neck pain and headaches

Coping With Neck Pain and Headaches

How many times have you thought of somebody to be “a pain in the neck”? Interestingly, however, a number of physical issues that affect the neck actually manifest themselves as “a pain in the head” – or a headache. There are many causes of neck pain and of headaches, so make sure you are informed before you decide upon a course of treatment – get a diagnosis from your physician or physiotherapist.

How to Relieve Neck Pain

Physiotherapists are trained to diagnose and treat neck joint dysfunctions and muscle imbalances. Your physiotherapist may employ some or all of the following techniques, depending on the individual diagnosis of your neck pain:

  • Gentle join mobilization and manipulation to loosen or unlock stiff neck joints.
  • Strengthening exercises for weak muscles, focusing on neck muscles and postural shoulder blades.
  • Stretching, massage, acupuncture, dry needling or other relaxation techniques to provide relief to tight or overactive muscles.
  • Deep neck muscle strengthening exercises for control, stabilization and limiting the joint movement of unstable joints.
  • Exercise, awareness, taping or a brace to correct poor posture.
  • Prevention advice regarding awkward postures to avoid in future.

In addition, if you have any type of nerve dysfunction, it will be addressed with special care. Depending upon the severity of your problem and its underlying causes, it should be resolved within a few days or a few weeks. Rehabilitation will be based on both treatment and prevention.

Why Does my Neck Hurt?

Although the physical problem originates in the neck, the pain radiates to the head, causing discomfort; the pain signals travel from your neck to the trigeminocervical nucleus in your brainstem and a headache results. Research has shown that neck headaches account for anywhere from 4% to 22% of all headaches treated clinically.

Various musculoskeletal or neurovascular structures in your cervical spine (neck) can be at the root of cervicogenic neck headaches when they are out of balance or malfunctioning. Your neck joints, neck muscles and nerves are the most likely culprits of your neck pain.

  • Your joints may be too stiff or too wobbly – unsupported because surrounding muscles are weak.
  • The joints may also be locked in an abnormal joint position, likely due to poor posture. Given the number of us who sit in front of computer terminals all day, this shouldn’t be surprising.
  • Problems with your cervical disks may also result in pain that radiates from neck to head.

Your neck muscles may work too hard if they are trying to protect injured joints. Over time the balance in your neck muscles changes, causing your head to feel heavy because some of the muscles that should be supporting your head have weakened, while the others have tried to compensate. Neck muscles work best when they have normal resting tension, length, strength, power and endurance.

why does my neck hurt

Common Neck Headache Symptoms

If you are experiencing one or more of these symptoms, you likely have a neck headache:

  • Tenderness at the base of the skull and top of the neck.
  • Neck stiffness or mild loss of movement.
  • Your headache pain radiates from the back of the head to the front.
  • Your headache is centred on one side of your head or the other and stays there.
  • When you apply pressure or massage the base of your skull or your neck, the pain eases.
  • Your headache is lessened or heightened by a sustained posture, neck movement, or sleeping on your stomach or with your head turned to one side.

Given that there are more than 300 known causes for headaches, your physiotherapist may determine that the neck isn’t the cause of your headache. If your symptoms indicate a different cause, they will direct you toward the proper source of treatment.

Is your neck causing you headaches?


muscle knot

What is a Muscle Knot?

During the centuries when tall ships adorned with sails dominated the seas, any skilled sailor knew how to tie dozens of knots with intriguing names such as the anchor bend, the bowline and the half-hitch.

The knots we get in our muscles aren’t nearly so exotic or desirable; they’re painful. In addition, they’re not actually knots. So, what are they?

The Knot That’s Not

We have approximately 3-400 pairs of muscles in our bodies; as one muscle pulls in a certain direction, the other pulls in the opposite direction. Given all the work done by these muscle pairs, it shouldn’t be surprising to learn that when we work muscles hard, we may create an imbalance within the pairings. There isn’t enough distance between the muscle fibres, so the muscles can no longer glide freely and get stuck together.

This tight, painful spot that we call a muscle knot can be referred to as an adhesion – fibres sticking to each other – or a myofascial trigger point (MTP). Trigger points may only hurt when you put pressure on them or they can regularly send pain signals along your neural pathway.

