Neck pain is a common presentation to any chiropractic or physiotherapy clinic. And prescribing home exercises to these patients is a key step in the recovery process. Remember, movement is a powerful stimulus to control symptoms and guide tissue healing. (Quick side note, for the sake of this article we’ll assume there are no red flags, significant tissue pathology, or neurological compromise.)

But knowing which exercises to prescribe to these patients can be tricky. To be effective the movements need to be safe, and the patient needs to feel in control. This is critical because moving an acute and sensitive neck often causes symptoms. This makes many patients reluctant – or even fearful – to perform these or any other exercises.

For these patients my go-to exercises are Neck Slides. 

These are non-weight bearing exercises, so they minimize compressive forces on the spine. So the actual, physical stress on the cervical spine is low. Here symptoms will be more related to tissue sensitivity as opposed to further damage or injury. These are important conversations to have with patients. Particularly those who display a fear of movement and who believe that pain equates to damage. We need to teach the brain to trust these movements again.

As a general rule, some symptoms are not only OK, but actually beneficial to move through. But that is not to say we just push through pain. We are trying to strike a balance between respecting the sensitivity of the tissue or movement, but not avoiding the movement.  So the instruction to patients is to “move to tolerance”.

Again, patient education matters here. Explaining to patients that symptoms here are more about the accumulation of chemicals (as opposed to damage) is helpful. Squeezing a sponge is a useful analogy.  It helps exemplify the use of movement as a pump to milk the tissues and push fluid and noxious chemicals away.

The Exercises

Supine Neck Slides (Neck Flexion-Extension Mobilization)