How to Prevent Injuries Even if You Work a Desk Job
Is poor posture why your neck and shoulders hurt? You can fix bad habits and relieve pain without even leaving your chair.
About two years ago, I pulled my neck. I couldn’t move for three days. Excruciating pain shot down both sides of my body with every inhale.
After the muscle relaxants kicked in, I could wriggle my fingers. I used them to call work and say I wasn’t coming in.
“What happened??” asked my boss, after my gasped tale of paralysis.
Here’s the embarrassing thing: I didn’t know.
“I was sleeping” I gasped, “ now my neck hurts and I can’t move.”
How can anything bad happen when you’re surrounded by pillows? Or sitting at your desk innocently reading an article on Medium? Or simply turning around to reach for something?
Apparently this is a thing. Even my boss was nonplussed. “It happens,” she said. “Let me know when you can move again.”
“Typically, incidence of neck pain increases with age. But today we’re seeing and treating more patients — younger patients — who never reported neck pain before.”
But it shouldn’t be a thing. The warning signs, if you know what to look for, can build up over weeks or even year. But by the time you feel pain in your neck, it’s been a long time coming.
When things get bad, maybe you get a massage. Maybe you self-medicate. Maybe a physio does some dry needling, or a chiropractor cracks your neck. After some of this lovely passive therapy, the type of therapy where you sit “passively” while people fix you, you get some relief. But the discomfort almost always returns.
At any point, you can take action to break this cycle and start reversing the process. The longer you wait, the longer it takes, but it’s still doable.
In addition to recovering from my own injury, over the past few years I practiced yoga enough to complete Alliance-certified Yoga Teacher training, including specific courses focused on the anatomy of shoulder and neck pain. I currently teach Hips and Shoulders yoga to help these areas of the body.
In this article, I’m going to share what I learned, how you can notice the warning signs, and how to prevent or reverse the damage you may experience in your shoulders, neck, and back.
Is this going to be hard work?
Pfft. No. Are you sitting down? Don’t worry, you don’t need to get up.
Just interlace your hands above your head, palms facing up.
Relax shoulders down.
Pull forearms backwards in a big, delicious stretch.
Big inhale. Exhale deeply.
Feels pretty good, doesn’t it?
That’s how easy this is. A leisurely stretch, with plenty of juicy information from your body, if you listen.
Let’s get started.
Getting to Know Your Shoulders
It all starts with muscles attached to the bones you have on both sides: the humble scapulae, also known as shoulder blades.
Try moving your shoulders forward and back.
As your shoulders move forward, you’ll notice your shoulder blades (scapulae) pull away from your spine. When your shoulders move back, your scapulae hug closer to your spine.
Two major muscles, your trapezius and your rhomboids, connect your scapulae to the rest of your body.
Your trapezius is a massive T-shaped muscle covering most of your upper back. It’s joined to your scapulae and spine all the way up to the back of your neck. This giant muscle is responsible for shoulder rotation and stability.
Your rhomboids sit underneath your trapezius, and also join your spine to your shoulder blades. Like your trapezius, your rhomboids help control shoulder movement and keep your upper body stable.
Remember the last time you checked your phone, read a book or typed on a laptop? While reading this post perhaps? Your head was or is probably tilted downwards. Your shoulders are almost certainly pulling (or falling) towards your chest.
When you sit this way, your trapezius and rhomboids work hard to keep you stable by creating a healthy tension between your scapulae and spine.
To compensate, other back muscles (the latissimus dorsi and the lower trapeziu—also known as lats and lower traps) create more room between your spine and scapulae by stretching and weakening.
The thing with muscles is: they learn. That’s why exercise gets easier with practice, and why long term habits are hard to fix. Eventually the lats and lower traps stop firing properly.
Your body adapts to make leaning forward easier, but your muscles are becoming unbalanced. The effects will show up in pain and a cascade of compensations.
To counter this cycle, try a simple yoga move called the Shoulder Shrug. It’s easy, feels amazing, and you don’t need to get up. You could even try one right now as you’re reading this (hint, hint).
Shoulder Shrug: Activates the back, opens the chest
- With your palms facing up, relax your chin down.
- Pull your thumbs towards the wall behind you.
- Squeeze your shoulder blades together. Imagine trying to touch your elbows together behind your back.
- Count backwards from 5.
- Relax, repeat. Do this a few times a day. More is better.
For more detail, let yoga teacher Lisa Day walk you through shoulder shrugs in just a few minutes here.
But what if you don’t do anything to counteract this? Don’t feel like loving your back? You don’t feel pain now, and don’t think it’s a problem? “No big deal,” you might think, if you think of it at all. (I didn’t, until I was in too much pain to go to work!)
Connections Into Your Torso
You know that saying, “for every action…”?
When one muscle lengthens and relaxes, it’s counter-muscle tightens and shortens. That’s why it’s easier to touch your toes if you tense the front of your thighs (your quadriceps). Tensing the front of your thighs tells the back of your thighs (your hamstrings) to relax, and you can reach further forward.
