Neck Pain

Pain Triggers – Shoulder Rides




Most parents know kids can cause pain… literally. Lifting and carrying children can result in stress and strain on the parent’s body, back, shoulders and neck. The shoulder ride is a typical suspect. Despite being great fun for the child, it can quite literally be a pain in the neck for the parent as sometimes it is just quicker and easier to pick up a child when walking a long distance.

So how can a parent minimise the stress and strain on their own bodies?

  • If you absolutely insist on lifting a child up onto your shoulders, try having them stand on a higher (make sure it is safe!) surface such as a table, so that they are at the correct height. Remember its always much better to lift with your legs, rather than your back and this is no different
  • There are carrying devices on the market to assist in carrying children on the back or shoulders. These devices are potentially a safer option for the parent, and avoids the child needing to use a tight grip on the neck or head to hold on.
  • If carrying a baby or infant in the arms be conscious of alternating sides regularly to avoid overloading on one side only.
  • Limit the amount of time or the regularity of shoulder rides.
  • Know when to say no. Don’t attempt it if you are tired, or sore.
  • Know your limits. At some point in time your child will be simply too big to carry. Try and explain to them that it is no longer safe to keep carrying them.
  • Learn a few smart stretches to help keep you limber. Your friendly physiotherapist can guide you, or help you out if you’ve already suffered the effects before reading this advice.shoulder-rides


If you suffer from neck or back, it is best to commence neck treatment straight away.  Your physiotherapist has numerous tricks that can help to quickly relieve your neck pain and muscle spasm.

If you have had neck pain or stiffness for a month or more, your GP may be able to refer you to a physiotherapist in Sydney as long-term stiffness can be treated effectively at any time.

If you are not sure what to do, please contact Sydney Physio Solutions for advice or to make an appointment with one of our neck physiotherapists.

Driving Posture

drivingCould your driving position be causing your pain?

With the number of hours we spend in our cars commuting to and from work or during our weekend errands it could be possible that your driving position is causing you pain.

Common pains experienced with driving are neck, shoulder, lower back and foot pain. If you do experience any of these what could you do about it?

  1. Before you get into the car ensure there isn’t anything on you that can alter your sitting posture. Empty pockets of pants and jackets removing wallets, phone and keys; as well as ensuring that clothing is not restrictive.
  2. Seat position:
  • Adjust the seat so that you’re not having to reach too far forward on the steering wheel and you can visually see the road well. By moving the seat forward you should have a slight bend in your knee and be able to easily press the clutch or accelerator fully.
  • You want to keep your spine upright by correcting the backrest position. Using pillows can be a great way of correcting your spine position or the height of your hip and knees. This should reduce the pressure on your spine.
  1. Steering wheel: the height is determined on how much clearance there is for your knees during sitting and where you can still see the display panel well. To determine the arm length you should be able to rest your wrist comfortably on the top of the wheel without reaching forward. Keep both hands on the wheel to stop any twisting or side bending in sitting.
  2. Mirrors: Adjust your mirrors last to prevent any twist of the spine, neck protraction or leaning forward with the body.
  3. Foot placement: common areas of pain can be your heel or the ball of the foot. If you rest your foot on the floor this could lead to heel pain. Ensure that your foot is straight and use shoes that have cushioning around the heel. If pain is persisting once you stop driving this could indicate there is another underlying issue that may need to be treated. Pain in the ball of your foot is generally due to the contact point of the pedal, and is can be influenced by shoe choice. Ensure to wear comfortable shoes or implement gel padding if necessary to the pressure through the foot.


Even once you have established a good sitting position it is important to ensure you take regular breaks. For long distance drives take a minimum of 10-15 min breaks every 2 hours. When you stop ensure to walk and perform stretches. When you return to driving, recheck and adjust your sitting posture to alleviate your current symptoms.

Whilst driving check your posture to ensure you don’t slouch.

If pain still persists with the above advise please seek treatment from your GP or physiotherapist.

Sleep Habits

Physios are often asked about the best position to sleep in, and what is the best mattress or pillow to use. Unsurprisingly, there is no one answer. However, sleep is obviously a crucial time to allow the body and mind to recuperate. Here are a couple of tips that I often advise.

dog upside down

In patients with low back pain, especially if it is one sided and referring into the leg, I advise them to sleep with their sore side up and a pillow/s between the knee to unload the spine. This also works very well for hip pain, particularly bursitis, as it removes the tension of the leg from the hip.

