Episode 45 - The Neck Pain Episode: Let’s Talk About What You Might Be Missing

Ever notice how your neck pain seems to show up out of nowhere? Or never where you expect it to?

In this episode of Three Questions, I break down neck pain through a nervous system lens and invite you to stop treating the neck like an isolated problem.  Instead of chasing the one movement or posture that “caused” your pain, we explore how habits, sensory input, vision, load, and nearby joints all shape how your neck actually feels and moves.

In This Episode You’ll Hear:

• Why neck pain is rarely about one bad movement or posture
• How vision, sensory input, and load change how your neck responds
• Simple ways to explore neck pain by paying attention to nearby joints

Whether you teach movement, train regularly, or just want to understand why your neck keeps acting up, this episode offers a more curious, less frustrating way to approach neck pain.

Links & Resources For This Episode:
Episode 32: Unfreezing the Narrative: Rethinking Frozen Shoulder
Find a Neuro Studio Teacher Near You
Connect with me on Instagram
Connect with me on Threads

Transcript

Meghann Koppele Duffy: Welcome to Three Questions where critical thinking is king and my opinions in research are only here to support your learning and deeper understanding. Hey, I'm your host Meghann, and I'm so honored you clicked on Three Questions today so we can talk about neck pain. Now I think everybody listening has probably experienced neck pain in their lifetime and it's often, sometimes you just kind of feel like, ah, you wake up.

Your neck feels like shit. You try to move around and it can be super frustrating because it's kind of hard to drive a car or do anything when you cannot move your neck. So let's get right into it, and I'm gonna ask you three questions to help you maybe get to the bottom of what's causing your neck pain or maybe get some ideas of where to go or where to look next.

So question oh one, if your neck pain could talk. What would it say? Who would it blame? What activity would it blame? So let's just kind of start there. So we all know we have habitual things we do, right? So if your neck pain could tell you what was wrong, what do you think it would say to you? Hmm. Do you always sit on the same side of the couch when you watch tv, when you're at work and you're on your computer, do you have two screens?

Are you always turning in one direction? Are you a chef in a kitchen? Where are you always kind of rotating and look in one direction? Is it your job? Is it how we sit, how we move, how we smile, how we interact? And you might be thinking right now, be like, I don't know, Meghann. It could be all of the above, and you're probably right.

Something that nobody really likes to hear is it's often not one thing that led to the thing, the injury, the pain. Now, even if I take a baseball bat and hit you with it, if I hit the same person, excuse me, a few different people in the same spot at the same force. They're going to have all different injuries because everybody's body responds to trauma load force differently.

And something that's kind of cool about the brain and body is everything matters. Everything is connected. So when you bend over to pick something up or look at something, it's so easy to blame. Oh, well I turned my head really fast and my neck went out. It. You think that head turned, how many times in your life have you turned your head that fast or done it?

Now, there's few things that could be in play here. Could have been the straw that broke the camel's back, like your brain has been kind of telling you. Your neck is sometimes achy, but it's not bad, and then it doesn't hurt. So your brain has been trying to communicate with you for a while and just you haven't had the time or the energy to listen, so you've been ignoring it.

It. And then finally you do that movement one more time and your brain says, that's it. I am shutting shit down. You're done. Yep. That could be an option, or it could simply be based off the current environment and sensory input. So when you turned your head to the left, maybe something over there to the right.

Caught your eye. So your eyes were kind of still looking over to the right or jumped to the right when you turned to the left. So our brain could have been confused and had a sensory mismatch. You could have turned your head with such force that the rest of your body didn't respond. What do I mean by that?

So everybody right now, take your left hand and touch it to your right shoulder. And I just want you to turn your head. And just notice what do you feel under your hand? Is there a lot of movement? Is there a little movement? Is there no movement? Okay. A lot of times when people turn their head, they also rotate their spine.

Some people move the most of all will joint in the body. What's called your glenohumeral. It's what we all think is our shoulder joint, but our shoulder is actually four joints, but the ball and the socket, you know, the more traditional one. Some people move that when they turn their head. It right When we turn our head, the rest of our body should, in a perfect world respond reflexively, things should stabilize, things should mobilize.

Everybody should do their part, and everybody's fine. But sometimes not everybody does their part. Sometimes people don't get the sensory feedback to move. So question one is a hard one to answer, so I'm gonna ask it again. If your neck pain could talk, would it point out something specific? And you're probably thinking is probably the thing you don't wanna change at all.