When your rhomboids and trapezius are loose, a couple of other counter-muscles tighten to balance things out.
Place a hand on your side, just below your armpit. Move your shoulder back and forward.
When your shoulder comes forward, you can feel a muscle on your side move — that’s your Serratus Anterior. (Sounds like a gladiator, doesn’t it? “Serratus Anterior, strength of a lion!”)
The Serratus Anterior attaches your scapula to your rib cage. It creates movement by contracting and pulling between these bones.
Remember how muscles learn and adapt?
As your back muscles stretch, your Serratus Anterior notices it’s contracting a lot to bring your shoulders forward.
To hold the shape more easily, it shortens, and becomes tight by default. Eventually the Serratus Anterior becomes so short you no longer have to work to pull your shoulders forward.
Your chest muscles (pectoralis) contract in a similar way, pulling your shoulder blades towards your ribs.
Now your back is loose, and your chest is tight.
At this stage, it’s easier to slouch than sit up straight. But you can take action to correct this.
To start, try a deliciously simple shoulder-opener: Elbow Circles. Once again, you don’t even need to get out of your chair.
- Touch your finger tips to your shoulders.
- Let your shoulders relax down.
- Fingertips resting on shoulders, draw big circles outwards with your elbows.
- Do as many circles as you like. It should feel amazing in the shoulders.
A Quick Review
We’ve covered a lot that happens just by habitually leaning forward to read your screen.
The muscles on your back, your trapezius and rhomboids, loosen.
The muscles on your sides and chest, your serratus anterior and your pectorals, shortened and tense.
This is the basic anatomy of a natural hunch. And it gets worse.
Unless you experience a severe case, you may feel nothing more than a tendency to slouch, a tight chest…
Most people get just enough to say, “I have sore shoulders, it’s nothing.”
Nothing at all…unless you count pain as a warning.
And here, finally, we reach the neck.
Behold: The Tiny-But-Mighty Levator Scapulae
You know that friend who always helps everyone, even if they’re exhausted?
Tilt your head to one side. Towards the back of your neck, feel for a muscle between the base of your neck and your shoulder.
That’s your Levator Scapula — the friend who takes the load, even if they’re exhausted. You have one on each side of your neck.
This picture shows the Levator Scapula highlighted in green. It starts at the spine, on the side of your upper neck (C1 — C4, meaning the first 4 vertebrae) and joins to the shoulder blade.
Compared to massive muscles like your Trapezius, your Levator Scapulae are little dudes, sharing the load when you move your shoulders or lift your arm.
Or they would be sharing it, except by now your trapezius and rhomboids are out to lunch. Guess who picks up the slack.
That’s right, the little Levator Scapulae. They bear the brunt of lifting your shoulder every time you move your mouse, unlock your phone or lift your hand to wave hello.
The big trapezius and rhomboids muscles should be handling these movements. Instead, the itty-bitty Levator Scapulae now does most of the work when you move your mouse, reach for a cup of coffee, or simply look left.
By now you might notice a pattern: if you don’t move your upper body much you won’t notice the warnings.
You may feel a little pain in the chest, a little stiffness in the neck. Maybe it’s hard not to slouch.
Until…it’s here. A full-blown syndrome.
Syndrome: Medical term referring to a group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms.
Levator Scapula Syndrome
The Levator Scapula holds on as long as it can.
The stress builds and builds.
Suddenly you pick up a pen, unlock your phone or sleep the wrong way and BOOM.
Surprise neck pain. Or maybe a throbbing pain that never seems to to go away.
Either way, it’s not comfortable.
By far the most common cause of a stiff neck is a muscle strain or soft tissue sprain. In particular, the levator scapulae muscle is susceptible to injury. — Richard Staehler, MD
Levator Scapula Syndrome is a painful neck condition primarily caused by repetitive motions and overworked Levator Scapula.
You use might pain meds, get neck massages, and stretch your neck.
Aaaah, sweet relief.
But because of everything else going on, treating the neck often doesn’t fix the neck.
Days or even weeks later, it comes back. Maybe it never goes away.
“That’s just my bad neck,” you might say. “My sore shoulders, no big deal”.
According to Dr Stewart Eidelson, the most common cause of neck pain is poor and prolonged slouched sitting posture. It probably started weeks — or even years — ago, with big muscles like your trapezius.
Luckily there are easy ways you can sooth this painful chain reaction. Try simple neck-releasing movements:
- Move your right ear towards your right shoulder.
- To open the neck and chest, place the back of your left palm against your back.
- Hold for 20 seconds; release.
- Repeat for the other side.
Forward Angle Bend
- Turn your head to the right.
- Put your right hand over the back left hand side of your head.
- Gently pull your head down towards the ground.
- Hold for 20 seconds; release.
- Turn your head to the left and repeat.
