Revised exercise for the longus colli & longus capitis
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- เผยแพร่เมื่อ 22 ส.ค. 2024
- The longus colli & capitis muscles are extremely important with respect to cervical and especially atlantal (craniocervical) stability and alignment.
These muscles are very often weak, especially in patients with hinge-neck postures, prior whiplash injuries, and similar.
Between the longus colli, capitis and the cervical alar fascia, courses the sympathetic chain. If the longii are severely weak, these nerves may become entrapped, leading to many strange problems such as vision disorders (improper ocular focus), tinnitus, and even atrial fibrillation, as these nerves directly innervate the ear's tympanic plexus, eye's ciliary muscles, cardiac plexus, and so on. The possibilities here are endless, it really is a rabbithole, and I have seen some very interesting cases both being triggered and resolving by rehabilitating these muscles.
Weakness of these muscles may also promote hyoidal muscle clenching, which will often contribute to TMD, as it pulls the mandibular condyle posteriorly. This creates an evil circle, as the longii will be stimulated even less, as the hyoidal muscles overtake their role. It is therefore incredibly important to stop clenching these in posture, and rather (re-)learn to stabilize the craniocervical junction with the longus capitis and colli muscles.
Read more in my atlas article:
treningogrehab...
Kjetl, you are simply amazing. I can’t find anybody online that goes nearly as in depth and precise as you do. It’s a shame cuz you don’t have all the flashy things the big pages have. They get 50m views for average workouts while you get small views for the right things. Keep it up brother
Thanks alot man
Fascinating. Found I need to use a very small angle on the chair to avoid the suprahyoid immediately firing up.
Took a few tries to "get" what muscle I was supposed to use and it felt like a totally new muscle being used. Sensed that the movement was initiating down between the sternum and adam's apple.
When you say between the sternum and adam’s apple, do you mean the lower neck area? Also has the excercise helped you with nerve/ neck issues?
As a physio I must agree, this is an excellent explanation about something that is certainly taught wrong most of the times. Thanks
Your exercises are like the puzzle pieces I've been missing for years trying to correct my posture and muscular issues in my pelvic floor, back, and neck. I've been to 4 PT's for these issues, none have come anywhere close to identifying my underlying issue and none have prescribed exercises as effective as yours. I can't thank you enough. And OH MAN my longus colli & capitis are weak... I'm that guy who has to be almost 90 degrees in order to not activate my SCM or suprahyoid haha. If you have any more tips to avoid activating the SCM, let me know!
I have hinge neck posture from doing massage and esthetics and now have severe postural issues and neck pain, exacerbating chronic migraines. I will be trying this exercise. Thank you ! 💕
Hi! How are you feeling now?
wow! I can really feel the muscles after a few repititions
Dear Kjetil, i have read your article about TOS and i have watched every related video on your channel many times. I have already tried everything else and have not gotten any results for more than 5 years. Now i want to try your method, but to be honest i find it hard to make schedule of exercises and reps i should be doing, i understand general concept but since its all slightly confusing. If you could make a one big video or playlist about how to treat TOS, it would be helpful i think for many many people. Including everything from low back strengthening, to scalene strengthening, to deep neck flexor strengthening to trapezius to whatever there is. Please explain what should be done on same day, how long between each exercise etc. If you could organize all this info into one long video or playlist, i believe it could be gold standard in treating TOS and it would help many of us who are doing this on our own since 99.9% doctors don't even know about this syndrome. I hope i explain myself clearly. thank you again for all your information.
his videos are really very revolutionary and he has helped me with my TOS, but I don't think he will do that playlist as he has already written one detailed article about TOS. How are you with your TOS now? Are u doing better with his exercises alr?
@@sky2833 I have been doing exercises for more than month now, i not really better yet certainly not worse either, i think i am no a right path for most part, on the right side i have a strange feeling starting from the first rib all the way to the behind the ear, it also touches my larynx, i have swallowing problem (audible click/grinding), voice problem (lost my singing range as well). I find it difficult to determine what should i do when and whether i am targeting right muscles. whats your story?
