Neck Strengthening – The Deep Cervical Flexors

By: Dr. Kevin McIntyre B.Kin., DC

In recent years, there has been growing recognition of the importance of deep cervical flexor strengthening in the management of neck pain and dysfunction. The deep cervical flexors (DCF) play a crucial role in providing stability to the cervical spine and supporting optimal posture. Strengthening these muscles has become a focal point in rehabilitation programs aimed at alleviating neck pain, improving function, and preventing the recurrence of symptoms. This essay explores the significance of deep cervical flexor strengthening, its benefits, and key exercises used in rehabilitation protocols.

The cervical spine, consisting of seven vertebrae, supports the weight of the head and facilitates various movements, such as flexion, extension, rotation, and lateral bending. The deep cervical flexors, including the longus colli and longus capitis muscles, are situated closer to the vertebral column and are responsible for stabilizing the cervical spine during movement. They work synergistically with other neck muscles to maintain proper alignment, prevent excessive strain on the spinal structures, and distribute loads effectively.

Weakness or dysfunction of the deep cervical flexors can contribute to poor posture, altered movement patterns, and increased susceptibility to neck pain and injury. Factors such as prolonged sitting, poor ergonomic setups, repetitive motions, and trauma can lead to imbalances in muscle strength and activation, further exacerbating neck problems. Therefore, targeting the deep cervical flexors through specific strengthening exercises is an important part of restoring stability, improving posture, and reducing pain in individuals with neck-related issues.

Benefits of Deep Cervical Flexor Strengthening:

Strengthening of the deep cervical flexors may help to stabilize the cervical spine. It is possible that sprain injuries like whiplash can lead to a mild lack of stability in the neck. Strengthening muscles like the deep cervical flexors may help to stabilize the area.
Strong deep cervical flexors can support optimal head and neck posture, reducing the strain on surrounding muscles and ligaments and minimizing the risk of developing postural abnormalities.
Studies have shown that targeted strengthening of the deep cervical flexors can alleviate neck pain and associated symptoms by restoring muscle balance, improving joint function, and reducing compression on spinal structures.
Incorporating deep cervical flexor exercises into rehabilitation programs not only addresses current symptoms but also helps prevent future episodes of neck pain or injury by addressing underlying muscle weakness and imbalances.

There are various ways to strengthen the deep cervical flexors…

Chin Tucks: This simple exercise involves gently retracting the chin while keeping the head in a neutral position. It activates the deep cervical flexors and helps improve posture.
Supine Neck Flexion: Lying on the back with the head supported, individuals perform controlled neck flexion movements, focusing on engaging the deep cervical flexors while limiting the use of the superficial neck muscles as much as possible.
Isometric Neck Flexion: Applying gentle pressure with the fingertips against the forehead while attempting to push the head backward activates the deep cervical flexors isometrically, promoting strength and endurance.
Theraband Resistance Exercises: Using resistance bands, individuals can perform various cervical flexion exercises to progressively strengthen the deep cervical flexors against resistance.

Some Perspective…

Many years ago, lower back pain research found that the transversus abdominis muscle was linked to lower back pain. For a few years after that, there was a large focus on strengthening the transversus abdominis in an effort to treat and prevent lower back pain.

Since that time, it’s been well-established that the muscles around the spine should be viewed like an orchestra.

There isn’t one muscle that is more important than another one for most cases of back pain, so general strengthening of all muscles is more appropriate. Neck pain and the deep cervical flexors are similar. Many years ago, some research uncovered the link between these muscles (their weakness) and neck pain. This does not mean that the strengthening of these muscles will solve all types of neck pain. It just means that the deep cervical flexors are another part of the “orchestra,” and many people neglect them in their rehabilitation of neck pain. Strengthening is important for all muscles around the spine.

By incorporating specific exercises that isolate and strengthen the deep cervical flexors, significant improvements in neck health and overall well-being may be achieved.

Please keep in mind that any strengthening exercise can also aggravate or exacerbate neck pain if done incorrectly. Please contact our clinic and schedule an appointment with one of our practitioners to learn how to do the exercises and find out if they are appropriate for your condition.