Carpal Tunnel Syndrome
Carpel Tunnel Syndrome causes tingling, numbness and pain in the fingers and wrist area. It happens when the nerve that runs from the forearm into the palm of the hand is compressed at the wrist.
But according to Dr. Ducat, only around 30% of hand-nerve symptoms are actually Carpal Tunnel. My chiropractor estimated even fewer—around 20%.
With very similar symptoms, thoracic outlet syndrome is often misdiagnosed as carpal tunnel syndrome, even though it’s caused by compression of blood vessels and nerves between your collarbone and first rib.
That’s nowhere near your fingers! How is that possible?
Your shoulder blades are connected to a lot, including your biceps. And your chest muscles (pectorals) are connected to your upper arm.
These lovely muscles not only impact your neck, but your arms and wrists too.
Three major nerves supply the hand: the medial, ulnar and radial. All three start at the neck. Compressing these nerves in the neck and shoulder area can cause pain in the wrist.
Posture and wrists are a web of reactions for another article, but it’s worth noting that improving your posture and these stretches can help remove pain in your fingertips, or even your toes.
Simple exercises can help offset bad posture and, more importantly, prevent pain. I’ve given you several targeted ones above. Here are a few more to try.
You can do these in just a few minutes, without leaving your chair.
Best neck release ever: Brain Cradle
- Interlace your fingers and place them behind your head, cradling the base of your skull.
- Use your thumbs to give the top of your neck a massage on either side of the spine (never massage the spine itself).
- Lift elbows towards ceiling; imagine lifting your head off your neck.
- Feel your shoulders drop down as you lift your elbows up.
- Enjoy feeling weight release off your spine, and your upper-vertebrae opening.
Here’s a complete version of this with detailed instructions.
Tip: You can also do this with one hand, using pointer-finger and thumb to massage your neck upwards as your elbow reaches for the ceiling. This stretches out your arm and shoulder more than doing both arms at once.
Seated Side Stretch
- You need an armless chair for this exercise.
- Cross your left leg over your right leg.
- Place your right elbow at the outside of your left knee.
- Twist gently toward the left, focusing on twisting with the upper back first.
- Hold this stretch for 10 seconds, then repeat on the other side.
More details, and related stretches you can do in your chair, are here.
- Five relaxing stretches to do sitting down, including a delicious hip release, from SVT Health & Wellness
- This lovely WikiHow on Preventing Upper Back Pain. Simple exercises to improve strength and flexibility (both are important) in the upper back. You’ll need to get out of your chair for some of these.
- Rochelle Cocco’s Fix-The-Neck provides extensive information on the anatomy and physiology of posture, and how to fix it
- Ergonomic tips from Susan Hall: optimizing furniture set up and the ‘desk-job’ environment
If you need a good therapist
Levator Scapula Syndrome is a common cause of neck and shoulder issues, but it’s not the only one. If you are suffering, a number of things could be happening. You may need the help of a specialist, like I did recently.
My hip went out, tilting slightly to the left. To balance this, my shoulders tilted to the right. My neck leveled my head by tilting back to the left.
Until my hip was reset, my spine remained in this “S” shape. Working on the neck felt nice, but wasn’t a long term fix.
You’re a smart person. Seek professional help if pain persists.
A good therapist will be prepared to answer these two invaluable questions for you:
- What did you fix?
- How can I prevent it from coming back?
They also dig into the details, instead of just fixing the face-value problem. To prevent pain from coming back, treating the underlying cause is key.
Kathleen Porter’s Exercise for Alignment
The human body is amazing and incredibly complex.
I’ll leave you with this exercise from Kathleen Porter, author of Natural Posture for Pain Free Living: The Practice of Mindful Alignment.
Pretend you’re holding a shawl behind you and you’re about to wrap the shawl around your shoulders, but just before the shawl comes into contact with your back, move your back into the shawl.
In other words, your breastbone or your sternum slides backwards towards your back. As you do that, you will feel an action through your abdomen.
These are your core muscles, primarily your transversus abdominis (TVA) muscle coming into action…this is your real core….
Next, wiggle the back of your armpits up towards the ceiling, and feel your spine lengthening.
Also notice the position of your chin. By bringing you chin down, the back of your neck lengthens and the cervical spine that goes through in the middle of your neck opens up. When you lift your chin up, you shorten your cervical spine.
To live pain-free, combining “pelvis, spine, head, neck, and shoulders and all the rest of your body” is a useful alternative to focusing on one place, like your neck or back. Remember all those connections!
Making the Commitment
If you spend a lot of time at your desk, you’re probably really good at your job.
You become an amazing writer. A phenomenal accountant. A straight-A student. One with an amazingly complex and miraculous body.
But sitting has a similar effect on your muscles whether you’re working, snoozing on the couch, or catching up on Instagram.
Your muscles are always learning.
While you sit and focus on your work (or your Instagram), remember to focus on your body too.
Your body is the only thing that’s with you from the day you’re born to the day you die. It can only compensate for poor posture for so long.
Give it some love.