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"The Importance of Neck Stabilization: Why You Should Skip the Neck Bridge Exercise and Try These 4 Alternatives Instead"

I might get a few yogis(someone who practices yoga) giving me a side eye on this, you should limit how high you do a bridge exercise.

I have learned many different types and names for the bridge exercise. The one recently is called the neck bridge. It began with wrestling and gymnastics and I see it done in yoga. Despite what many find as benefits, ie. mobility, flexibility, and neck strength, I agree with other experts stating that this exercise should be avoided.

Why should you avoid the neck bridge or avoid going to the end range with a bridge? First and foremost, avoid them due to the compressive forces and strain on the cervical spine, nerves, and discs. The cervical spine is the most mobile part of the spine and potentially most vulnerable to injury. Jabob Horstman, PT, DPT, et al stated in his research titled "Cervical Stabilization Exercises in People with neck pain following concussion" that the structures (neck) provide stability may be challenged with even minimal force sustained, thus increasing joint laxity. I know from my experience as a Doctor of Physical Therapy that most people do not have adequate stabilization of their necks. And if we focus on the global stabilizers (large muscles like the Sternocleidomastoids) we are ignoring the important deep stabilizers of the neck.

What are the best cervical stabilization exercises? My decisions about prescribing cervical exercise are evidence-based and from 20 years as a Physical Therapist and 27 years as a Licensed Massage Therapist. Each individual's needs vary but all can benefit from the following four exercises.

  • Supine Deep Neck Flexor exercise.

    • I prefer teaching patients with the use of a pressure biofeedback cuff with the pressure set at 20 mmHg to begin. Starting at 20, gradual chin tuck and hold for 5 seconds. Then rest for 5 seconds. Progress 5 mmHg more to 22, 24, 26, 28. If a patient can successfully hold the 5 levels at 5 seconds each, they are ready to progress with adding arm or leg movement and even head movement. From there the deep neck flexor set and lift the head slightly and hold progression.

  • Sidelying Deep Neck Flexor exercise.

    • Place a towel roll under the neck. Begin with the chin tuck/retraction and slowly lift your head to neutral to the midline of your body. If you are unable to do this, begin in small range increments as with the supine exercise. 5 sec holds x5 reps.

  • Prone Deep Neck Flexor exercise.

    • You may have to begin with your forehead resting on a towel roll and progress to propped up on your elbows. Again as with the supine, begin with short increments and build up.

  • Seated Deep Neck Flexor exercise.

    • Begin sitting on a chair or if you are ready: a stability ball. Sitting tall: tighten your abdominals, squeeze your shoulder blades back, and begin your chin tuck/retraction. Hold for 5 seconds for 5-10 reps. This like the previous exercises can be progressed by adding arm only, leg march, and alternating arm and leg marching.

If you have completed all four exercises with proper mechanics and progressed each, you may be ready for advance with exercises with your head pressed against a ball on the wall, your head stabilizing on a bench, and active resistance band exercises.

It is best to begin these exercises with a skilled and experienced provider like myself to make sure you are doing these exercises correctly to prevent injury and pain. Contact me and we can get started!

#Live Inspired!

Karen Baltz Gibbs, PT, DPT, CSCS, LMT, CMP, Owner Garage Training & Rehab Gym

phone: 971-719-3162


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