Home > Articles > Cervical Pain and the Deep Neck Flexors

While everyone from the local gyms to your healthcare practitioner talks about strengthening the “core” muscles to prevent or cure lower back pain, we rarely hear anyone speak of the other “core” muscles that need to be strengthened to help reduce or relieve neck pain.

Research shows that approximately 70% of people will experience neck pain at some point in their life. This is almost the same number of incidences stastically of people that will experience lower back pain, but neck pain is not as widely discussed. This is a shame as neck pain can be just as debilitating as lumbar pain and as easily helped. The causes of injury are numerous ranging from trauma from a motor vehicle accident to a simple sprain or strain from a recreational activity. Any degree of injury has been shown to inhibit the recruitment and strength of the muscles in your neck. We call these muscles the Deep Neck Flexors and they’ve been shown to be one cause of loss of cervical range of motion, headaches and chronic neck pain.

The deep neck flexors are small stabilizing muscles located on the anterior (front) and anterior-lateral (front and off to the side) surfaces of the cervical spine and are deep to the Sternocleidomastoid muscle.

The deep neck flexor muscles are identified as the Longus Capitis and Longus Colli muscles. The location of the deep neck flexor muscles suggest they play an important role in stabilizing the cervical spine. Researchers have reported that the Longus Colli and muscles located on the posterior (back) of the neck form a sleeve that stabilize the cervical spine in all positions against the effects of gravity. Therefore, if muscle recruitment is impaired the balance between the stabilizers on the front and the back of the neck will be disrupted. This will cause loss of proper alignment of the spinal segments and a posture that could lead to cervical pain.

Now that we have covered the anatomy and the functions of these muscles, let’s go to the exercises that make them function properly. Two exercises have been shown in research to be the most effective in recruiting the deep neck flexors. One exercise is more specific then the other, but both are good to re-train and strengthen these muscles after injury.

Exercise 1. Head Nod Exercise:

Lie on your back with your knees bent without a pillow under your head and neck.



With your eyes, look down at a spot on the wall just above your knees. Then follow your eyes with your head making a gentle nod of your head like you were saying “yes”. (Another way to think of the movement is as if you were bringing your chin to your “Adams apple”.)



Hold for 10 seconds and repeat 10 times once or twice a day.

Exercise 2. Head Lift Exercise:

Lie on your back like the previous exercise. Your head should be in a neutral position and then lift your head off the floor or table (about 3-4 inches) slowly and then return.



Perform 10-15 repetitions once or twice a day. (Note: this exercise targets the strength and endurance of these muscles)

It cannot be over emphasized that both of these exercises should be performed in a painfree range of motion. If you are having difficulty doing these exercises without pain, then please come a see one of our physical therapists. They can help you master these exercises and get you quickly back on the road to recovery!

Jason Avakian MSPT, OCS, CMPT
Peak Sports and Spine Physical Therapy- Renton Clinic