Integrating Upper Cervical Flexion with Postural Exercises

chin nod with shoulder w exercise

Several weeks ago I published a quick video tip on a variation of the chin tuck exercise, the chin nod exercise.  I received a lot of nice feedback regarding the use of the nod and wanted to share the next phase of the progression, integrated the chin nod into exercises.

Just like any other aspect of our rehabilitation and corrective exercise programs, the ultimate goal should be to groove motor patterns with simple exercises and slowly integrate them into more complex functional movement patterns.  While the chin nod is a great choice to work on upper cervical flexion in those with postural adaptations and an upper body cross syndrome, it is really only a small part of the pattern.

We always talk about strengthening the lower trap and serratus and performing manual therapy on the pecs, subclavius, upper trap, and levator (just to name the big ones…).  The chin nod is also a simple way to set your posture prior to some of these activities.

As an example, I shot a quick clip on integrated the chin nod into the shoulder W exercise, which is fantastic for posterior cuff and lower trap strengthening, as well as opening up the anterior shoulder.  By adding the chin nod prior to performing the exercise, you essentially enhance the outcomes of the exercise by assuring proper alignment.

This isn’t rocket science, but by integrating the chin nod into exercises like this, it really helps groove the correct motor pattern better.  Incidentally, this is one of my favorite exercises for those with cervicogenic headaches and neck pain.  Have them sit up tall in the car at red lights and perform this exercise.  Great, even without Theraband.  I even use this integrated chin nod and shoulder W exercise as my breaks while sitting at the computer!


The Chin Tuck and Chin Nod Exercises

Chin Tuck Chin Nod ExerciseToday’s post is a quick and dirty video technique post on the chin tuck exercise technique.  The chin tuck is a pretty common exercises used for neck pain and postural adaptations.  The chin tuck exercise essentially works on upper cervical extension and lower cervical flexion.  I like using it as part of my reverse posturing series of exercises to get out of the forward head, rounded shoulder posture that we see so often, essentially Janda’s Upper Body Cross Syndrome.

While I do use the chin tuck exercise, I do sometimes find that it can be performed too aggressively by some, especially if you are having some acute neck pain.  You don’t want to jam you neck straight back and combine upper cervical flexion with a shear force.  My good friend and excellent therapist Todd Howatt turned me on to this over a decade ago.

Rather than aggressively shear your upper cervical spine, you may want to start with more of a chin nod rather than a chin tuck.  Perhaps this is just nomenclature, but the visual shouldn’t be “jam your head straight back” but rather to imagine a dowel going through your head between both ears.  You want to rotate your head around this dowel and essentially perform a nodding motion.  I tell my patients to focus on feeling a stretching sensation in their suboccipital region.

This movement can be performed both standing (or sitting in your car, wink, wink…) and lying on your back.  I usually start lying down to prevent the jamming back movement.  I will often instruct to use your hands on each side of your head to help with the rotational movement around the dowel concept.  You can use this as part of reverse posturing, repeated movements, or for deep neck flexor strengthening.  To focus on strengthening, gradually work up to slightly lifting your head off the table and holding for a duration of time.

Check out the video below for some visuals:

What do you think?  I am still pro using the chin tuck exercise at times, but also incorporate a chin nod exercise when the chin tuck is uncomfortable or with acute neck pain.