@@zuraiashvili8647 wow thanks for replying! Was really glad I found someone similar as me with TOS! I used to workout a lot mainly doing pull ups, row, heavy backpack push ups and neglecting my upper traps and serratus anterior muscle, my lats got really strong but for some reason I still can't get a straight posture and still have forward neck posture despite doing cervical retraction excercises. And goddamn it to realise I have been following the wrong advice for years, by pulling down shoulders back and down. I have also been stretching my upper traps as it felt super tight. Although it gave me immediate relief but tightness came back worse. Also I have been feeling tightness in my levator scapulae and upper traps. For me it didn't hurt much just the tightness and chronic fatigue with insomnia. Felt overactive all day but still cant sleep maybe due to intercranial tension when lying down. Then suddenly one day, I kept waking up with numbness in my hand, both hand went cold on me. Tingling and numbness mainly in fourth and fifth finger. And I knew something was very wrong. It was then that I realised I have TOS when i saw his article on TOS. Went to see doctor and the doctor said my neck was normal. But I wasn't convinced and I bought the x ray and saw my neck was really long. Could see my t1 and half of my t2 vertebrae. All symptoms of droopy shoulder syndrome and thorasic outlet syndrome. U can find the article on ncbi. Have been lifting up my shoulders by 1-2 cm ever since and I felt immediate relief, most of the numbness went away and I seemed to breathe better, much less tension in my neck! But the recovery phrase for the first 2 weeks were hell when i did some scalene excercises. Scalene beside collorbone became really swollen, and I was breathless during the initial recovery phrase. I think I overdone the exercises. But then after that period, my forward head posture suddenly improved after lifting up my shoulders. Heard lots of crunching noises in my back and neck while doing those exercises. Did you hear that noises when doing those corrective exercises? Was quite scared if those noises as I am not sure whether my neck bones are grinding each other but I think it was mainly of adhesion or fascia breaking up after years of that muscle going into spasm to protect me from further pulling down my shoulders. I'm still recovering right now, and the muscles knots in my levator scapulae have gotten smaller and a lot of tension have been reduced.
@@zuraiashvili8647 try to see a doctor and get the x ray from them if u are on budget and can't get a ct scan or MRI. Even though they think it's fine, u can see if ur shoulders are really depressed. TOS is a really contrerversial topic, that is why so many people failed to recover from it as muscles are too weak to make it through the initial recovery phrase or they think that they shouldn't be strengthening the muscles but stretching it as stretching gave them immediate relief after doing it but strengthening makes them worse. But what they don't know was that strengthening is the real solution to fixing the issue.
@@zuraiashvili8647 try focusing on all the big muscles like upper traps first before going into the smaller muscles like scalene muscles. Don't hinge at your neck can help with your TOS tremendously.
Must admit, it's a very hard exercise to monitor. To see and feel if you're flexing the neck while tucking the chin as well as feeling to make sure the suprahyoid isn't clenching.
If someone has asymmetrical neck weakness do you change the exercise to a unilateral one (if that’s even possible here) or do you do these and eventually the weak side will catch up
No one has a chair/table like this where the torso can be reclined so the head is at this perfect angle. Can you do this in standing or sitting? Or how else would you recommend the setup?
Subscribed!Thank you so much!I was wondered why I was having the tightness in the front of throat like I was getting choked all the time and drastically affect my daily life for years!I'm guessing due to the hyperactive suprahyoid muscles being tight?
Sounds more like a nerve problem. TOS or JOS
@@MSKNeurology TOS is thoracic outlet syndrome but what is JOS?
@@zuraiashvili8647 Probably Jugular Outlet, I think?
having trouble relaxing the scm and hyoid muscles. is their a certain posture of the tounge and/or jaw that can prevent this.
Any opinion on the eccentric (reverse) version of this? I've been set this by a physio in the past. You basically go from a sit-up/crunch position to lying down flat but very slowly. Slowly going from flexion and chin tuck to neutral. Might be easier for those that are weaker and/or don't have a medical bench.