Mattresses are often a great source of contention. The main advice that I give to patients is to make sure they feel comfortable and supported and check that they are not waking up in a valley in the morning! This would indicate that it may be time for a new mattress. This is where you need to have a trade-off between feeling comfortable but also supported. When patients are deliberating between a slightly softer or firmer mattress I generally recommend the firmer mattress as they tend to soften over time anyway.


When it comes to neck pain and pillows, I advise patients to select a pillow that maintains a neutral neck position. If you are unsure of what a neutral position is then you may want to consult your physio. The pillow chosen will vary depending on whether the person is a stomach/back/side sleeper, but it will also vary based on the person’s size and natural spinal curvature.

In general, side sleepers will probably need a high profile pillow, whereas back sleepers will likely only need a low profile pillow or sometimes no pillow at all (or a rolled up towel behind the neck).

When a patient is suffering from acute neck pain and finding it difficult to find a position of comfort, I generally recommend lying on your back with a McKenzie cervical roll under the neck. This usually keeps the neck in a minimally stressful position. If the patient also has associated arm pain, then I may advise them to have a pillow under their arm to support it and take the weight of the arm off the neck.

Workstation Position

The goal of ergonomics is to make work more comfortable and to improve both health and productivity. Many ergonomic problems can be fixed by rearranging, adjusting or modifying existing furniture and tools, so don’t be in too much of a rush to go out and purchase the next great ergonomic “THING”.

We know that sitting for long periods can have negative consequences for our health, and that regular breaks along with standing for part of your day can help to prevent and relieve aches and pains when they occur. However, often sitting cannot be avoided, at which times it is important to ensure that your office chair is set-up to provide optimal support for your back.


Steps for setting up your workspace:

Adjust the chair height so that your elbows are at desktop level (roll your shoulders back and relax them first).

Sit fully back into your chair, adjust the seat back for good lower back support, use a lumbar roll if the back of the chair does not support your lower back.

If your chair seat has a tilt feature, set it so that you are comfortably supported.

If your feet don’t comfortably reach the floor or there is pressure on the backs of your legs, use a footrest.

Locate your monitor so the top third of the viewing area is at or below eye level. Use monitor stand if required. As long as you can clearly view the screen contents there is no specific distance that you need to be from the monitor.

With elbows at the desk level, ensure that your wrists are straight. Use wrist rest if required, and if you have armrests try to adjust them so they support your arms without beings too high or too low.

Position the mouse as close as is practical to the keyboard, so that both elbows are directly under the shoulders while working. If this is not possible you may need to consider purchasing a mini keyboard.

To reduce stress on the neck when working from paper documents, a document holder can be placed between the keyboard and monitor.

Always either put the phone on loudspeaker (depending on your office environment) or use a phone headset if you need to use the computer while talking on the phone, this will help avoid neck and shoulder strain.

Use your mouse pad or another soft surface to pad the edge of your desk. Avoid pressing your hands or forearms against any desk edge.

Adjust screen brightness and contrast for clear comfortable viewing, and clean the screen regularly. Also remember the 20-20-20 rule: look away from the monitor every 20 minutes to a distance of 20 metres for 20 seconds. This helps avoid eye strain.

Finally and very importantly remember to take breaks regularly preferably every 45 minutes to an hour for 1 or 2minutes. Go get a glass of water talk to a colleague etc.

Couch Potato Syndrome

Admittedly, sometimes after a long day at work it is hard to resist the temptation to take the train home and fire up Netflix or the like for  ‘lock in’  & non-stop uninterrupted episodes of Game of Thrones, your favourite sport, or some version of reality TV.  What a way to escape and not have to think about – well, anything…

For many of us now, with access to mobiles, social media and on demand telly, this is becoming more and more common place.  We may not want to admit it, but Couch Potato is not just the hash brown left over form Sunday brunch, but in fact the way we end up through the week and weekends….it is certainly hard to resist when the episodes just keep coming.

Unfortunately, when we spend most the day sitting at the desk or in meetings  and then do the same at home, the body does not often get the level of physical activity it needs to function optimally.  The spine in particular is a machine that is built to move, and often this is where we feel the most aches and pains from sitting too long – especially sprawled over the couch with arms and legs in every direction!

When you sit on the couch – do try and keep your spine in relatively good line and maybe even get a little footrest to support yourself and throw a decent pillow behind your neck to support it – watch for excessive twisting or slumping of the body – then you can have your rest time without getting up in pain!

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Simple Ways to Reduce Neck Pain

We all know that basic workplace ergonomics can support a healthy neck. If we keep our desk at elbow height, our computer screen at eye-level and our feet flat on the floor we should be fine, right? Unfortunately, it’s not always the case. In fact, Australians suffer from high levels of neck pain and it’s consistently rated as one of the top five causes of disability. So what can be done to reduce work-related neck issues?

1. Get up and move

Research shows that a sedentary lifestyle is bad for your health. Even when you have the correct posture, sitting for prolonged periods of time can increase your risk of heart disease, diabetes and even mortality. It should come as no surprise that it can also be detrimental to your neck.

Sit-to-stand desks encourage movement and are a great place to start if the option is available. Try to alternate between sitting and standing every hour throughout the day. If you don’t have access to a sit-to-stand desk, set a reminder to stand up every 45 minutes and have a short stretch or walk.

2. Stay fit

Engaging in regular exercise and physical activities outside of the office has been shown to decrease neck pain and headaches. You don’t need to spend hours exercising. If you’re short on time, high intensity interval training is a great way to get results quickly.

3. Manage work stress

Many of us are aware that stress can lead to neck pain and tension headaches. When we stress our shoulder and neck muscles tighten, resulting in discomfort. Everyone gets stressed from time to time, but if it’s causing problems it’s important to resolve it before it gets out of control. Exercise, meditation and breathing are all great techniques for reducing stress.

4. Breathe

Take two minutes and try this… as you sit there reading, feel how much tension there is in your neck and shoulder muscles. Now concentrate on breathing deep down into your stomach so it moves in and out with each breath. How’s the tension in your neck and shoulder muscles now? Can you feel the difference?

These muscles aren’t meant to work all day to do your breathing for you, but we get stuck in a negative pattern and forget what’s actually meant to happen. Practice diaphragmatic breathing and you’ll find that a lot of your neck tension will disappear.

5. Don’t look down

Research suggests that looking down for extended periods of time increases the forces passing through your neck by 600%. The more you look down, the more likely you are to have neck problems. Keep this in mind when you’re reading a book or looking at your smartphone and aim to keep your ears in line with your shoulders.

Deep Neck Flexors

Deep Neck Flexors – The ‘core’ of the head and neck muscles…

Most of us have heard about our deep core muscles and how they support the spine – ‘pull in your core!” “this will build your core” and we seek out every way possible to train these guys…yet not often do we hear about the deep muscles of the head and neck, aka the deep neck flexors.

The role of the deep neck flexors is to keep the head in a neutral position relative to the neck, so that the head doesn’t drift forward and create stress on the muscles and joints around it – which is often what we see with neck pain and headaches as the load increases.

So ask yourself….


So – if you happen to catch a side glimpse of yourself and see your head slowly drifting forward, it’s not all doom and gloom. Take a moment to have a look at the video below and start training the ‘core’ muscles of your neck – you will thank yourself for it!


Headaches – understanding cause, triggers and treatment

Many people think that if they don’t have any pain in their neck then their headache is coming from elsewhere. However, the reality is that most headaches arise as a result of stiffness in the joints in the upper neck. When these joints get excessively stiff, they can refer pain into different parts of the head. Still sceptical?

If your headache is coming from your neck then skilled palpation (touching) of the neck joints and the overlying muscles by your physiotherapist will reveal whether your neck is the culprit by reproducing your headache.

For some people this is a little unnerving at first. However, it is a good thing if your headache symptoms are reproduced, as this then becomes the method for relieving your symptoms and confirms your neck as being the root of the problem.

Sustained pressure on the tight joints/muscles should cause a reduction in intensity of your headache as the tissue starts to release. Dry needling is another technique useful for settling down tightness. Once the joints responsible for the headache have been loosened you’re on your way to recovery.

Patients commonly report alcohol, hormonal changes, tiredness and stress as triggers preceding a headache. In terms of understanding the interaction between these triggers and the onset of a headache you need to understand that stimuli in the neck and the brain combine together to set your total level of sensitisation.

