When Your Neck and Shoulders Tighten Up Again No Matter How You Loosen Them

My neck and shoulders are always knotted up. Even when I loosen them, they come back within days.

People like this get massages, do stretches, and try to fix their posture. It feels good at the time but does not last long. They are told it is because of their posture, their pillow, or their stress, but no matter what they change, it does not get better.

In these cases, before loosening the knotted muscle by force, I first look at why that muscle cannot rest and keeps working.

Muscles do not knot up because they are lazy

Among the muscles of the neck and shoulders are some whose original job is to move the neck, but which help with breathing when needed — the muscles at the front and sides of the neck, the muscles that lift the shoulders, and the muscles between the ribs. When you breathe quietly as usual, these are hardly used, because the diaphragm does most of the work.

But once a habit of breathing shallowly and quickly sets in, the diaphragm cannot work enough, and these accessory muscles of the neck and shoulders step in instead. The problem is that they are called upon little by little all day, even while you sleep. Muscles that should rest cannot rest, so even when loosened, they knot up again within days. The cause remains right where it was.

Up to here is the part explained by respiratory physiology. That the accessory breathing muscles of the neck and shoulders are overused in shallow chest breathing is a well-known fact.

From here on is my clinical viewpoint. I see much of chronic neck and shoulder stiffness not as a matter of "posture" alone, but as a mark that the axis of breathing has left on the muscles. Shallow breathing comes from tension, and tension in turn makes breathing shallow. Within that loop, the neck and shoulders keep being called upon. So if you only loosen the knotted spot, the cause remains, and it soon returns.

So what do we do

I do two things together.

First, I return the already-hardened tissue. Muscle and the surrounding tissue that have been knotted for a long time, if loosened by forcefully cracking them open, soon rebound and harden again. I lower the tension by a method of gradually softening. I do not stretch it in a hurry.

Second, I change the upstream so that the muscle no longer has to work. When you restore breathing so that the diaphragm does its share, the accessory muscles of the neck and shoulders can finally rest. This must be released for the "loosen-but-it-returns" loop to be broken.

When you must go to the hospital first

Neck and shoulder pain, too, has signs that must not be missed. If numbness or weakness runs down into the arm, if moving the neck sends pain shooting down the arm like electricity, if pain wakes you at night, or if you are losing weight for no reason, you should get a detailed examination first. Nerve compression from a cervical disc, and rarely another disease, may be hidden.

I do not say that all neck and shoulder stiffness is due to breathing. Posture, repetitive work, discs, and joint problems certainly exist too. But if it is stiffness that returns within days no matter what you do, you should ask at least once why that muscle cannot rest.

Finally

Stiffness that returns no matter how you loosen it means not that the muscle is lazy, but that it keeps being called out from somewhere. Stopping that call is the real treatment. Rather than looking only at the neck and shoulders, I will look together for why that muscle is doing the work in someone else's place.