IN CASE YOU MISSED IT

That pain in the neck

This story was first published in The Straits Times on March 6, 2014

Modern jobs and lifestyles involve hours of sitting at desks or in front of computers, or doing the same tasks over and over again.

This can take a toll on the body, causing repetitive stress injury. It is a modern malaise that doctors say can be helped by strength training.

A lack of physical activity and a lot of time sitting in one place may lead to muscle weakness and tightness in the upper body. This results in poor posture, putting a person more at risk of repetitive stress injury when occupational demands are repetitive or involve lifting or carrying heavy loads, said Dr Mohamed Fadzil, a resident physician at the Changi Sports Medicine Centre at Changi General Hospital.

Basic stretches and strengthening exercises have been shown to be effective in preventing such injuries as they improve flexibility and strengthen muscles.

One study conducted in Canada in 2003 showed that exercise during leisure time reduced the risk of upper-body repetitive stress injury at work.

In another study published in 2008, Danish scientists at the National Research Center for the Working Environment in Copenhagen found that strength training could reduce pain from repetitive stress injury by 75 per cent.

The scientists recruited 48 women who worked mostly at computer keyboards - in banks, post offices, administrative offices and an industrial facility - and who had complained of neck pain lasting more than a month in the past year.

They were divided into three groups, with one group doing strength training with a focus on neck and shoulder muscles; the second group doing general fitness training by riding an exercise bike without holding onto the handlebars; and the third group only receiving health counselling.

The first two groups worked out for 20 minutes three times a week for 10 weeks. The women rated the intensity of pain in their neck muscles immediately before and after each training session and two hours after each workout.

The strength training group registered a 75 per cent decrease in pain on average while they were working out, as well as during a 10-week follow-up period in which they did not work out.

Those who did general fitness training had only a short-term decrease in pain that was too small to be considered clinically important, while those in the third group had no improvement in their symptoms at all.

Another Danish study, presented at the World Congress of the American College of Sports Medicine in 2011, showed that even short, two-minute periods of resistance exercise can help to loosen tight muscles and bring the body back into its proper alignment.

A good exercise programme prescribed by a physiotherapist who has assessed the injury, coupled with posture and ergonomics advice, can help those with repetitive stress injury, said Ms Ruby Poh, a senior physiotherapist at Singapore General Hospital.

The main focus of such an exercise programme is to stretch overly tight muscles and strengthen weak ones so that the person can maintain a good posture and proper alignment of his body.

Aerobic exercises such as brisk walking, cycling, jogging and swimming can be continued as long as they do not aggravate the injury or symptoms, she added.

Also important is to reduce the activity or action that is causing the injury.

If it is work-related, modifying the workplace using ergonomics may be necessary to prevent the problem from getting worse.

Ms Poh demonstrates some stretching and resistance exercises which are useful in keeping repetitive stress injuries at bay.

If the pain persists, consult a doctor or a physiotherapist.

wanching@sph.com.sg


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Supported neck extension

Clasp both hands together and place them behind the neck with elbows facing forward (Photo 1).

Without arching the lower back, slowly move the head back and look up to the ceiling (Photo 2).

Hold the position for 10 seconds before returning to the starting position.

This helps to relax the neck muscles and prevent neck ache.

Repeat 10 times every one or two hours. You may do this either standing or sitting down.


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Neck bends

Bend the head towards the right shoulder.

Place the right hand on the head and apply a gentle pressure downwards to help stretch the neck muscles on the left side.

Hold the position for 15 to 20 seconds before returning to the starting position.

This helps to prevent neck ache. Repeat five times and then change sides.

Do this every one or two hours. You may do this either standing or sitting down.


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Wall angels

Stand against the wall and raise the arms up such that the elbows are at shoulder level and bent at 90 degrees (Photo 1).

Lower the elbows towards the waist (Photo 2).

Hold the position for 10 seconds before returning to the starting position.

Do this 10 times every one or two hours. This helps to strengthen the muscles between the shoulder blades which is important for good posture. Having poor posture while carrying out tasks such as typing, carrying or lifting increases the risk of getting repetitive stress injury.


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Shoulder pull backs

Grab a light to moderate resistance band with both hands and hold them up to around shoulder level (Photo 1).

Gently pull on the band and move the shoulder blades backwards without arching the lower back (Photo 2).

Return to the starting position and repeat 10 to 15 times. Do two or three sets a day.

This helps to strengthen the muscles between the shoulder blades, which are important for good posture.


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Wrist exercises

Rest the forearm comfortably on a table without leaning forward too much in the chair.

Hold a 1kg dumbbell in the hand with the wrist in a neutral position and over the edge of the table (Photo 1).

Slowly flex your wrist to raise the dumbbell upwards while keeping the forearm rested on the table (Photo 2).

Slowly return to a neutral wrist position and repeat 10 to 15 times. Do two or three sets a day. Avoid lowering the wrist beyond the neutral position (Photo 3).

This exercise helps to strengthen the wrist and forearm muscles and prevent carpal tunnel syndrome, which causes pain and numbness in the wrist.

This story was first published in The Straits Times on March 6, 2014

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