4 Exercises for Neck and Upper Back Pain


Neck and upper back pain are commonly reported medical conditions in the United States caused by a variety of factors that affect the muscles and ligaments around the base of the skull. The pain can be quite limiting and can cause considerable stress on the muscles in this area. For sedentary workers, poor posture in the workplace can be a big contributor to these pain symptoms and is often a tough habit to break.

Take a few minutes each day to fight back with these neck and upper back exercises:

Upper Trap Stretch

The Upper Trap Stretch helps to stretch and relax the muscle between your shoulder and neck. When tight, this muscle can cause pain and limited range of motion.

1. Slowly tilt your head to one side and hold for 5-10 seconds.
2. Repeat on the opposite side.

Levator Scapulae Stretch

The levator scapula runs along the back and side of the neck and attaches to the shoulder. It functions primarily to help the head and neck rotate and bend to the side.

1. Gently turn your head to a 45 degree angle. Bring your nose to your armpit.
2. Repeat on the opposite side.

Chin Tuck

The Chin Tuck is an effective exercise for combatting neck pain as it helps to strengthen the muscles that pull the head back into alignment over the shoulders. It can also help you to develop good postural habits.

1. Tuck your chin for 2 seconds and then relax.
2. Repeat 8-10 times.

Wall Angels

Wall Angels help to keep poor posture at bay by combatting muscle tightness and weakness.

1. Stand up straight, making sure that your shoulder, elbows, and bottom are touching a wall.
2. Keep your shoulders back as you use your arms to mimic the motion of a “snow angel”.

For more information, visit our pages on Neck Pain Physical Therapy and Back Pain Physical Therapy

Office Ergonomics: Simple Tips to Keep Moving Throughout the Day


For those who work at an office job, sitting at a desk all day is pretty unavoidable. As most people come to find out, long periods of inactivity day after day isn’t the best thing for our joints and can lead to neck pain, shoulder pain and back pain. Therapydia physical therapist Michelle Fell, PT, offers a few simple tips to keep us all moving throughout the day.

• Park far away from your building to get a brisk walk in before and after work
• Take the stairs instead of the elevator
• Bring a water bottle to work and make yourself get up throughout the day to fill it up at the water fountain. Hydration and movement, great!
• Set a timer to remind yourself to stand up throughout the day and move around!

Visit our Resources page for more information on how to avoid neck pain, shoulder pain and back pain.

Do you know the difference between soreness and pain?

The attached article describes the difference between soreness and pain. People often don’t seek help until they are experiencing pain that limits them from participating in their fitness regimen of choice. We can help you stay injury free on your path to becoming the best version of yourself.

Our bodies move in the path of least resistance, meaning if you have limited range of motion in one area of your body, another area will pick up the slack. This is often referred to as a compensatory movement pattern. Over time with increased training loads and volume this can lead to injury. By having a movement assessment performed prior to starting a fitness program we can help you restore movement patterns and decrease your injury risk while improving your performance.

Call us today to schedule your movement assessment and let us guide you to optimal performance. 504.324.8345


Self-Assessment Episode 1: Breaking Down The Deep Squat

CrossFit Injury Prevention

Often times I see athletes in the gym or speak with clients in the clinic that are spending precious time performing mobility drills that aren’t improving their pain or increasing their performance. If your shoulder feels tight while performing an overhead squat, you must have a shoulder mobility limitation, right? There are numerous studies that have linked dysfunction in one part of the body with pain and dysfunction in another part of the body. Without an assessment, we are blindly spinning our wheels in the hopes of improving our performance.

I am very excited to start this assessment series to share with coaches and athletes some of the things I see in the clinic that contribute to pain and dysfunction. This assessment is geared to the pain free athlete to help them move more efficiently, decrease risk of injury, and improve performance. If you are injured or experiencing pain, you should seek medical attention before athletic activity. I encourage everyone to perform assessments and reassessments as part of their daily routine to ensure that the applied mobility is beneficial.

Assess Your Squat Flexibility

I want to kick off the assessment series by breaking down the deep squat. We will start by assessing closed chain dorsiflexion, which is the position the ankle is in during the bottom of the squat. Dorsiflexion describes the movement when you bring the top of your foot and your shin closer together.

When this motion is limited or stiff, an athlete may toe out excessively. They’ll have trouble keeping their knees over their toes or their heels may lose contact with the ground which will force them forward. If you’re not as flexible and it’s difficult for you to move your knee forward align with your toe, you’ll compensate by putting more strain on your knees and hips. Besides pain in your knees and hips, these imbalances could lead to pain in your back as well. Depending on where you feel limited around your ankle, this assessment will give you an idea as to whether you need to improve flexibility. You might need to work on mobilizing a joint or specific muscle around your ankle. The goal is to have no pain and fluid movement when going into your deep squat.

Finding Your Ankle Limitation

Key Points:

• Find the issue that’s affecting your deep squat
• Start four inches from the wall and perform in half-kneeling
• Drive your knee forward and keep it in line with the second toe
• Neutral arch and heel in contact with the floor
• Repeat on opposite leg
• Do you feel a stretch in the calf or above your heel?
• Or do you feel more of a restriction in the front (joint)?