Now, as I said, everything's kind of multifactorial here, right? But I know sitting on my couch with my computer down here with my legs straight, or my legs crossed, like this is not great for my head, neck, shoulders. It's not when I'm in that position kind of working on, and I get kind of in the zone if I'm working on my dissertation.

I never feel great when I get up from that position yet. I keep doing it every day. Why you ask? Um, this is not about me. This is about you. But if I'm being honest, I like sitting on my couch. 'cause I like being next to my dog. Willie doesn't like coming up to my office with me for some reason, and then he'll cry and I wanna be around him.

Okay? So my comfort on the couch is actually causing a problem. So what I set up last week was a little standing desk, desk situation and a more comfortable desk situation. 'cause for me, if I'm not comfortable, my creative juices cannot a flow., What about you? Is there something you're doing and you always feel bad after?

Your neck feels worse? What is it? Yell it out loud. And now I'm gonna ask you, do you really wanna change that thing? Is the neck pain bad enough? Now, here's the deal. People don't like to hear about chronic pain. When you have a pain pattern, oftentimes people ignore it 'cause they're, well, it's not that bad until it gets really bad.

But when you get to that point of high levels of pain or chronic pain, it changed the way. It changes the way your body responds to sensory input. And when you're in a lot of pain, it's really hard to override that sensory input. And something else that people kind of look at me and they go, oh God, previous experience always wins if sensory input is crap.

What do I mean by that? So if you're not getting good sensory information, your brain doesn't know where your shoulder is in space. Maybe you had a previous injury there, or the lighting's bad in the room, or there's a lot of auditory, or your clothes are uncomfortable, or all of the above, or you just did a really tough workout and now your body's sore and that's affecting your proprioception.

Maybe you haven't worked out in years and your proprioception is poor. So all these things matter, right? So again, when we go to move, those will all be a factor. So think about it, if you really wanna make a change here, if you really wanna decrease your neck pain, you've got to take away some things. So number one, you might be like, well Meghann, I don't want to stop playing tennis, pickleball, golf, whatever the thing that might be that causing, that's causing you pain.

So I have a rule, don't subtract and okay if golf or sitting at your computer is bothering you well, and some things that can change that sensory environment so that you go into a different pattern. So going back to the chronic pain, I jumped around a little bit. I'm coming back. When we wait till it's a three alarm fire, it's very hard to change all those signals.

That's when you might have to bring in me a movement professional or somebody who is going to be outside eyes to be like, I know you think you're moving your foot this way, but it's actually going that way. I can't tell you how many times I've had to video a client and show them, and they're always like, what the heck? and I'm like, I know it didn't feel like you were doing that, did it? And they're like, no. They're like, am I crazy? I'm like, yes, but not for this reason. Right? No. It's just your proprioception was giving your brain different signals. Okay. Now what I want you guys to think about, let's just kind of go back.

Go back to your answer to question one. Ask yourself if you're willing to change that for me, I am willing to change it to a certain degree. If you're not willing to change it. Stay with me. So I'm only willing to change to a certain degree 'cause I like being on my couch with my dog. Okay. I sit, we sit in our PEMF map.

It's amazing. We get our infrared, we get our PEMF. It's healing. I feel great. So I'm, that's non-negotiable. So guess what I do before I do some quick little movement drills. I do shoulder exercises and an eye exercise to make sure I open up my visual field. And I really activate my shoulders in a way that they can be more responsive.

So this way my op, my bigger visual field, I don't have to drop my head so much. I can see the screen more when I have better proprioception of my shoulders. 'cause I just moved, I kind of feel when they slouch and do weird stuff more. Okay, so, and don't subtract if you don't wanna take away that thing that might be causing you neck pain.

Add something so that you can do that thing with better sensory input, which will change the motor output. IE create a new movement pattern. Get you outta that pain cycle. Now, question one B, do you think your answer to the question was accurate? It's so easy to blame one thing or the thing you wanna change.

But maybe it's an accumulation. Which leads me to question two, and this is a really important one, guys. Does your neck pain feel better or worse when you're exercising as compared to when you're moving around all day? Let's break this down. So two, there's two camps here. Let's do camp one first. Your neck is killing you.

When you're going to drive, you kind of feel like you can't even move your head right. So you're going to wash dishes, you're trying to do laundry. You're trying to do your work at your computer. Your neck feels like crap. You go to the gym, you do some exercises and your neck isn't bothering you during those exercises.

