Dear (constant contact name),

Welcome back! This Fall marks the beginning of a run of articles from times of boredom at the office. This three-part series will center around what to do when your body starts hurting and you can't figure out why. More importantly, it will teach you how to fix that pain. We are going to focus on three areas of the body that are the most common areas of pain. This article will cover what to do with neck and upper back pain. The remaining articles will focus on shoulder and lower back pain. We're also featuring a wonderful cookie recipe this month, just in time for the cooler months ahead. Scroll down and check out Jaden Danenberg's "almost paleo cookies"! 

Join us as we strive to help fix your pain and dysfunction!

Mike Danenberg
Director of Sports Performance
Neck & Upper Back (Thoracic) Pain - #1

The first issue to address with neck pain starts with proper breathing. We are going to conduct an experiment. Go to the bathroom or another place that has a mirror and I want you to stand at it. Take 3 deep breaths. If your shoulders met your ears, that is a sure sign you didn't know you have a diaphragm. Good News! This article teaches you how to use it! Breathing without using your diaphragm places more stress on the small muscles of the neck and rib cage. If those small muscles are always fatigued, they get tight and start to restrict movement to the upper back. We are going to go over a more efficient way to breathe. This will be achieved by utilizing this awesome muscle known as the diaphragm. 

Crocodile Breathes/Breathing:

Start by lying on your stomach with both hands interlaced and supporting your forehead. Now, I want you to take a breath in by trying to expand your abdomen as much as you can. Pull the air in through your nose and out through your mouth. Try to think about driving your stomach into the ground. If you have neck pain in particular, practicing this technique will help tremendously. I am talking to you, TMJ patients and those with chronically tight necks.

WHAT TO DO: Crocodile Breathing: 1-2 minutes
*This is great for times of stress and insomnia*

* If you are to unable to lie face down to perform the crocodile breathing- 
Lie on your back, but the surface you are lying on must be solid. Place one hand over your navel with the other over the center of your chest. When you breathe, use your diaphragm to expand your abdomen. Make sure the navel hand rises and the chest hand stays down. Also, try to push out with your obliques. I always imagine trying to break a belt around my belly. 
WHAT TO DO: 1-2 minutes
*This is also great for times of stress and insomnia*

Neck Nods (Do not do with knee pain):

Get on the ground and place your hips over your heels. Pull your shoulder blades towards your hips by pulling your shoulders away from your ears. Hold your tongue to the roof of your mouth and slowly lower your chin to your chest and reverse the motion by extending back. 

WHAT TO DO: 2-3 sets of 8-10 reps

Neck Nods (If you have knee pain):

Get on the ground and make sure your wrists are under your shoulders and your knees are under your hips. Repeat the above instructions. 

Thoracic Spine:

Now, the next problem we have to address is restoring mobility to your thoracic spine. This represents the space between your neck and your lower back. Spending hours in a seated position causes our bodies to adapt to being in that position. Over time, the spine gets stuck in a flexed position with both shoulders rounding forward. This also places enormous stress on the neck as well. The thoracic spine is responsible for spinal flexion, extension, and rotation.
Since the problem lies with extended periods of chronic flexion, the primary focus will be on restoring thoracic extension and rotation. We must first address thoracic extension. Regardless, of what corrective exercises you choose to do, whatever position you stay in the most will have the greatest impact. This means constantly paying attention to your posture throughout the day. I have provided one corrective exercise for restoring thoracic extension and it requires that you have a foam roller.

Thoracic Extension w/ Foam Roller:

Lay back on the foam roller with contact being right around and/or below the shoulder blades. Make sure foam roller is perpendicular to your spine. Place both hands behind your head to support your neck. Now, tilt your pelvis by slowly pressing your lower back into the ground and then squeeze your glutes. Take a breath in, using your diaphragm, and as you exhale you will slowly arch your back over the roller. Be sure not to arch your lower back.

WHAT TO DO: 2-3 sets of 10-12 reps

Now the last mobility drill for your thoracic spine addresses rotation. You have probably noticed that as you have gotten older, your ability to turn by rotating your upper back has diminished. Most of us literally have to turn our whole body around to look behind us. If you have a child that is 5 years old or younger- Have them stand with their back to you. Now ask them a question. I guaranteed you that they will turn by rotating their thoracic spines and keep their hips square. Just another fun experiment to do. 
Fun side note: Have you ever noticed how a toddler can perform a deep squat so low their butt touches their hamstrings? If that is true, I guess a perfectly executed squat cannot be bad for the knees. Food for thought. Now on to the corrective exercise.

Rib-Grab Thoracic Rotation:

Start by lying on your left side with a firm pillow supporting your neck. Stack your knees and bring them up until they are at 90 degrees. You'll want a small pad in between your knees to squeeze. Place your right hand on the left side of your rib cage and place your left hand on top of your legs. Take a deep breathe in- using your diaphragm, squeeze the pad in-between your knees and slowly rotate your upper back while keeping your hips square and from rocking back. Make sure you rotate AS YOU EXHALE! Very important. Never hold your breathe with this corrective 
exercise as you rotate.
WHAT TO DO: 2-3 sets of 10-12 reps


First, follow the above corrective exercises to improve your thoracic mobility and make your neck happy again. The next article will go in-depth on shoulder pain and will also include progressions for the correctives in this article. My goal is to provide a streamlined plan to get you out of pain from start to finish. These must be done in order because each progression will build upon the other. If you follow these articles, hopefully, at the end you will have a better understanding of why you are in pain and what to do to get out of it. If you have any pain or discomfort with any of these exercises, please DO NOT do them. Feel free to schedule your complimentary first session to learn how to execute these exercises properly. I look forward to sharing next months article. Let's all pray for a cooler Fall! Take care and stay mobile! ~Matt B.
Jaden's Almost Paleo Cookies

Gluten and Dairy Free!
1 cup of organic almond flour
1 cup of organic coconut sugar
1/3 cup of organic cocoa powder
1/2 tbsp of baking soda
1 cup of organic almond butter
1/3 cup of bourbon maple syrup
1 organic cage free egg

Set oven to 350 degrees.

Mix ingredients together in a bowl and then form into balls. Line a cookie sheet with parchment paper and place cookie balls on the parchment paper.  

Place cookies in the oven for 22 minutes. Take the cookies out of the oven, lift the parchment paper off of the cookie sheet and place paper and cookies on a cooling rack or counter top to cool for 10-20 minutes. The cooler they get, the crunchier they are. 



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Thank you for being our patients. We appreciate the trust you place in us to help you meet your wellness and fitness goals. Whether you see us for injury, run analyses, or workouts, we look forward to helping you any time.  


The Team at Performance Therapy 
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