Packed Neck for Swimmers Part II

From Swimming Science

We’ll begin this second installment with neck assessments. Lot to cover this week, so let’s get right into it!

Assessment

There are many available assessment tools, but any that you use should address mobility (length), stability (strength) and timing.

Mobility – Chin tuck to chest with mouth closed. If the swimmer can’t touch the chin to chest, there is a mobility restriction.

Stability – Chin tuck. Can you pack the neck when asked to do so? You can also perform this exercise while supine on the ground or a table.

Timing – Situp test. Does the neck become unpacked during the situp? You can use a unweighted version of Dr. Mullen’s Eccentric Bosu Situp pictured below to assess muscle timing of the neck. The same move without a Bosu will also provide valuable information about neck firing patterns.

 

Assessments are ongoing throughout training and allow us to organize swimmers into the right categories for optimal interventions.

1. No limitations. -> Go hard!
2. Can pack when thinking about it, but loses neck packing during loaded or complex movement -> Cue packed neck in training. Coach ‘em up.
3. Almost there, but need more time -> More emphasis on corrective work. If no improvement, then proceed into category 4 below
4. Can’t do it at all -> May need manual therapy intervention.

Not Just the NeckI’ll reiterate last week’s theme that packing the neck is a full body concept. Isolated neck training should not encompass a large portion of a dryland program. If it needs to, you’re probably dealing with a patient. However, neck exercises deserve a place in dryland warmups and as complementary exercises in supersets. See, Freestyle Flaw: Bobble Head for sample neck exercises.

In Part I we talked about the neck as feed forward mechanism, but it is also part of the body’s audit systems which are a feedback mechanism. We have natural audits everywhere. Lactate production is an audit on energy expenditure. The stroke count per length variability is an audit for stroke efficiency. Pain is an audit for threats and damage. Audits simply provide information when something has disturbed homeostasis so we can make adjustments, whether consciously or unconsciously.

One explanation for the neck as an audit is the close link to respiration. Apical breathing (chest breathing) involves heavy use of accessory breathing muscles, which include the upper trapezius, levator scapulae, and sternocleidomastoids, among others. When reciprocal inhibition occurs within Janda’s postural syndromes, hyperactivity in the accessory breathing muscles may inhibit the deep neck flexors making it harder to pack the neck.

Recruitment of accessory breathing muscles and inhibition of the deep neck flexors accompanies poor use of the diaphragm. Okoru (2011) found that oral breathers had worse cervical spine posture and decreased respiratory muscle strength than nasal breathers. There are times when those accessory muscles is needed such as during extended periods of intense activity. However, diaphragmatic breathing as a default setting spares the accessory breathing muscles. As such, breathing can promote optimal recruitment of the deep neck flexors and allows the athlete to exploit the feed forward mechanisms offered via a packed neck.

A forward head position and unpacked neck will add stress elsewhere. Sometimes the body adjusts and is asymptomatic, but often it does not. Forward head position is also linked to upper extremity trigger points and headaches. (Fernandez-de-las-Penas 2007, Hidalgo-Lozano-2011) Pain affects neck flexor endurance (Harris, 2005), but improving endurance can help relieve pain (Falla 2006). Manual therapy on the neck was also shown to improve grip strength in judo athletes (Botelho 2011).

An aside...
I’m going on a mini-tangent, but one indirectly related to the topic and directly related to the entire mission of this website. A 2009 study (Wolf) from the American Journal of Sports Medicine looked at injury patterns in Division I swimming analyzing a single program from 2002-2007. Notable findings:

• 38% of swimmers suffered an injury outside of the water, which included both dryland and non-training incidents.
• Freshmen were more likely injured than upperclassmen

That 38% number seemed a little high when I first read it, so I looked further and found another very similar study from more than ten years earlier (McFarland 1996). This study included only female collegiate swimmers. Notable findings:

• 44% suffered injuries in dryland training
• ….and another 11% suffered injuries out of the pool! ( work hard…play hard?)
• Most dryland injuries were from lower body training. Pool injuries were upper body.

Here we have two studies over ten years apart with data showing the same thing: lots of swimmers are getting hurt outside the water during dryland training. Whether improvement in upperclassmen injury rates resulted from freshmen adapting to the program or leaving altogether is unclear.

At the college level, we can’t necessarily implicate the coach for a high rate of dryland injuries, since the strength staff is likely the ones calling the shots in the weight room. Because swimming is not a marquee sport like football or basketball (sad as that may be to admit), the senior strength staff and athletic training staff usually pick football and basketball for their assignments leaving swimming to a junior staff member covering several different sports. Curiously though, the senior staff often finds a way to make time for the women’s volleyball team…and no, I’m not making that up.

Getting back on task!The whole reason for the aside was to reinforce the importance of attention to detail in exercise technique. To have two studies in the research literature looking at college swimming both showing that close to half the team is injured in dryland is quite sad (and let’s face it, relatively speaking compared to other sports, there aren’t that many studies out there looking at swimmers). Attention to detail in such matters as neck posture may be the difference between an Olympic medal, NCAA Championship, or early retirement.