Okay? That's camp one. Camp two is you're feeling fine day to day, not bothering you, driving, not bothering you when you're sitting at work, not bothering you. In other situations, but when you go to the gym and you do your rows, or even maybe you're in a plank or you're doing some leg presses or lunges, you're like, why the hell does my neck, what is it buzzing in a lunge?

Okay, that is camp two. So camp one. You feel better working out, not good in daily activities. Camp two, you feel the crap working out better in daily activities. Let's dig into Camp one first. So oftentimes when you feel better working out, I don't make up fairytales. This is all I know to be true. When you're working out, you are focused and you might be like, I'm not really foc.

You're focused enough, meaning your brain is getting enough sensory information. So ask yourself when you're at the gym, are you someone who likes to lift heavy or you like someone who lifts light? Okay, whichever answer to that question is that's information. So if you like to lift heavy, great. Your shoulders are responding well to heavy load.

Your neck is responding well. And what do I mean by responding is say we're doing like a bicep curl or we're doing a lunge. Our spine, our deep spinal muscles should reflexively stabilize. So kind of isometrically hold the spine in the position it is in, or you want it in. Also, our abs should help stabilize our spine, but it should not be your primary span spinal stabilizer.

Anybody that's telling you to use your abs to stabilize your spine does not understand biomechanics. Your deep spinals need to stabilize first. Uh, thinking abs first is the same idea as leaving all your doors and windows open in your house and then setting your alarm. Okay, you got an alarm, you're protected.

But those criminals could just walk right in. Eventually the alarm might go off or it might not. Okay, so abs are important. Deep spinals. So heavy load. You feel great when you lift heavy load. And then people are like, yeah, but I felt like crap after. Yes, because after you're in the real world, not carrying heavy loads, I have to be honest, my shoulders respond better to heavy load.

So when I'm walking around, my shoulders sometimes feel a little achy when I'm walking. Okay. My shoulders feel better when I'm walking my dog because I'm getting, and he's a tiny little beagle, but he is a fierce. He pulls, I know we should train him. I should do a lot of things, but I get a lot of sensory feedback in my hands.

Sometimes I switch holding my cell phone and do different things. When I have good sensory feedback into my hands, my shoulders respond better, and that's a problem. I've been in my workouts working on what's called open chain. So hands open, no sensory feedback in my hands. So when I'm lunging, oftentimes that's open chain in your hands.

Whether they're hanging or they're doing not, they're just doing something. If they're holding heavy weights, that is more of, that's not closed chain, but that's open chain with clear, good sensory feedback. So whatever you're doing in the gym, that feels good. It's not the exercise. It's how the sensory feedback is allowing you to do the exercise.

Is it heavy or light load? Are the exercises, exercises where you're isolating joints or moving joints together? And let me tell you, both are important. Just go to the gym and like isolating joints rotate. Get your spine involved. Move your shoulder and hip. Get weird, okay? Because there's many people who feel good in the gym.

When they're doing linear movement. So yes, your brain is responding to specific movements, but then when you get in the real world camp one, your hips, shoulders, spine are not stabilizing or moving when they have to because there's not heavy load. It's not organized, and I don't want you thinking about everything you do.

I have a joke with my students and I just did a workout with a friend. I was like, now let me just do my squats now. Do not cue me. The chicken is cooked. I did all my prep work. I isolated, I, I rotated, I mobilized things together. Now, if my squad is still shit, that means I didn't prep. It's like cooking. If you cook chicken and it tastes like crap, well, it was probably in the prep, right?

You didn't season it enough, or your season isn't, is in spots not others, or you overcooked it. It. Right. So in our daily life, I want think dinner is served. If it tastes like crap, you didn't do enough prep work. And if you kind of listen to me or follow me on the neuro studio, I talk about DMAs a lot.

Daily movement activators. I don't give homework. Nobody likes homework. Like I love when teachers complain, my students don't do their homework. Yeah. Because they're adults and they have shit to do and they don't wanna do homework. I integrate concepts for example. An older gentleman I'm working with, he is very forward posture.

Now, everybody keeps telling to lift his head up and I'm like, Nope, let's leave it there. We open up his visual fields first, and then all of a sudden he's standing up taller. Now he needs to look at his feet. He has neuropathy and no sensation in his feet. So telling someone not to look at their feet when they have no sensory input coming from their feet can be hard for them.

They might not be able to walk. Please don't think I'm telling everybody to look at their feet, but if I can improve his visual field so that I improve his propriocept, uh, peripheral vision, not proprioception. Yes. And if I improve his peripheral vision, he doesn't have to drop his head so much to see his feet.

