head.

SPECIAL CONSIDERATIONS IN THE
VETERINARY PRACTICE

In addition to appropriate muscle activation, a few intentional changes can help alleviate strain on your neck to reduce discomfort. Implement these in your practice as early as tomorrow.

Elevate your computer screen. To avoid prolonged neck flexion while working at a computer, it’s important to have your monitor at the optimal level. The best practice is to ensure the top of your screen is even with or just below your eye level while sitting upright with a neutral spine.10 This can be challenging to achieve with shared computers in a hospital setting. Don’t hesitate to elevate your monitor or laptop with a textbook or case of canned food if you plan to type or read for longer than a few minutes. 

Remain cognizant of your posture. Check in with your posture several times throughout the day. This is particularly important during long stints of looking down or sitting at a computer. Set an hourly alarm as a reminder to correct your posture or enlist an accountability buddy to stretch with during lunch to reset your alignment. Better yet, lead your team in a flexibility break each day to improve everyone’s posture. 

IMPROVE PATIENT CARE AND SELF-CARE

The “Movement Is Medicine” series will focus on common areas of discomfort for veterinary nurses in the workplace, starting with the neck. Although this series will primarily discuss how intentional movement can protect your body on the job, it’s important to note that physical activity can also boost mood, elevate confidence, improve focus, increase energy, reduce stress, and improve quality of life.

Adults should engage in at least 150 minutes of moderate-intensity aerobic activity plus 2 days of strength training each week.3 This might feel like an inconvenience—the last thing on your mind after a long shift—but think of it as an exercise prescription. You would want your clients to comply with prescribed recommendations, so aim to hold yourself accountable for 30- to 45-minute sessions 5 times each week.

The key to adding fitness to your routine is to discover a modality of movement that you enjoy. In addition to these straightforward movements outlined in this series, try hula hooping, tai chi, fencing, bowling, rowing, dancing, or swimming. Find something that you truly look forward to.

Your ability to continue caring for your patients depends on your own self-care, and this includes caring for your body. By strengthening underutilized muscles and stretching, you can aid in injury prevention. Your future self and patients will thank you. 

References

  1. Cima G, Larkin M. Hurt at work. JAVMA News. Published October 10, 2018. Accessed September 8, 2021. avma.org/javma-news/2018-11-01/hurt-work
  2. Sharma A, Madaan V, Petty FD. Exercise for mental health. Prim Care Companion J Clin Psychiatry. 2006;8(2):106. doi:10.4088/pcc.v08n0208a
  3. Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for americans. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854
  4. Moley PJ. Neck pain. Merck Manual Consumer Version. Accessed September 8, 2021. merckmanuals.com/home/bone,-joint,-and-muscle-disorders/low-back-and-neck-pain/neck-pain 
  5. Lee S, Kang H, Shin G. Head flexion angle while using a smartphone. Ergonomics. 2015;58(2):220-226. doi:10.1080/00140139.2014.967311
  6. Institute for Quality and Efficiency in Health Care (IQWiG). Neck Pain: Overview. Accessed September 8, 2021. ncbi.nlm.nih.gov/books/NBK338120
  7. Bryant CX, Green DJ. In: ACE Personal Trainer Manual: The Ultimate Resource for Fitness Professionals. 4th ed. San Diego, CA: American Council on Exercise; 2010.
  8. Richey R. Heads up! Fix tech neck with these corrective exercises. American Fitness Magazine. 2018. Accessed September 8, 2021. blog.nasm.org/heads-up-fix-tech-neck-with-these-corrective-exercises
  9. Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012;7(1):109-119.
  10. Occupational Safety and Health Administration. Computer Workstations eTool. Accessed September 8, 2021. osha.gov/etools/computer-workstations

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