Care and Injury Prevention of the Cervical Spine
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The cervical spine is the most flexible and thus most easily injured area of the vertebral column. It consists of 5 regular vertebrae that allow flexion, extension, sidebend and 50% rotation of the neck; one thicker pivoting axis that allow the remaining 50% of the rotation and a flat broad atlas that cradles the lower part of the skull and allows small nodding and tilting movements. (The head slide is a combination of sidebend of vertebra 3-7 (to one side) and a tilt of the skull on the atlas to the other side).
In ideal posture, the head should be positioned slightly back with the center of the ear directly over the middle of the shoulder and the chin slightly tucked in. The neck has a natural C-curve just like the lumbar spine (hollow at the back). The most common postural problem is to carry the head in front of the body with the chin jutting forward. This position increases the natural curvature and may compress the facet joints and the nerves which lie just beside these joints. This may cause pain, spasm, numbness etc. in the neck, shoulders, arms and /or hands and conditions such as tendinitis and carpal tunnel syndrome. This posture will eventually result in TMJ problems and shortened muscles at the base of the skull (sub-occipitals) and front of the neck (sterno-cleidomastoids and scalenes). Chronic shortening of these muscles may cause a variety of symptoms such as headaches, dizziness, ringing in the ears, severe arm and chest pain and vision problems.
This posture can be further aggravated by halter-style costume bras. Heavy from beads and/or coins and pulled tight for security, they can exert incredible pressure on lower cervical vertebrae and possibly cause disc and nerve damage.
The gentle fluid movements of Oriental dance are beneficial for the ENTIRE spine, unlike the rigidity of ballet, the tense sharp movements of Flamenco, or the violent and dangerous hyperextensions and 360 degree rotations of African and Jazz dance. Repeated neck hyperextension will inevitably result in whiplash injuries including strain and spasm of the anterior neck muscles, chronic posterior neck pain, decrease or reversal of the natural C curve, nerve damage, joint disease, disc degeneration/herniation and even sublaxation of the first rib.
Recently, certain Oriental dance teachers have begun to incorporate psuedo-Jazz movements, especially neck hyperextensions into their choreographics. It is very important that dancers understand that these movements are not only uncharacteristic of our art form but will almost certainly result in the above mentioned injuries.
These neck hyperextensions and rotations however, are typical in both Zar and Khaleegy movements and can create similar problems. Although the hyperextensions should always be avoided it is possible to create an almost identical but safe rotational movement as follows:
- Side bend the neck ear to shoulder.
- Flex the chin to the chest.
- Side bend other ear to other shoulder.
- Simply lift the head into neutral with the chin slightly lifted.
Be careful NOT to let the head drop back toward the shoulder blades and always maintain the space of a full hand-width between the base of the skull and the base of the neck. It is also very important to relax the thoracic spine so that it can absorb and counter-balance the movements of the cervical spine.
Small lateral head slides typical of Oriental dance are actually very beneficial for the neck, but large, exaggerated lateral slides or half and full circles should be avoided, as they may overstretch crucial ligaments at the base of the skull and destabilize the joints.
We can easily maintain a healthy and pain free neck while dancing if we are careful to keep the head properly positioned (see beginning of article) at all times, if we allow the neck to relax and naturally follow the movements of the thoracic spine and shoulders and if we never hyperextend the neck.
However, if anyone does already suffer from chronic neck, shoulder and/or arm pain, muscle tension, numbness due to previous motor-vehicle or dance related whiplash injuries and/or postural dysfunction I must stress they should seek a complete assessment and appropriate treatment from a qualified health care professional such as an osteopath, or a massage/manual/physiotherapist with advance post graduate training in osteopathic and myofascial release techniques.
In closing I would like to say that most serious neck problems can be avoided or reversed with treatments from such qualified therapists combined with awareness, avoidance of potentially injurious habits and activities and appropriate exercises. Due to the sensitivity of these areas I will not recommend general exercises and home care in this article although I would be happy to answer specific questions at hadia@hadia.com
For more detailed information on anatomy please refer to my previous two articles on the lumbar and thoracic spines.