Strengthening the neck after C6/7 disc herniation

[ekoeler]

In November of last year, I was doing wide grip pullups on one of those bent bars at my work's gym (first time trying one of those), and I felt something pop in my neck. I was extending my neck to get my chin over the bar, and yes, I realize that was bad form. Over the course of the next couple of weeks, I experienced the worst pain I have ever felt in my life in my upper back, shoulder, forearm and hand, as well as extensive finger numbness. Long story short, the MRI showed that I herniated my C6/7 disc, which probably caused the severe radiculopathy. After 10 days of ibuprofen, then a 6 day course of methylprednisolone, the radiculopathy ceased for the most part. My neurologist performed some nerve conductivity tests and concluded that there is no permanent nerve damage, though my left shoulder and tricep are still very weak and atrophied. Supposedly, I will regain my lost strength over time.

I have been going to PT, and they prescribed double-chins, isometric neck extensor work, rows (with band), shrugs (unweighted), tricep/bicep isolation work, and a number of rotator cuff isolation exercises with tiny dumbells and bands. At home, I have recently started a linear progression of front squats (I can't put the bar on my scapula due to lingering pain in the area), bench press, and deadlifts. If I have time, I add in LTEs and curls at the end. So far so good.

I will be paying much more attention to my neck posture in everyday life and especially while lifting, keeping my chin tucked, chest out, and spine neutral, but I wanted to know if you have any suggestions for how to strengthen my neck? I used the search function, and I did note that you recommended against doing power cleans for someone in my position, but I did not find any recommendations for directly working the neck. Is there any way to safely load the neck, with a harness, barbell shrugs, etc? Should I focus on isometrically strengthening it? Is simply keeping the correct posture while doing the big lifts enough to prevent this from happening again? Deadlifting and squatting fixed all of my former back problems (occasional tweaks and spasms), and I am looking to do the same for my neck.

In case it matters, I am a 42-old man, 6'4", 210 pounds. I was a mediocre distance runner (raced 10Ks) prior to discovering Starting Strength about a year and a half ago (when I was 180 pounds). I recently made the decision to forego running in favor of strength training, just in time for my injury.

Thanks in advance.

Eric

[Mark Rippetoe]

I have the same basic injury. Neck strength has nothing whatsoever to do with this. There was most likely pre-existing pathology. Stop wiggling your neck around and irritating the joint. The symptoms will resolve in the near-term, but will re-occur periodically, most likely eventually requiring a fusion at that level. When this occurs, you'll have no more problems with it.

[ekoeler]

I was afraid you would say that about eventually requiring a fusion. I suppose I will progress the PT exercises as much as I can and be extremely careful about my posture at all times. That's what I get for slumping over a computer for 20 years. For what it's worth, both my brothers and my mom have herniated this same disc, so I am sure there is some hereditary structural issue/weakness.

Thank you for your time.

[Mark Rippetoe]

What I'm telling you is that if the PT exercises cause you to wiggle your neck around, STOP DOING THEM.

[wakk0]

I have the same basic injury. Neck strength has nothing whatsoever to do with this. There was most likely pre-existing pathology. Stop wiggling your neck around and irritating the joint. The symptoms will resolve in the near-term, but will re-occur periodically, most likely eventually requiring a fusion at that level. When this occurs, you'll have no more problems with it.

Rip, why does neck strengthening exercises not help with disc injuries? Wouldn't strengthening the surrounding musculature cause less pressure to the compressed disc at the site of the herniation?

[ekoeler]

Yes, I apologize, I got that. I was referring to the isometric neck extensor stuff, shrugs, etc. The physical therapists make sure that I do not move my neck around, and they are very careful even when they want me to test my range of motion (they basically told me to avoid neck flexion at all costs).

By the way, my neurologist wants me to avoid all overhead work forevermore. I do not want to give up OHP in the long term. What would you recommend? My plan was to start very light at some point, focus on posture and form, and progress normally.

[Frayedknot]

I am not a medical professional.

I truly believe the most effective rehab of my neck was resuming barbell training, albeit at lower numbers due to the muscle weakness. My doctor and PT recommended I stop the training and I initially did. However the continued weakness interfered with my life (couldn't get on the floor and play with my boys) so I confirmed with my ortho that lifting was not likely to cause catastrophic injury. My doc didn't really push it when I told her I was going to be non-compliant. My issue manifested itself on Christmas Day 2012. I was expecting to PR bench press with a 315 lbs 1RM. I could barely press 95 lbs. over the next year I pushed, fought through flare-ups and progressed. On Christmas Day 2013 I pressed 275 lbs easily. I always have to watch my posture, especially when tired. I also have a cervical traction device I use when symptoms start to flare up. I believe that it I had followed medical advice I'd still be weak as a child and in pain.

[FatButWeak]

Just one data point: I had severe and persistent neck pain, which was probably due to some sort of bad form deadlifting or cleaning, Im not sure. I then did Smolov Jr for overhead press, which I ran alongside a modified Texas Method. Not only did pressing 3-4 days per week improve my shoulder strength, but my form became rock solid and imporved and my neck pain disappeared.

Smolov Jr. is pretty much a volume program, which has your pressing fairly light weights for lower reps with more sets. Without meaning to, my pressing form evolved from a SS 2d edition press to a SS 3d edition press. One day I just realized I was pressing as described in the 3d edition. And my neck pain was gone.

[Beau Bryant]

Rip has it covered but I had the same injury a couple times. Jumping from aircraft and MMA took its toll on my neck. After a warmup press about a week before our SS seminar last year I had it fused following Rip's advice. I'm still not sure how I functioned during that seminar, I'm pretty sure I was delirious with pain.

About 8 months later after having it replaced and fused I have pulled 450 for 5, pressed 155 and benched 225 for 5. Squatting is not a problem. I started pressing, squatting and pulling 10 days after surgery and there's no doubt this stopped all atrophy and healed the nerve damage much faster than not doing it. My thumb is still numb but i have no atrophy of the tricep. I had to use a junior bar to press but the more I pressed the more the nerve seemed to "remember". If I missed a couple days without pressing I would lose 5 or more pounds on the press and would need to start over at a lighter weight.

I understand our situations are different without you having sergical intervention but I'm
pretty sure returning nerve function would be accomplished the same way. You need to figure out a way to fire that pathway under increasing loads and do it often.

[GaryP]

I had this fusion done a little over 10 years ago, and have been doing the four basic lifts for the last 2 years with no neck problems. Pull-ups are another story. Wide grip causes me considerable neck discomfort and I never do them. However, close-grip pull-ups with the index fingers about 4 inches apart are very doable. Just never extend your neck while doing them (as you now know).