Don't do the reverse. It will almost always cause severe over training
@@MSKNeurology Thanks for the advice. I’ll take your word for it. Gotta find a way to sit up at the suggested angle now!
this exercise deepens my voice
its cool thanks
Lol I think it has the same effect for me
Aside from this one, what neck and shoulder exercises to include if I have both forward and lateral translation? Have a history of whiplash so I guess neck extensors/flexors and upper trap and whole upper back are all weak and must be strengthened. Thank you.
me too
Is it possible for stimulation of these muscles, when nerve entrapment is involved, to cause a significant exacerbation of anxiety (or things that feel like it)?
I did this exercise yesterday, maybe a little harder than usual, and today I've felt very unsettled and uncomfortable, couldn't relax enough to sleep, chest tightness, and a bit flare up of anxiety. Could that fall under the category of strange and diffuse effects of this?
Thank you so much for everything. I've read and re-read your articles, and memorized your videos, during the course of a very difficult time, and I've been steadily, slowly improving.
I think I might have injured this muscle in an accident and have also those strange feelings since.
@@tomtomson648 you may wish to look into the vagus nerve. it runs under c1 and can wreak havoc if distressed.
what do you mean by clenching the muscles in throat?
When I try this in supine, is it normal to not be able to do the exercise unless my suprahyoid clenches and becomes hard to the touch?
Interesting. I was taught a different (incorrect) way of doing this a couple months ago where you tuck your chin and keep your head lifted off the ground. It actually triggered what felt like a panic attack, twice. I'm going to start doing this exercise instead
Does it make sense that overdoing this might cause problems like anxiety, given the close proximity to the autonomic nervous system?
I had similar issues with exercises like this. At first, I also thought it had something to do with the proximity to some nerves, and while I can't totally rule that out, in my case it seemed to be the result of those exercises affecting my ability to breathe by messing with my posture that induced the panic symptoms.
@@doctorshutup9817 it definitely affects my breathing too. The vagus nerve goes right between the longus muscles. Eventually I would assume you were able to tolerate them without panic attack type symptoms? Or did you stop once you achieved a certain level of reps? I’ve built my way up to 1 set of 12 reps, 2 days per week and have been progressing pain wise, but still get anxiety
@@powershowgames9410 TBH, I have some mixed feelings about the usefulness of some of these kind of exercises. Perhaps if you have whiplash or something severe like that, it may help, but even in later videos, kjetil(MSK neurology) states that he hasn't had a ton of success with these deep flexor strengthening exercises and opts instead to practice sitting with a good, long-neck posture.
Personally, the root of my problem seemed to be costochondritis resulting from an injury that threw my thoracic, cervical, and lumbar spine out of whack. I've been having a lot of success using a device called the backpod as well as relaxing my suprahyoid muscles (thru massaging and good posture) which seems to be helping me actually KEEP my progress. One of the major obstacles in my experience is, if this has been going on for some time, each segment of the spine can throw the others back into disarray if not resolved.
I have atrophy in this muscle from a skateboard fall 5 years ago, and cervical instability with atlas subluxation.....
Sarah Walsh have you found anything to help?
@@cecetolove Do exercises for those muscles, also try to keep a good posture and avoid supporting your head in any ways. When those muscles are weak you feel like you want to rest your head as much as possible, don't do it! Just standing straight and looking forward will use those muscles and therefore strengthen them.
Hi, have started with 90 degrees as I was not able to do it in inclined manner. After few days or weeks depending on progress, am I expected to slowly move towards inclined state? From 90 degrees to 80, 70, 45, 30 and finally to zero?! Pls comment !
Can someone answer to my question?
How often should I do these? Is it ok to do them on the same days as the scalene strengthening exercises?
I once heard that you can't do too many of these.
I agree. @MSKNeurology you don't mention how often to do it?
Great combo exercise but people don’t have that sort of bench. I guess a chair against a wall might be similar…?
The base of my cervical spine hurt so bad doing this exercise. Any advice? Thanks
Neck hinging
This exercise is a good substitute to chin-tuck, right?
Does going to the gym make this worse
I have pain in the longus all the time when I look down with my head (chin on chest, look at my phone) or when I bend over. is this a sign of a weak longus colli or a weak posterior neck muscle?
What if you can’t sit in a recliner position. What would be the next best position to do it in?
Sit straight and lean the head back
My thyroid is shifted to the left and not centered (probably because of a maloclussion and a jaw that shifting to the left when biting
amazing .. this helps me so much !
How is that different from a typical neck curl?
For patients with autonomic dysfunction as a result of neck nerve entrapment, would lordosis restoration devices like Denneroll or neck cloud help? In combination with strengthening weak muscles?
No. Lordosis restoration devices are crap
is it possible to do this exercise without any SCM activation at all? No matter how slowly i go, i can always feel them turn on
Yes
It's not possible, no. The SCMs will always be activated to some degree in cervical extension-to-flexion as that is their design.
There is hinging in this exercise. Is this good for someone with IJV compression due to cervical hinging?
You're missing the point. Doesn't matter if you restrict the hose for 5 seconds. It matters if it's being shut for hours.
would this help with a dowagers hump post cervical fusion?
The deep cervical flexor exercise you showed earlier works perfect for me. When I do the exercise like in this video I only use my SCM even though I am lying at a 45 degree angle. Do you recomend the other exercise if this is the case with me? Thanks
which one I think I need this
How does it look like when autonomic trunk is irritatied, what are the symptoms or complaints?
treningogrehab.no/atlas-joint-instability-causes-consequences-solutions/
Doesn't this enervate the scm?.
the anterior digrastic area be completely soft all the way through while doing this exercise?
That's what I said, isn't it?
@@MSKNeurology sure is boss. was just surprised at how terrible these muscles function in my case. thanks
@@werdtothewerds If it's difficult, it's usually right. Good job.
@@MSKNeurology 🙏🙏🙏🙏🙏🙏
You say you’re supposed to feel it in the deep front of the neck but i feel it more in the back of the neck right under the skull, is that bad?
If you're feeling the opposite of what I said you should, then you're probably able to answer your own question
@@MSKNeurology how to counter it
Can these be done daily?
I feel significantly weaker on my left than I my right . Is there a way to modify the exercise so the left can be targeted?
Just keep at it with some patience. Don't try to reinvent gunpowder.
@@MSKNeurology thank you
You could touch the side of your neck you want more to work for better brain muscle connection. Or close your eyes and move them right to left. See if you can feel the neck flexors being activated at the same time and use that during flexion. Or touch your temple on your weak side while flexing, or have someone touch it for you.
How come my two coms (one that you found was too long for you to bother to answer it and one i replied afterwoods making my question very short) have deseapered ? As well as their notification ?
Don't think I've deleted anything unless you were disrespectful. I can't remember to be honest.
@@MSKNeurology i don't think i ever was disrespectfull (youtube commentary wise).
Never mind.
My question was : when I do some of the neck excercises you advise to do i feel weird sensations in some of my fingers and/or patches of my body.
I take is as "my body is putting itself in order and i should carry on" but I hope i'm not doing myself any harm.
What do those pin and needles ans/or cold and iced sensation mean ?
@@lazlokonia8237 Then, for sure I didn't delete it However, your question is too vague. I have no backstory and no idea which exercises you're referring to. That said, on a general notion, reduce the reps until the aftermath is tolerable. Watch my "reps and sets" video.
@@MSKNeurology it happens especially with your longus capitus exercices and also with "Angel walls" (when I rise my hands)
@@MSKNeurology and thank you for your kind answer
this is just gunna work out your scms
Hi, how many reps and what frequency would you recommend please
Watch my "sets & reps" video
Scms are getting tight. İs that normal?
ish, you're training too hard
Anyone else barely able to do 3 reps of this 🙄
Be careful, if you overdo this you will feel like shit for weeks.