How to Get Rid Of That Pain in Your Neck? Answer: Physical Therapy

Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. Incredibly, the cervical spine supports the full weight of the head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and every day wear and tear. Neck pain can be very bothersome, and it can have a variety of causes. Here are some of the most typical causes of neck pain: Injury and Accidents; Growing Older (degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine); and Daily Life (poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate…stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness…postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms).

Degenerative Disc Disease can cause reduction in the elasticity and height of intervertebral discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm.

Head and neck posturing with a habitual ‘poking chin’ (cervical protrusion) can result in adaptive shortening of the occipital muscles. It also causes the cervical spine to change alignment resulting in increased stress of the facet joints and posterior discs and other posterior elements. Janda described a cervical ‘Upper Crossed Syndrome’ to show the effect of a ‘poking chin’ posture on the muscles. With this syndrome, the deep neck flexors are weak, as are the rhomboids, serratus anterior, and often the lower trapezius. Opposite these weak muscles are tight pectoralis major and minor, along with upper trapezius and levator scapulae.

A Licensed Physical Therapist after evaluating the neck region and the body globally would use his/her fine-tuned skills to perform any of these varied treatments: Therapeutic Exercises (focusing on strengthening deep neck and pariscapular muscles) and McKenzie repeated movement exercises; Manual Therapy (to include soft tissue massage, joint mobilization/manipulation, and manual traction); Postural /Biomechanics Retrainng; and Modalities (such as mechanical traction, electrical stimulation, and cold laser).

Knee Pain? Solution: Work your glutes.

Many of us will experience different degrees of knee pain at least once in our lifetime. Factors that can affect the level of knee pain include: faulty movement patterns, muscle force and/or length, posture/alignment and physical activity (occupational, recreational, self-care activities). Many health practitioners choose to treat just the symptoms of knee pain; using modalities such as kineseotape, medication, ultrasound, and inconsistent massage which offer short term relief. To treat the underlying mechanisms of knee dysfunction it is prudent to include: therapeutic exercises to strengthen the glute maximus/medius muscles; self myofascial release with foam roller of quadriceps, hip flexors and gastrocnemius/soleus complex; corrective exercise to improve faulty movement patterns; and manual therapy such as joint mobilization.

After taking a continuing education course on Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PhD, PT and Co-Director of Musculoskeletal Biomechanics Laboratory at U.S.C., I realized the relationship between hip/glute weakness and knee pain. Hip motions that can influence the knee are femoral internal rotation and adduction. These motions if unchecked by strong glute maximus/medius muscles will cause a Genu Valgus (knocked knee) stress on the knee complex. This hip extensor/abductor weakness combined with quadriceps overuse will cause increased patella-femoral joint reaction forces and thus knee pain.

Many personal trainers and even physical therapist would incorrectly treat knee pain with numerous quadriceps strengthening exercises, but this inherently leads to more quadriceps overuse and thus no significant improvement in knee symptoms. Therapeutic exercises to strengthen glute maximus/medius include: bridging, sidelying hip abduction with external rot/extension, quadruped hip motions, single leg stance activities with progression to functional/dynamic movements that require hip/knee stability.

Rehabilitation With a Personal Trainer vs. Physical Therapy

When tackling your fitness goals, its important to know your body. Are you looking to improve your fitness level or do you have some injury or pain that you need to heal? Your fitness goals will determine whether you see a personal trainer or a physical therapist. Learn the difference between training with both from this article posted on Livestrong.com and written by Nick Ng. For more questions, call our studio at 619-756-7500!

Rehabilitation With a Personal Trainer vs. Physical Therapy
Personal trainer. Photo Credit Creatas Images/Creatas/Getty Images

Personal fitness trainers design exercise programs and help their clients execute them to maintain or improve health, while physical therapists diagnose, treat and manage pain, injuries and diseases. Fitness trainers often encounter clients with existing difficulties, such as severe back pain and diabetes, and plan activities that blur the line between fitness and medicine. When a problem is beyond their expertise, trainers must refer clients to a proper rehabilitation professional, such as a physical therapist.

Therapist Education and Qualifications

Rehabilitation With a Personal Trainer vs. Physical Therapy
Physical therapist. Photo Credit Jupiterimages/Creatas/Getty Images

Physical therapists must have at least a master’s degree in physical therapy, kinesiology, sports medicine or a similar field. If your bachelor’s degree is not exercise related, you need to complete prerequisites as mandated by a university before applying for the physical therapy program. Physical therapists must also be licensed by the state they practice in, pass the National Physical Therapy Examination and fulfill state requirements such as jurisprudence exams, according to the Bureau of Labor Statistics. They must also take continuing education courses to keep their practice updated to maintain their license.

Trainer Education and Qualifications

Rehabilitation With a Personal Trainer vs. Physical Therapy
Sports Medicine is a degree for therapists. Photo Credit Hemera Technologies/AbleStock.com/Getty Images

The profession of personal training does not have an educational standard and is self-regulated. Trainers can have a master’s degree in biomechanics with five years of experience working at a clinical and athletic setting, or simply a weekend certification with no experience. However, personal trainers should have a minimum of a bachelor’s degree in exercise science or a related field as well as an accredited certification that extends their academic knowledge, such as PTA Global or the National Academy of Sports Medicine. They should also be CPR and first-aid certified.

Scope of Practice

Rehabilitation With a Personal Trainer vs. Physical Therapy
Physical therapists works with injured patients. Photo Credit Hemera Technologies/AbleStock.com/Getty Images

Physical therapists diagnose, treat and rehabilitate patients who have an injury or disease that limits their movement. Their job is to help patients move independently, alleviate pain and prevent disability. They often work with patients with joint and muscle pain, multiple sclerosis, arthritis, cerebral palsy, stroke, spina bifida and post-surgical conditions.

Besides designing exercise programs, personal trainers also coach clients to a healthier and more active lifestyle, help prevent injuries and help clients follow through with their physician’s or physical therapist’s advice. They also screen movement patterns to ensure that clients can move well without pain or severe limitations. Trainers may not recommend diets or supplements, unless they are registered dietitians.

Expert Insight

Rehabilitation With a Personal Trainer vs. Physical Therapy
Personal trainer with client at gym. Photo Credit Chris Clinton/Digital Vision/Getty Images

A personal trainer may perform the work of a physical therapist only if he is a licensed physical therapists also. This hybrid professional may work with a patient with back pain and a high school football player who wishes to gain muscle size and speed.

Some personal training certification agencies provide a clinical exercise certification for trainers who have little or no experience or qualifications in the rehabilitation field. When in doubt, choose a physical therapist over a personal trainer for rehabilitation services.