Neck Range of Motion

Neck Range of Motion

While more people complain of back pain than neck pain, neck pain from range of motion limitation is far more evident. The patient is stiff-necked, either contributable to muscle pain or vertebral range limits. In the neck section of the spine, vertebrae are designated C1 to C7. Some people may have a C8 segment.

The C1 vertebra is also known as “Atlas“, and is the topmost neck bone. It looks and acts differently from every other bone in the spine. In relation to “Axis“, the name given to the C2 neck bone, Atlas┬ámoves in the largest arc of all the cervical bones. In fact, 50% of your neck rotation takes place at the C1/C2 junction. However, it does not have the largest overall range of motion.

Rather, the C5/C6 interspace is considered to have the largest all-around range of motion in the neck. This is suspected to be the reason why more people have C5/6 degeneration and other problems than from anywhere else in the neck.

cervical lateral flexion

neck bones in sidebending

C7 is located at the bottom of the cervical spine, and has the least amount of motion when the neck rotates to the right or left. However, C7 shows a greater range of motion when bending the neck from side to side.

neck rotation

Neck bones in right rotation

Most people don’t give much thought to it, but when you turn your head from side to side, the spine itself has a twist to it that increases in range as you get toward the top. The same type of motion pattern is seen when bending your neck from one side to the other. In other words, C7 stands pretty much still and each segment above that moves a fraction more than its lower neighbor.

Facet jamming is one reason for range of motion problems affecting the neck. Medium and long-lever muscles that make up the cervical column can also go into spasm for many reasons and, as a result, affect varying range of motion. We experience this most often when using poor posture and by unfortunate sleeping positional habit.

Muscle dysfunction from improper nerve conduction can affect range of motion as well. In an earlier example, we noted that neck extensors can inhibit neck flexors. In that case, when the muscles that flex the neck (bend the head forward as if we want to look down at our feet) become inhibited and the ones in the back of the neck become hyperactive, hypertonic, and painful. Inhibited muscles must be turned back on in order to resolve this issue.

whiplash ligament damage

Whiplash ligament damage

Muscles are not the only soft tissue we can point to when it comes to limiting the neck’s range of motion. We also have many ligaments in the cervical spine that are ideal prospects, especially after an injury such as whiplash. When a ligament is damaged or torn, scar tissue develops at the point of damage. Adhesions can cause the many different nearby tissues to stick to one another, much like supergluing your hand to your leg. They don’t separate easily and trying to move one part makes another part hurt.

Scar tissue is also not made up of the exact same material the ligament is, and is not as strong as the original tissue. Continuing to pull on adhesions can tear the repair tissue and cause the repair process to begin all over again. This could go on indefinitely with constant cycles of pain, no pain, then sharp pain again.

Damaged ligaments can also affect nerve roots as they exit the spine and cause pain as well. Even though muscles and bones all look and feel fine, there is still localized and often referred pain (pain that travels elsewhere). Proper assessments can determine whether your neck pain is muscular or ligamentous in nature and which treatment options are best suited to your condition.

Other range of motion pages: