Concussion aftercare: Neck strength information sheet

Introduction

 A guide for families and carers to learn about concussion aftercare and neck strength in children and teenagers. 

This information sheet is for educational purposes only. For further information regarding this topic, please talk to your child's health care team.

Neck exercises

Neck exercises can help in your recovery from concussion. The recommended exercises are very gentle and usually take about 10 minutes each day to complete. The exercises are designed to restore the movement and muscle control around your neck and to reduce unnecessary postural strain and muscle pain.

When you are doing the exercises, stop and contact your doctor or therapist if you notice:

  • dizziness, light headedness, blurred vision, fainting or disorientation
  • sudden pain shooting down your arm, or numbness or weakness in your arm or hand
  • unusually severe neck pain, and/or
  • exercises that consistently produce a headache, which stays. 

For each exercise:

  • move smoothly and slowly, without sudden jerks; the key is care and control
  • keep your mouth and jaw relaxed; keep your lips together, teeth slightly apart and let your tongue rest on the roof of your mouth
  • gently hold your shoulders back and down so that they are relaxed while you are doing all exercises (see posture correction exercise, Activity 4)
  • in movement exercises, try to move the same distance to each side. If one side is stiffer, move gently into the stiffness. Move in that direction a little more often, expect some discomfort, but remember exercises should not cause severe pain.

Exercises while lying down

Lie down with a soft pillow under your neck, and with your knees bent up.

Activity 1: The chin nod exercise

  1. Gently and slowly nod your head forward as if to say 鈥榶es鈥�.
  2. Feel the muscles at the front of your neck.
  3. Stop the nodding action just before you feel the front muscles hardening.
  4. Hold the nod position for five seconds and then relax.
  5. Gently move your head back to the normal start position
  6. Repeat up to 10 times.

Activity 2: Head rotation

  1. Gently turn your head from one side to the other.
  2. Move your eyes in the same direction.
  3. Progressively aim to turn your head far enough so your chin is in line with your shoulder and you can see the wall in line with your shoulder.
  4. Repeat 10 times to each side.

Activity 3: Shoulder blade exercise

This exercise will relax and ease any tension in the muscles on top of your shoulders and it will give you pain relief.

  1. Lie on your right side with your arm resting up on two pillows.
  2. Roll your left shoulder blade back and across your ribs towards the centre of your back.
  3. Hold the position for 10 seconds.
  4. Repeat five times.
  5. Repeat lying on the left side for the right shoulder blade.

Exercises while sitting

Activity 4: Correct postural position

  1. Correct your posture regularly by gently straightening up your lower back and pelvis (sit tall).
  2. Now gently draw your shoulder blades back and down.
  3. Gently tuck your chin in. Hold the position with ease for at least 10 seconds.
  4. This position will prevent and ease muscle pain and tension in your neck and shoulder muscles.
  5. Repeat the correction regularly, every half hour during the day.

You can do this exercise at work, in the car, on a train or bus and sitting at home.

Activity 5: Neck retraction

  1. Sit in the correct postural position described in Activity 4.
  2. Gently draw your head back, sliding your chin back horizontally and keeping your nose pointing straight ahead. You should feel the retraction movement at the base of your neck and your neck should stay long.
  3. Repeat this 10 times every hour when sitting.

Neck movement exercises

Sit in the correct postural position as described in Activity 4.

Activity 6: Rotation

  1. Gently turn your head from one side to the other.
  2. Move your eyes in the same direction, progressively aim to see the wall in line with your shoulder.
  3. This activity is similar to the activity you did lying down, only this time you do it sitting.
  4. Repeat 10 times.

Activity 7: Side bending

  1. Gently tilt your head towards your shoulder and feel the gentle stretch in the muscles on the side of your neck.
  2. Perform the movement to both sides.
  3. Repeat 10 times.

Activity 8: Bending and extension

  1. Gently bend your head towards your chest.
  2. Lead the movement with your chin.
  3. Moving the chin first, bring your head back to the upright position and gently roll it back to look up towards the ceiling.
  4. Leading with your chin, return your head to the upright position.
  5. Repeat 10 times.

Neck strengthening (activities 9 to 11) should only be started later in your recovery. If you are unsure when to begin this, ask your treating health professional.

Activity 9: Neck strengthening exercises (isometric, no movement exercise)

  1. Sit in the correct postural position as described in Activity 4.
  2. Make sure your chin is relaxed and slightly down.
  3. Place your right hand on your right cheek.
  4. Gently try to turn your head into your fingers to look over your right shoulder but allow no movement.
  5. Hold the contraction for five seconds.
  6. Use a 10% - 20% effort, no more!
  7. Repeat with the left hand on the left cheek.
  8. Do 5 repetitions of the holding exercise to each side.

Activity 10: Neck bending and extension in the four-point kneeling position

  1. Adopt the safe four-point kneeling position
  2. Knees directly under hips, and hands directly under shoulders
  3. Lower back in a neutral position
  4. Slowly look up toward the ceiling as far as you can go.
  5. Hold for 5 to 10 seconds.
  6. Follow this by slowly bending your neck, leading the movement with a chin tuck or nodding action.
  7. Continue the neck bending movement as far as possible, aim for your chin to touch your chest.
  8. Throughout this movement you should hold your neutral lower back and shoulder blade posture.
  9. Perform 5 to 10 repetitions.

Activity 11: Neck rotation in the four-point kneeling position

  1. Adopt the safe four-point kneeling position.
  2. Slowly rotate your head (turn your neck to one side).
  3. It is important to maintain the gentle chin tuck or 鈥榥od鈥� position throughout the movement.
  4. Also, make sure your head stays level with your body, and does not drop down.
  5. If you do this exercise correctly, you should be looking over your shoulder at the end of the movement.
  6. It helps to do this exercise positioning yourself so that you are side-on to a mirror and can check your head position.
  7. Repeat to the other side.
  8. Perform 5 to 10 repetitions.