Tying Those Knots or How do Knots Form?

how do knots form

There are three common causes for muscle knots:

  • Accidents: Acute trauma to your body, such as a fall or a sports injury can strain your muscles and joints.
  • Postural stress: Regularly carrying heavy objects (e.g., purses) on one shoulder, sitting too long with poor posture, sitting without support – bleachers, anyone? – or lifting heavy objects improperly.
  • Overstimulation: Strenuous sporting pursuits or exercise; lifting weights.

Preventing Muscle Knots

Now that you understand a bit about the causes and the mechanics of muscle knots, you’d undoubtedly prefer to avoid them! There are steps you can take to prevent a muscle knot from developing:

  • Hydration and Diet: Drink plenty of water and maintain a healthy diet. Water helps to lubricate your muscles, while caffeinated drinks, alcohol and fast foods loaded with salt help dehydrate you. Ensure that you get enough of foods that contain B vitamins, potassium and calcium, such as bananas and yogurt. If you are mindful of what you put into your body and eat and drink healthily, you are less likely to get injured.
  • Lifestyle: Lack of sleep and ongoing stress makes you more vulnerable to injury. Get proper rest and don’t abuse your body. Even a short period of daily meditation or yoga can be useful for relaxation.
  • Massage: It’s not just for spa days – think of professional athletes. Massage therapy is a useful tool for keeping muscles oxygenated, flexible and healthy.
  • Regular Breaks: Many of us today spend our lives seated at a desk and tied to our computers. Our bodies are designed to move, and it’s unhealthy for them to remain in one position for too long. At work or at home, get up each hour and walk around a bit – fill up your water bottle, for example. While sitting at your desk, stretch your neck, uncross your legs and straighten your shoulders. Movement is good.
  • Exercise Regularly: As noted above, our bodies are designed for motion. Build regular exercise into your weekly schedule so that you remain flexible and strong. A physiotherapist can assist you in determining which exercises are best for your lifestyle and physical strengths and abilities.
  • Stretch: When you finish exercising and your muscles are warm, do a series of stretches to help them remain flexible.

How to Get Rid of a Muscle Knot

how to get rid of a muscle knot

As much as we’d all love to avoid muscle knots altogether, they may occur. When you feel a knot and experience pain, your body is sending a signal that it needs help. Consider these possibilities to get rid of a muscle knot:

  • Rest: It’s time to take a break from whatever is causing the pain, whether it’s sitting at your computer or lifting weights at the gym. Give your body some time to heal.
  • Massage: While it’s great for prevention, massage therapy is also very useful as a treatment for knots. A registered massage therapist can break up your adhesions, relieve muscle pain and suggest appropriate self-care that may include foam rollers or other tools.
  • Physiotherapy: If you have been bothered by pain for a while, a physiotherapist will help identify the underlying causes and will provide relief with the most appropriate techniques.
  • Stretch: Gentle range-of-motion activities are usually helpful, but it is best to discuss your proposed routine with a physiotherapist, massage therapist or athletic trainer before embarking on it. Be sure that your movements are pain free.

Muscle knots are NOT insurmountable. With the proper attention, you should be able to resume your usual activities and prevent them from recurring regularly.

Bothered by muscle knots?


physiotherapy exercises

Physiotherapy Exercises: Balance, Range of Motion and Strengthening

Whether you are seeing a physiotherapist for help in regaining leg strength after a hip replacement or to build up some aerobic capacity after heart surgery, your visit will have one commonality: physiotherapy exercises will be involved. After all, physiotherapy can be defined as a treatment method that focuses on the science of movement and helps people to restore, maintain and maximize their physical strength, function, motion and overall well-being. It’s all about learning to make the proper moves.

The Most Common Physiotherapy Exercises Explained

Although each patient’s physiotherapy program is unique and tailored to the nature of their physical issues, there are three types of physiotherapy exercises commonly included in rehabilitation programs:

  • Balance
  • Range of Motion
  • Strengthening

Balance Exercises

Physiotherapy can explore both static and dynamic balance. Static balance refers to control of your stationary body, while dynamic balance refers to the control you have over your body while it’s moving. Deep core stability and hip and leg muscle control are essential for good balance.

Without good static balance, you may be prone to falls and their unpleasant consequences: fractures. As people age, their bones are more fragile and hips and pelvises are more vulnerable.

When your dynamic balance is impaired, you end up with poor muscle and joint control that can lead to instability-related conditions such as back pain, sciatica, hip pain, bursitis or knee pain. Poor dynamic balance also affects your sporting pursuits, because you are not working from a stable platform.

Balance exercises work to improve both balance and proprioception, or awareness of joint position. They help you to adjust and maintain as your centre of gravity shifts. Five minutes a day of balance exercises is a good start, and your exercises should not cause symptoms or increase them.

Possible balance exercises include:

  • Single Leg Balance: Stand on one leg with arms extended and attempt to maintain your balance for a minute.
  • Single Leg Pillow Balance: Stand on one leg on a pillow with arms extended, maintaining your balance for a minute.
  • Heel-Toe Walk: Slowly walk in a straight line, carefully placing one foot down and bringing the other foot in front, touching the heel of the front foot to the toe of the rear foot.

Range of Motion Exercises

Range of motion refers to the movement of a joint from its fully flexed position to its fully extended position. Although each joint has a normal range of motion, the amount of joint movement varies from person to person.

There are three types of range of motion exercises: passive, active-assistive and active.

  • Passive range of motion exercises: As you remain still, the physiotherapist will move your limb along the joint range; it is often done if you are unable to move a limb yourself.
  • Active-assistance exercises: Although the patient can move the limb, the physiotherapist helps complete the motion along the joint range or until the point that pain kicks in.
  • Active exercises: The patient performs the movement without any assistance from the physiotherapist.

Here is a sample of range of motion exercises for various body parts:

  • Neck: Head tilts, forward and back: Bow your head gently and try to touch your chin to your chest. Now, move your head back to the starting position. Next, tilt your head back as far as possible so you are looking at the ceiling; return your head to the starting position.
  • Shoulder: Shoulder rotation: Raise your shoulders up toward your ears, as if you were shrugging. Lower them to the starting position, and relax. Pull your shoulders back. Then relax them again. Roll your shoulders forward in a smooth circle; reverse direction and roll your shoulders smoothly backward.
  • Legs: Leg lifts: Lie on your back and raise your leg so that it is 15 to 31 centimetres off the floor. Hold for 30 seconds. Return to the floor. Repeat.

Strengthening Exercises

Strengthening exercises are done to ensure that your muscles have normal strength, in order to prevent future injury. In situations where your muscles have not moved for a while due to injury, strengthening is essential.

Exercises to increase muscle strength fall somewhere in type between the high repetitions and low resistance of endurance training programs and the fewer repetitions and high weight load of the programs designed to increase muscle size.

Here is a sample of strengthening exercises for core stability:

  • Transverse Abdominus: This muscle is a key stabilizing muscle in the abdomen. Lie on your back and slowly draw the section of your abdomen situated below your belly button upwards and inwards away from the line of your belt and breathe normally. Keep your rib cage relaxed and not elevated. Practise holding this muscle at 20 to 30 per cent of a maximum contraction for 10 seconds; repeat 10 times.
  • Plank or Prone Hold: Lie down on your stomach. Prop yourself up on your elbows and toes and hold for as long as possible.

Ideally, you should see a physiotherapist for an exercise program that is tailored to your needs. Remember, physiotherapy exercises can be preventive as well as rehabilitative.

Looking for a TAILORED exercise program?


What is Physiotherapy

What is Physiotherapy?

A common question for people that have never visited a physiotherapist is the very basic question of “What is Physiotherapy?”. Physiotherapy encompasses rehabilitation, injury prevention and health promotion/fitness. The profession employs a holistic approach to treatment, looking at the patient’s lifestyle and engaging them in their own treatment.

Physiotherapy Definition

Physiotherapy can be defined as a treatment method that focuses on the science of movement and helps people to restore, maintain and maximize their physical strength, function, motion and overall well-being by addressing the underlying physical issues.