Pretty cool trick. Yeah. So I gave him a homework exercise. I go, you brushed your teeth. He was like, yeah. How many times a day? Two, sometimes three. I go three. Say more. He's like, well, if I have a stinky lunch, I like to brush my teeth. I'm like, excellent. So after every time you brush your teeth, you brush your tongue.

He's like, of course I'm not a psycho. He didn't say that, but it's funnier if he did. After you brush your tongue, tongue brush it, and I, we did two drills, either him biting his tongue or pressing his tongue to the roof of the mouth. He liked pressing his tongue to the roof of the mouth, which is ideal.

And I told him, keep your tongue at the roof of your mouth and I want you to look your eyes up. End down just three times without changing the pressure at your tongue. And he is like, done. And then he emails me and he's like, Hey, is that okay? I do that at my desk. I was like, yes. However, I wanted him to swallow first.

So most of us are probably listening to this sitting. If you're walking, keep walking. I want everybody to take a big swallow. Where did your head end up at the end of your swallow?

Keep your head in that position. How do we keep our head in that position? Well, we've gotta touch it and touch something else. So swallow, touch your chin and your sternum bone, or you can touch your chin and your shoulder. You have to touch part of your head and a part of your body. I like to make L's with my fingers.

Okay. Or you can just put your hand on your face. Just make sure you're touching kind of jaw and upper head. 'cause y'all like to move your jaws when you don't think about it. Okay, so we swallowed, we set our head position, then we touch our head in relation to our body. Now I want you to move your eyes up and down without moving your head or your tongue.

Bonus points if you cannot change the distance between your hand and your tongue. Keep going. Eyes up and down, rest, swallow again. Do the same thing and now look right to left. But I recommend being on the left or the right side of your chin. 'cause again, people are sneaky with their jaw. Right there. You just gave your brain enough sensory feedback to stabilize your jaw and your spine so you can move your eyes.

Because when you have a bigger visual field and you can see more, you don't have to turn your neck as much. So a little trick there, we'll talk about in question three, just opening up your visual fields. Can help your neck pain provided you're not moving your head. And I'm gonna tell you a little secret, every time I give a client an eye exercise, they always move the head a little bit, which all that indicates is their spine wasn't stabilizing, it was mobilizing.

Okay? So I want to make sure I can differentiate those two. Let's take a step back. Beep, beep, beep. Let's go back to my gym people. If you feel good at the gym, what exercise gives you no neck pain? When you're home, go do that exercise. You don't have weights. Grab something heavy, grab a water bottle, squeeze your hand.

Try to do the same movement you did at the gym that made you feel good. Whatever you're doing at the gym, there's enough sensory feedback and your brain likes the movement pattern you're doing. Keep in mind, a pain level of one still is meaningful to me. I know it's not a problem now. But it will be a problem.

I can promise that it might be five years, 10 years, 25 years. I don't want you to have that problem. You're not a baby. If you report pain, you're someone who pays attention and will live a longer life with less pain. I mean, I can't guarantee that, but you know, the life you live will hopefully be with less pain.

I guess I could say that. Now let's do option group two. So you guys feel great. You're never in pain. And then you go to the gym and exercise and you're like, I feel like crap. Okay. There's a lot of people like that and it's always funny. I laugh. My clients who never exercise have less problems than my clients that exercise.

Why? Because the exercises you're doing, although you're trying to focus on your form, I know you guys are doing your best. You're not bad movers, it's just you got some bad intel. So if your neck is feeling stiff or a little weird at the gym, you need to address it. You know when anybody take a Pilates class and they're like, oh, my neck hurts.

'cause I hear Pilates teachers telling people to lift their head from their abs. What you're ma, you're telling the person to map head movement from moving the lumbar spine. I know you probably didn't mean that, but most people do not flex their lumbar spine. So just think, drop your chin to your sternum.

Put your hand behind your neck, touch all those little bumps. I kind of like to spread my fingers out. I guarantee you none of them move except the top or the bottom of your one or maybe one in the middle. Most people just bend at C7 or they don't even, they just bend at their lumbar, so they slouch computer people.

You flex your lower back and then in order to see your computer, you lift your head. So you're actually in spinal flexion at your lower back, um, cervical extension. And your vestibular and visual system were very confused because if you actually sat up tall, this is what your brain thinks is straight from a visual vestibular.