The discussion on front squats vs. back squats is a prime example of the intersection between safety and performance. There’s a place for everything, including back squats, but if you can’t maintain cervical spine integrity or your predominant stroke flaws can be traced to a forward head position/unpacked neck…do we really want to reinforce this pattern with hundreds of pounds leaning on the back of the neck? Just something to consider when weighing the costs and benefits of these options.

This is not good…Pull ups are another area of the gym where we can groove the packed neck under a load. Although I’m strict with form, I’m not going to “no-count” an otherwise legal pull up just because someone doesn’t have a perfectly packed neck over the top of the bar. As a practical matter, some neck flexion and extension is permissible to avoid head-to-bar collisions. However, an extended neck in the starting position often means a thoracic spine limitation, which may place the shoulder at risk. (See also Dr. Mullen’s inverted rows series for additional thoughts on proper execution of dryland pulling movements).
Packed neck = Good body position

Unpacked neck = Poor body positionWhen someone can’t pack the neck in an exercise like the pull up or an inverted row, the neck again functions as an audit and guides us into regressions, such as thoracic spine mobility work and the localized neck exercises referenced above. Focusing on the neck will guide both our progressions and regressions for the program. Consider the situp. A basic situp or crunch may be easy for some to perform with a packed neck but difficult or impossible for others.

Nice abs but weak coreSwimmers who can demonstrate a packed neck in a basic situp are candidates to move to advanced abdominal training (see Dr. Mullen’s Eccentric Bosu Situp article). Someone who can’t do a situp with a pakced neck probably shouldn’t load the movement or do high repetitions. Those who improve neck packing may find themselves able to progress more rapidly via improved recruitment patterns throughout the entire body.

The Eyes Have ItOne purpose of dryland training is to train fundamental movements to become automatic when applied in the swim stroke. If a packed neck becomes natural, that’s one less cue to think about when we get in the water. As a complement to packing the neck, we must also consider the eyes, which drive our head and neck movements. The eyes don’t get much attention, but they are important as a gateway to the world for the brain. If we change neck habits we must also change vision habits, though the reciprocal may also occur. In other words, retraining the eyes may also help pack the neck and facilitate all the good things that come from a packed neck.

Open water swimmers and triathletes tend to have higher freestyle head positions, as the eyes’ range of motion is inadequate for sighting without help from the neck. In the pool, “staring at the black line” is more than just a figurative term, as looking downward will complement the cue to pack the neck. However, as noted in Part I, freestyle head position is a very individualized trait and should be addressed with care. In short axis strokes, optimizing gaze angle when above the water can help facilitate neck packing. Knowing and practicing where to look can prevent excess neck extension both in block starts and in backstroke starts. The key is achieve compatibility between gaze cues, head position, neck position, and thoracic spine mobility

Summary
This concludes not only Part II of our examination of Packing the Neck but also our Elite Characteristics series. Consider this conclusion temporary as we are sure to update this information as our understanding evolves over time during our constant quest for improvement. Hopefully you got as much out of reading it as I did writing it.

References

1. Falla D, Jull G, Hodges P, Vicenzino B. An endurance-strength training regime is effective in reducing myoelectric manifestations of cervical flexor muscle fatigue in females with chronic neck pain. Clin Neurophysiol. 2006 Apr;117(4):828-37. Epub 2006 Feb 21.
2. Okuro RT, Morcillo AM, Sakano E, Schivinski CI, Ribeiro MÂ, Ribeiro JD. Braz J Otorhinolaryngol. Exercise capacity, respiratory mechanics and posture in mouth breathers. 2011 Oct;77(5):656-62.
3. Hidalgo-Lozano A, Fernández-de-Las-Peñas C, Calderón-Soto C, Domingo-Camara A, Madeleine P, Arroyo-Morales M. Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles. Scand J Med Sci Sports. 2011 May 12. doi: 10.1111/j.1600-0838.2011.01331.x. [Epub ahead of print]
4. Harris KD, Heer DM, Roy TC, Santos DM, Whitman JM, Wainner RS. Reliability of a measurement of neck flexor muscle endurance. Phys Ther. 2005 Dec;85(12):1349-55.
5. Wolf BR, Ebinger AE, Lawler MP, Britton CL. Injury patterns in Division I collegiate swimming. Am J Sports Med. 2009 Oct;37(10):2037-42. Epub 2009 Jul 24.
6. McFarland EG, Wasik M. Injuries in female collegiate swimmers due to swimming and cross training. Clin J Sport Med. 1996 Jul;6(3):178-82.
7. Botelho MB, Andrade BB. Effect of Cervical Spine Manipulative Therapy on Judo Athletes' Grip Strength. J Manipulative Physiol Ther. 2011 Nov 10. [Epub ahead of print]

By Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community, for more information refer to Pike Athletics.