Think about it like a glass of water. If that glass is empty or minimally filled then you do not experience a headache. If the glass overflows with water then that level of sensitisation causes a headache. So the key therefore is how to stop the glass from overflowing. Stress, tiredness and hormonal changes are largely out of our control. But what if we consider neck stiffness as a trigger (even though you may not feel stiff in your neck)?

We can control our neck stiffness to a large extent through treatment, posture and exercise. So, if we keep the neck loose and empty the glass of water as much as possible then we can avoid teetering on the verge of overflowing the glass and causing a headache. If the glass is near or close to empty then it will take a big stimulus to tip it into overflow.

If headaches are impacting on your life, talk to your Physio about how to manage them or contact the team at Sydney Physiotherapy Solutions at either our Sydney CBD physio clinics or our new Chatswood Physiotherapy clinic.

Easy Tips to Avoid Neck Pain at Work

Healthy working- five easy tips: So as well as the screen position, what else can you do to avoid neck pain & stay ‘office healthy‘?

1. Bob Marley once said ‘Get up, Stand Up’ and nothing could be truer when it comes to preventing neck pain. One study showed the longer you sit, the more likely you are to have neck pain. Standing up frequently, whether to pop to the water cooler, chat to your colleagues or just go for a walk around- all will help.


Stand up desks are becoming popular. These often adjust between sitting and standing.

2. Don’t keep the neck too still! Avoid holding the same neck position for long periods of time. Especially if looking down. Studies have shown people who look down (we call this ‘neck flexion’) for long periods are more likely to get neck pain. It’s easy to get caught up in a document you’re reading- so remember to move frequently. Sometimes document holders can help.
3. Dead as a Dodo. The Dodo bird became extinct because it was unable to fly- it was suggested it was too slow, heavy and unfit. Don’t become the dodo- there’s lots of research that shows keeping yourself fit prevents neck pain, and has heaps of other health benefits too!
4. Don’t let work get you down! If you are stressed, or unhappy at work, you are more likely to get neck pain. Speak with your boss about changing things that don’t work for you. And try point (3) above- research shows if you do exercise or sport it’s likely you’ll be happier at work.


5. Sit. Stand. Move. Repeat. Regular movement is so important we are mentioning it again. You can have the poshest desk with the most expensive seat, and the latest computer screen. However, if you sit there all day and barely move, you’re still more likely to get neck pain, as well as other problems.

In summary: Movement is key. And if you can add in some exercise (whatever you enjoy doing, it doesn’t need to be the gym) you are minimising your risk of getting neck pain- and also gaining lots of other health benefits!

Neck Pain and breathing

The knowledge of how to breath with your diaphragm comes pre-programmed in every new baby. It is well understood and implemented by the infant with no complications.

How does breathing get messed up and lead to neck problems?

The diaphragm is your primary breathing muscle. It is a thin, wide sheet of muscle that separates the rib cage from the abdomen. It has a high domed shape which flattens out significantly when it contracts. The dome-shape is much more pronounced than most people realise, and that shape is important to understand.

breathing-hydraulics-s                Unknown

When the diaphragm contracts, that dome flattens significantly to allow space for the lungs to expand. As it flattens it pushes downwards on the viscera in your stomach. As the viscera is like liquid, which can not be compressed, the stomach must bulge out to accommodate the action  of the diaphragm. Hence, good breathing is usually described as “abdominal breathing” or “diaphragmatic breathing.” So the stomach in a person breathing correctly looks a bit like the happy buddha when they are breathing in.

The innocent infant grows into a self conscious teen and adult who responds to cues around them to keep their tummy in, in response to vanity. Smaller, less efficient muscles in the upper chest, throat and neck designed to help breathing in times of high demand (like running) are recruited to do the every second of every day task that is breathing. These are called accessory muscles e.g.. pectorals minor and scalenes. These are small muscles which quickly become overused and tight, leading to poor muscle stability around the shoulder and neck. See the connection to neck pain !

How to practice breathing your diaphragm

1. Lie on your back – put one hand on your chest and one hand on your tummy. As you breath in, allow your tummy to rise (do not push it up) while your chest does not move. To breath out, allow your tummy to flatten. Practice this in different positions. Sitting is the hardest. Practice this during different tasks and activities such as walking, gym, hanging out the washing etc.

2. To strengthen/condition your Diaphragm you can put a large heavy book on your stomach while lying on your back and practice diaphragm breathing with the extra weight of the book on your stomach. You could start by doing 20 breathes once a day and build up to more if you feel comfortable.