Stretching Out Your Feet & Ankles

Key Points:

• Self-myofascial release techniques with foam roller
• 5 to 10 passes from heel to knee on outside/middle/inside of the back the leg
• 10 to 20 repetitions on each side of half-kneeling ankle stretches
• 10 to 15 repetitions on each side of elevated foot stretches
• 10 repetitions of squatting while elevating balls of the feet
• 5 repetitions of goblet squat

This post was written by Jonathan Burke, DPT, the Clinic Director at Therapydia NOLA. His primary professional focus is sports medicine and treating musculoskeletal injuries and conditions. Jonathan is certified as a CrossFit Level 1 trainer and coaches at a local box in the New Orleans area. Additionally, he’s Manual Therapy Certified, a Certified Strength and Conditioning Coach, and Functional Movement Systems Certified.

Sciatic Pain, Are You Suffering? Louisiana Residents Now Have Direct Access to Physical Therapy!


Top 10 Most Burning Questions for Sciatica

Therapydia NOLA

1. Q. How long is this going to take to go away?
A. It depends…it depends on YOU.

In general, it takes 4 to 8 weeks to go through the first 2 phases of healing (no pain, all movement and strength back to normal.

It may take another 1 to 4 months to get back to all activities you want to do…depending on how active you are. This is the third phase of healing.

Here are some variables that determine how fast someone can heal;
√ Overall health. Healthy people heal faster. Young people heal faster.
√ Other health issues such as diabetes, heart disease, high blood pressure, tobacco use, alcohol abuse and body weight all influence healing rates and make the time to heal longer.
√ Diet. People who consume more nutrients in their calories (Dr. Joel Fuhrman calls this “Nutrarian”) heal faster than those who primarily eat processed foods.
√ Rest levels. Our bodies need sleep and rest to rebuild. A lack of sleep slows healing time.
√ Stress levels. People who have high levels of stress heal more slowly.
√ Sedentary lifestyle. People who sit all day for work or to watch TV heal more slowly.
√ People who follow advice and instruction from top level healthcare professionals heal more quickly than those who do not follow through with care.
√ People who are highly aware of their daily postures and habits heal more quickly, because they can adjust habits such as sleep or sitting positions more quickly.

2. Q: How long before I see improvements?
A: Most people we see in the clinic feel better in 2 to 3 visits or within 1 to 2 weeks. If you go longer than 2 weeks without feeling better or moving better, you may be wrong about the cause of your sciatica.
Because we offer one on one care with our patients, your therapist can and will reassess you progress before and during you visit to assure you are getting the care you need to meet your goals.

3. Q: Can I be completely healed or will this come back again:
A: Most people we see who complete the 3 Phases of Healing (meaning they no longer have pain, motion and strength are back to normal and they’re back to doing all the activites they want to do without pain) have a minimal chance the pain will return. The stronger the person is, the less likely the sciatica symptoms will come back.

Your body is a bit like a car. If you take care of it, regularly change the oil and keep it running and fine tuned, there is little chance it will break down. If you ignore it, it is very likely to break down and be in need of repair.

4. Q: Do I need any special equipment?
A: At Therapydia NOLA we use a minimalist approach. We do no use big fancy equipment. [Our model focuses on one on one hands on physical therapy.] We use a variety of techniques including, manual therapy, instrument assisted manual therapy, dry needing, SFMA, and if needed, we have a traction unit in our private treatment room. All patient treatment plans for both in clinic and at home exercises are tailored to each individual and monitored closely by their Doctor of Physical Therapy. Our patients are never handed off to an assistant or tech.

5. Q: Should I use heat or ice on my leg?
A: The cause of most sciatica (pain, numbness or tingling in the leg) is in the lower back. Ice or heat on the leg will not change this.

Consider that sciatica is “inflammation”. So if you’re inflamed, do you want to put heat on it and make it more inflamed? Or ice to calm the inflammation down? We have seen some people use ice on the lower back to calm down the inflammation temporarily.

6. Q: Which exercises should I do:
A: The best exercises for you depend on what the cause of your sciatica is.

We cover the 3 most common causes;
Herniated discs
Stenosis, arthritis
Pelvic or SI joint problem

Each has a series of gradually more advanced exercises. Your therapist will address this and design your exercise program.

7. Q: How often should I do the exercises: And do I need to do them forever?
A: Most people we work with in the clinic for sciatica do the exercises at least once per day, every day. Some will do them up to 3 times per day.

Doing the same exact exercises for years without changing could be a mistake. In general, to get stronger, your exercise should progress and get more difficult. With training your body adapts.

Keep in mind, there are 2 rules for training;
1. Everything works.
2. Nothing works forever.

One of the best programs you can move on to once you complete the 3 Phases of Healing for your sciatica is a consistent walking program. People who walk every day have less risk of reinjuring their back and sciatica.

8. Q: What do I need to do for complete care? Am I going to relapse?
A: The best thing to do for sciatica, if you are worried about it coming back again in the future, is to complete all 3 Phases of Healing.