How to Become a Physiotherapist - Physiotherapy Canada

The healthcare professionals who provide physiotherapy are called physiotherapist. They are highly trained, with master’s degrees in physiotherapy, and are skilled at pinpointing the root causes of an injury, as well as treating them. Often, a problem originates in a completely different part of the body than the spot where the pain is centralized.

Physiotherapy is a registered profession in Canada. The Canadian Physiotherapy Association notes that physiotherapists:

  • Have met national entry-level education and practice standards;
  • Have successfully passed a standardized physiotherapy competence examination; and
  • Are registered with the college of physiotherapists in their province/territory.

Once they are certified and registered, physiotherapists can pursue the designation of clinical specialist. This program, run by the Canadian Physiotherapy Association, “certifies physiotherapists who have focused their careers and can demonstrate advanced clinical competence, leadership, continuing professional development and involvement in research in a specific area of practice.”

Candidates for the clinical specialist designation must have a minimum of five years of applied clinical experience and a minimum of 300 clinical contact hours per year for the past five years in the clinical specialty area.

Physiotherapists work in concert with other healthcare professionals, and physicians may recommend a course of physiotherapy after an injury, surgery (e.g., hip replacements) or such health issues as heart attacks or strokes.

Physiotherapy Treatment: What Conditions do Physiotherapists Treat?

As professionals, physiotherapists are experts at providing physiotherapy treatment for:

  • Preventing injury and disability;
  • Managing acute and chronic conditions;
  • Improving and maintaining optimal physical performance;
  • Rehabilitating injury and the effects of disease or disability;
  • Educating patients to prevent re-occurrence of an injury.

Patients may be referred to or seek assistance from a physiotherapist for a variety of health issues and receive valuable assistance.

Physiotherapists offer treatments relating to the following conditions:

  • Cardiorespiratory: providing support, prevention and rehabilitation for people suffering from diseases and injuries that affect the heart and lungs, such as asthma.
  • Cancer, palliative care and lymphedema: treating, managing or preventing fatigue, pain, muscle and joint stiffness, and deconditioning.
  • Incontinence: managing and preventing incontinence and pelvic floor dysfunction.
  • Women’s health concerns: addressing health issues surrounding pregnancy, birth, post-partum care, breastfeeding, menopause, bedwetting, prolapsed, loss of bladder or bowel control.
  • Musculoskeletal: preventing and treating clients with musculoskeletal conditions such as neck and back pain.
  • Neurological: promoting movement and quality of life in patients who have had severe brain or spinal cord damage from trauma, or who suffer from neurological diseases such as stroke, Parkinson’s disease and multiple sclerosis.
  • Orthopedic: helping patients prevent or manage acute or chronic orthopedic conditions such as arthritis and amputations.
  • Pain: managing or preventing pain and its impact on function in patients.

Physiotherapy Techniques: What Techniques do Physiotherapists Use?

Physiotherapists employ a variety of techniques, depending on the nature of the injury or problem they are treating. The most common physiotherapy techniques are:

  • Manual manipulation: Moving joints and soft tissue helps to improve circulation, drain fluid from the body, and relax overly tight or muscles with spasms.
  • Electrical nerve stimulation: Small electrical currents delivered to affected areas helps to suppress and block pain signals to the brain.
  • Acupuncture: Needles stimulate the nervous system and work to dull pain, release muscles, boost the immune system and regulate various body functions.
  • Demonstration: Teaching proper movement patterns allows patients to help heal themselves.
  • Functional testing: Testing a patient to assess his/her physical abilities.
  • Device provision: Prescription, fabrication and application of assistive, adaptive, supportive and protective devices and equipment.

What to expect from a visit?

Each session with a physiotherapist is unique, because it depends on the client’s health issues and needs. However, a visit to a physiotherapist generally includes:

  • Learning about the patient’s medical history;
  • Assessing and diagnosing the patient’s condition and needs;
  • Helping the patient set and reach physical goals;
  • Creating a treatment plan that accounts for patient’s health, lifestyle and activities;
  • Prescribing a course of exercises and necessary devices.

If you are experiencing issues with movement or function or are just seeking to optimize your health, why not check out a trusted resource like a professional physiotherapist.

Having issues with your MOVEMENT?