SUP neck syndrome

Words: Elaine Farquharson

Pics: Elaine Farquharson, Georgia Schofield @georgiascofieldphotos and Peter Tranter

As a physio I hear a lot about your niggles from SUP, but did you know a lot of your pins and needles and arm pains could be coming from your neck? In the last edition of SUPM, we learnt about the importance of posture to keep ourselves healthy out on the water. This month we are going to take a closer look at our necks and understand the mobility and posture needed to prevent overload as well as some of the potential problems you can develop if you are not aware of your technique or kit.

The job of the neck is to hold up our head, but it also protects the vital blood vessels and nerves. Did you know that your head is the heaviest body part? Research shows in our neutral posture it weights 10lbs. Bending the head forward by about 30degrees can increase the weight to 40lbs and in our SUP racing position as high as 60lbs. This creates a lot of strain on our muscles, joints and discs. They need to be trained well and we should perform exercises to counterbalance the overload. For example, lying on a Pilates foam roller after SUP’ing helps to lower disc pressure, loosen stiff joints and stretch some of the muscle tightness.

Pins and needles, dizziness and headaches
The nerves and blood vessels are protected in the tunnels or foramen of the spine. We are designed to open and close these tunnels when we move. However, if we do that for prolonged periods it can irritate these structures. This can explain symptoms like pins and needles, dizziness, and headaches. The problem is the weight of our head during a long paddle is a challenge to maintain good posture. We end up sagging the neck, poking our chins out causing a hinging effect at a joint segment.

This closing of the joint space irritates the nerve even more. You might not notice neural symptoms initially as they often come on later or wake you up at night. We can easily prevent this though if we ensure good spinal mobility in the mid-back, choose the correct paddle length, and improve muscular endurance of the neck and shoulders.

So, to be able to SUP with a good neck health we need to be able to bow forward whilst avoiding sticking our chin out. The neck needs to remain nice and long and it’s the job of the deep neck flexor muscles that hold the front of the neck in this neutral position. So, if you’re a weekend warrior and spend all week at your desk then sort out your workstation for the sake of your SUP enjoyment!

Press up
To strengthen the deep neck flexor muscles, pretend you have a hot air balloon on the crown of your head lengthening the neck or you can perform a gentle nodding exercise lying on your back with your head on a pillow. A progression of this is to perform a press up against the wall but keep the neck long and your imaginary balloon overhead. Keep your shoulder blades sucked onto the chest wall they shouldn’t be wobbling around as you perform the movement.

To have an efficient forward paddle stroke we need to ensure the thoracic spine has enough flexibility to rotate to plant the blade in the water. If we don’t have this, we tend to round the back to gain reach which increases our pokey chin position. Also, we stop using our lats and start to use little neck muscles instead which fatigue quickly causing further slouching and overload.

Thoracic spine
A short paddle can also further perpetuate this problem. To improve mobility in the thoracic spine try lying on your back with your knees up and roll the legs gently side to side. A good exercise on your board is to place the paddle across the sternum and practice rotating the torso left and right keeping your pelvis still, the paddle will give you some reference that you are moving correctly.

A good pull phase to the stoke depends upon our muscular strength and endurance. A big blade is going to require more force. If you’re not strong enough go for a smaller blade especially over longer distances, otherwise you will cheat, and those poor neck muscles become overloaded.

Then there’s your shaft length, if it’s too long as we pull through, you’ll have no choice but to shrug your shoulder hence overloading the neck. Just to complicate it even further you may have a perfect paddle, but your leg motion will relatively cause you to behave if your paddle is too short or long if you don’t get your leg movement correct. So, there’s a lot of technique and biomechanics to ponder on when you’re enjoying the challenge of distance paddling.

Talking of shoulders did you know your shoulder blade posture is important to neck health? If they are weak, they tend to slouch downwards dragging on the neck muscles, or if you allow uncontrolled movement such as shoulder blade winging the neck muscles again can over work. So, make sure you build up the back of the shoulder blade muscles through exercises like rowing, and try not to just let the front more dominant pectorals get tight. If you do this, you’ll end up rounding your posture and joint stiffness will follow which can hurt.

The head itself plays a very important role in balance. It’s the first part of the body we gain control of as a baby and with that goes reflexes and skills such as head righting reactions to keep us upright. We also use our eyes and ears for balance which will affect your neck posture. If you go too narrow on your board or the conditions are too challenging it could be the reason why you are developing a lot of tension in your neck.

Try improving your balance on dry land and remember to challenge your visual field too. Can you move your head but keep your eyes still or move your thoracic only whilst you have your eyes closed? Our proprioception is crucial if you want the neck to be more relaxed during SUP.

Breathing
I bet you never think about how your breathing works either, well that’s important too. Poor intercostal action means we start to use our accessory muscles and yes, you’ve got it they’re also your neck muscles. Guess what if you have thoracic stiffness as well then it doubles the problem with your breathing. So perhaps practice checking how your breath too. The lower ribs should move out on inspiration and relax in on expiration, especially when you are working hard.

So, there you have it, the complexities of the neck and how complicated our body is to keep the whole thing healthy. It’s possibly the most overused and challenged region through SUP, however the good news is there is so much we can do to keep it working well and healthy. Remember prevention is much better than cure so a little TLC from time to time will be worth its weight in gold.

Elaine Farquharson

Elaine owns and runs Dorset Sports Physio, based in Weymouth community college sports centre. She offers sports physiotherapy, biomechanics and coaching to the Dorset communities. Elaine’s specialist interest is tri sports and SUP, not only as a competitor but also through her work as a coach and physio. Elaine’s specialist work with the lower quadrant has helped her achieve advanced practice recognition in hip and pelvis and works closely alongside Dorset’s expert hip surgeons and lower limb specialists. Elaine’s facilities offer a large private treatment room, three sports halls, a fully equipped gym, sports pitches, and also racquet courts across the two sites. Elaine also has a hydrotherapy pool and Pilates studio off campus. @dorsetsportsphysio

Further articles:

https://standuppaddlemag.co.uk/sup-boarding-tips-in-wind/

https://standuppaddlemag.co.uk/avoiding-sup-related-back-pain-2/

https://standuppaddlemag.co.uk/2020/09/22/shoulder-health-in-paddling/

https://standuppaddlemag.co.uk/avoiding-sup-related-back-pain/