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Sometimes patients come into my office and they know why they hurt.  “I was bench lifting weights and I felt my back give.”  Most of the time, though, I hear, “It’s my shoulders again.  You know, that is where I carry my stress.”

I know it feels that way, but there are more specific causes than “stress” for that chronic shoulder and neck pain.  And it is the number one work-related injury in America.  Prolonged sitting, like prolonged typing, can cause repetitive strain/stress injuries.  There are two factors at play, poor posture and inactivity.  The most common desk (and car) posture is with the head way forward, the shoulders rounded, and the pelvis tilted toward the back.  And then this awkward, abnormal posture is maintained for hours at a time.

When the head protrudes just 2 inches forward, it adds an extra 20 pounds of leveraged pressure on the spine and creates a shear force on the vertebrae in the neck.  After about 20 minutes of this, the neck muscles have used up their energy stores and begin to get fatigued.  When these muscles are too tired to hold up the head, the pressure is transferred to the ligaments of the spine.  This is not a job they were designed for, and they quickly can begin to weaken and become injured.  So when you sit at your computer for six or seven hours a day,your neck and shoulders are being injured without even moving, every day.

So what can you do?  Come in for adjustments to help repair the damage, first.  Then, stop the cycle of reinjury (straighten up!), repair your damaged muscles, ligaments, and tendons (strengthen up!),  and change the habitual posture that is causing the problem (keep it up!)  In other words, sit up straight and move around more.  Really, it is that simple.   (And that difficult.  It will take persistence to change your habits.)

Every chance you get, remind yourself to roll your shoulders back and down and bring your head back and up, lengthening the back of your neck.  It will feel like an awkward military posture, and in about 12 seconds you will forget and be hunched over in your habitual C-shape again.  Which is why you remind yourself again and again.  I find it easiest to correct my posture when I am standing and walking.  Imagine that rather than having your feet on the ground, you are actually dangling from a string attached to the top of your head.  If you are hanging from a string, gravity will make everything fall in a straight line.

In the natural environment your body evolved in, your back muscles can hold you upright all day without tiring, as you spend your time walking and moving around.  As soon as you notice your tight shoulders and stiff neck bothering you, take that as a reminder to move around.  I can keep on adjusting and stretching your muscles to relieve that shoulder and neck pain, but if you keep reinjuring yourself from prolonged bad posture, we are in for a long term relationship.  Straighten up, keep reminding yourself over and over to straighten up, and you will need me a lot less often.