Phase One is where you focus on getting rid of the pain, numbness and tingling.
Phase Two is where you focus on getting normal movement back and full strength.
Phase Three is where you go back to previous activities you want to do.

We will want to know what your previous activities were before your sciatica, once you are at phase 3 we will guide you back into those activities slowly, after a couple of months we will want to re-check your progress. However, it is very important that you also continue your home program of exercises to insure your body continues to get stronger.

Some people will have a relapse. We will then take a look at the activity and at the program to help them get back on the right track. As mentioned before, people who are stronger recover more quickly. It is usually only one to two visits before that person is on the right track again.

9. Q: How do I know the cause of my pain?
A: There are 3 common cause of pain and here are some general guidelines for each;
-People with sciatica from herniated disc usually have pain bending forward, twisting, coughing or sneezing. The sciatic pain they experience is usually sharp and runs specifically down the back of the leg, possibly into the foot. Herniated disc sufferers are usually 35 years of age or younger.
-People suffering from sciatica because of stenosis or arthritis usually answer yes to these 3 questions;
50 years of age or older?
Pain with standing or walking?
Relief with sitting?
-People suffering with sciatica from SI Joint or Pelvic problems usually have pain with sitting for long periods of time. The sciatica they experience is usually on the outside of the thigh. Symptoms may include heaviness of one leg or feeling twisted.

10. Q: Which position should I sleep in?
A: On your back is best. Next would be on your side. Last would be your stomach.
Regardless, it is best to keep your spine in a neutral position and not twisted to the left or the right, keeping it’s natural curve. Pillows or folded towels can be placed under your knees, side, or feet to help you sleep in the least painful position for you.

Going To Have Surgery? Think Prehab First

Therapydia Pre-Surgery Treatment

Preparing to go under the knife is filled with a lot of to-dos. Scheduling your surgery date, going to pre-op surgery appointments, and talking with others about their surgery experiences. A main concern for everyone is—how long will it take me to bounce back after surgery? What many people don’t know is that going to physical therapy before surgery increases their odds of a having a successful outcome and quicker recovery. 50% of having success post-surgery is due to the surgeon—and the other 50% is the patient’s commitment to recovery. This starts with pre-rehabilitation physical therapy, or “prehab”. One study looked into patient outcomes between groups of patients that underwent ACL surgery. The patients that participated in prehab had better knee strength and range of motion at 12 weeks. On average, those patients returned to sports 2 months before the group who didn’t participate in prehab.

Get In Shape Before Surgery

Research has shown that prehab before surgery helps patients regain their baseline strength levels faster. Those who participated in a prehab physical therapy program were able to stabilize their pain, increase strength, and improve their range of motion before surgery. Therefore, after surgery, the only way to go is up. Prehab is a physical therapy program that can be started 2 to 6 weeks prior to surgery depending on the type of operation you’re having. Patients normally expect physical therapy after their operation. Therefore, prehab may feel like a new concept. Yet, the goal of both prehab and postoperative physical therapy are the same.

Physical therapy for prehab focuses on increasing strength and flexibility of the muscles in your surgery area. After surgery, your muscles can become weaker and stiff. If your muscles are stronger and more flexible before surgery, the post-surgical effects can be less severe.

Here are some surgeries that could highly benefit from prehab:
• Hip and knee surgeries or replacements
• Rotator cuff repair
• ACL/MCL reconstruction (if not completely torn)
• Neck and back surgery

Recovering successfully means having better strength and range of motion going into surgery. For example with knee surgery, you’ll typically need quadricep strength to balance and move your knee joint after surgery. By beginning to build up quad strength before surgery, you’ll see greater knee stability and faster recovery. Prehab extends to preparing you to use assistive devices like a walker or crutches post-surgery. For example, you might need to be shown how to navigate obstacles such as stairs or curbs with crutches and learn how to move with them without putting strain on your injured limb.

The Sooner, The Better

Anyone can elect to go to prehab physical therapy before surgery. If your condition doesn’t require immediate surgery and is scheduled ahead of time, prehab is definitely an option for you. There’s usually a waiting period prior to any surgery to accommodate facility and surgeon schedules, your schedule, preoperative visits, and insurance clearance. Take advantage of this time to be as physically prepared for your surgery as possible. Prehab can and will allow you to have better functional outcomes and the ability to start moving again faster.

Food For Thought Friday: Make A Simple Change

Today’s Food For Thought Friday is simple. A simple challenge to make one healthy food swap for a week. Perhaps carbonated water instead of a diet soda. Stevia instead of sugar or sweetener packets. Brown rice instead of white rice. Anything you chose, just one swap for one of your favorite unhealthy foods or drinks. Let us know how you feel next Friday!! That’s it!

Therapy Thursday: Move2Perform Sports Injury Prevention

Are you at risk for injury? Move2Perform software measures movement and analyzes the movement results to predict injury risks. Their software has been studied with positive results and adopted by US military and international sports teams. (www.move2perform.com). Want to know your risks?