Question:
One of my returning clients who hadn't worked out in a few months and had a whiplash a year ago came to me after a stressful work trip complaining of her stiff neck and pain in the neck. I did some Cadillac exercises (light tension) protraction and retraction, some spinal rotations and some gentle abdominal work, breaststroke preps on the Arc Barrel. She said that the next day and the day after she feels much stiffer and she carried some grocery bags for 10 minutes today and she is in a lot of pain! Could this have been the result of the workout? I'm assuming she probably has a neck injury that needs to be checked before I continue? Or should I continue with regular gentle workouts?
Danielle H.
Fully certified Instructor
Answer:
When in doubt about whether or not a client is injured, it's always best to err on the side of caution and refer them to a licensed health care professional for an evaluation. Once they've been given the green light to return to an exercise routine, you can begin working with them privately.
While I can't diagnose your client, or discern whether or not her neck pain was the result of her workout, I can tell you that focusing on the shoulder and thoracic spine mobility, stability and strength was the right way to go for a client who has neck and upper back issues. The Cadillac is a wonderful tool for this because of its position, base of support and options for resistance training.
For neck injuries, it's a good idea to avoid excessive range of movement, especially from the prone position (ie. On an Arc Barrel) at first. Depending on your client, you may also need to avoid open kinetic chain exercises, such as with the legs in the air, or include supported open chain exercises.
When using the Cadillac and Stability Chair, start with standing and seated exercises, which are good for strengthening a variety of areas on the body, but without straining the neck. Then progress to four point kneeling and Mat exercises as the client heals and pain is reduced. When it's appropriate, you can begin to include supine inclined and supine positions that are easy for the client to transition into — remember that it can often be difficult for someone with neck issues to get in or out of positions and that the transition can add unnecessary strain.
Remember to use lots of props throughout the workout and progressions to support the neck and reduce strain, such as cushions under the head, feet resting on a barrel or a box.
Stefania Michas
Merrithew® Master Instructor Trainer
Senior Program Director, Education