So on YouTube, watch me that vestibular position and visual position is what your brain is mapping straight. Obviously that's wrong if you're listening to me. I slouched in my lumbar spine, so I've got a rounded lower back, but then I lifted my head so I could see the screen. So I've got a opposite curve in my neck.

So if I, because I'm here all the time, my eyes are seeing that I'm sitting straight up, my brain thinks my head is, even if you're looking at me and not seeing me from the chest down, my head and spine look fine, but when I actually get in a good lower back position and not change my head. My head is looking up at the ceiling, so it becomes a major sensory mismatch.

Okay, so if your neck hurts when you're doing crunches and stuff like that, you are probably not able to flex your cervical spine if it hurts in the front of your neck. That's because it's being overstretched and aggravated, because your neck is probably stuck in extension, chin up, and you're trying to bring chin down.

It's like a tug of war. Nobody will win. Okay, if you wanna try this, all my students hate this. I tell them to lie down on their back and just lift their head up and I ask them, where do they feel the pressure increase on their back ribs? Some people it's pretty low at their lumbar. Some people it's higher up.

And I tell them, I want you to lift your head off the ground and tilt and move it around without changing or increasing the pressure of any part of your spine that's touching the floor. And it is really hard guys. Because it is very hard to isolate the cervical from the lumbar. Okay, so I've kind of jumped into question three without telling you question three.

So to close up, question two, if you feel better at home, then you're at the gym. Know what you're doing at the gym. Notice what loads you're doing, what movements you're doing, what joints you're isolating, what you're moving together, and then bring that home when your neck is feeling like crap. Do those things.

If you're the opposite, you feel great at home, but you feel bad at the gym, hire a neuro studio trained teacher. We've got level two and level three all over the world. You need to find someone. Reach out. I will get you a person, and they will help you remap. So when you're at the gym, you can do every single thing you wanna do.

I want you to lift heavy light, do Pilates, do CrossFit. I want you to do all the things you wanna do. I just wanna make sure your brain's getting the right information and can create a new movement pattern. And question three, have you ever paid attention to what happens when you move your neck to the nearby joints?

We've done this three different ways today. We did it by touching our right shoulder and turning our head. We did it by touching our head and moving our eyes. Now lift your arm out to the side and touch your opposite shoulder and jaw. What's happening there? Touch your belly. Notice what happens to your belly when you move your arm or your head.

Most of us put your hand on your belly and don't pull it in. Turn your head big. Anybody else rotating it? Their lumbar is fine too. I can feel my belly moving. Nobody will die. So here's what I want you to do. Put a hand on a belly, hand on your sternum. Keep those hands lined up. That's what you're focusing on.

And now try to turn your head. It without your hands turning, moving, or changing pressure. Well, that feels real different.

Question three is for you guys to explore. Question three is you guys being curious when your neck hurts, touch nearby joints. And you might be like, Meg, I don't have a degree in biomechanics. You know what you're doing touch when you move your head. Touch your shoulder joint when you move your head.

Touch your cheekbone and jaw. No lie. Everybody touch your cheekbone and jaw on one side and turn your head. I'll tell you what I observe when I turn to the right, they move together. The distance doesn't change. When I turn to the left, my cheekbone seems to come back, but my jaw doesn't. So what I'm gonna do is I'm gonna stay over to the right where it's good.

And then I'm gonna slowly try to turn my head back and it feels like I'm all jaw to the left, but I'm not, feels amazing. My shoulder feels relaxed. My brain, my nervous system feels better regulated. How do you feel? Are you feeling more frustrated, feel like you have more things to do? Well. In the effort to come up with solutions, we gotta get in the weeds.

Think of a romantic comedy. We had our meet, cute, we met, everything was going great. Then there was a bit of a breakdown in communication. We gotta no a fight. We break up. Everything's bad, but we all know the ending of the story. We will end up back together. So don't be afraid to be in the confusion. Get curious, get in the weeds.

Touch different parts of your body. Touch your feet. Press your foot down in the ground when you move your head and just start observing. Because your neck does not move in isolation. It moves with all your systems. And without good sensory feedback and the ability for our body to respond, our brain has to go back on previous experience and often movement patterns that were causing pain.

So I hope you enjoy today's episode. Have some ideas about how to deal with your neck pain, and yes. I will be doing an episode like this for all different parts of the body. A lot of people have been asking about the shoulder after the frozen shoulder episode, so I'm going to do a whole episode about the shoulder and in reference to the neck because they work together all the time.

If you have any questions, you know where to find me. Send me your dms, ask me questions, because that's how we're all gonna learn, and I will see you next time.