Deep Neck Flexor Strengthening

By Erin Reidman – CC’s Staff

We have touched on influencing factors for cervicogenic headaches in previous posts. Deep neck flexor (DNF) strength plays a key role in stability throughout the cervical spine and studies have shown that those with neck pain often have impaired strength and motor control of these structures. These studies show an increased amplitude the more superficial neck muscles including the sternocleidomastoid and scalene muscles. Findings also include decrease EMG activation of the deep neck flexors and decreased range of motion for craniocervical flexion. It is the resulting asymmetry and altered coordination of muscle that contributes to neck strain and headaches. Physical therapy aims to first identify the involved deficiencies and implement specific strengthening and coordination tasks to improve the deficiencies.

Strengthening of the DNFs is extremely beneficial in treating this condition. Specifically, a low-load for craniocervical flexion focused on motor control of the deep neck flexors is often prescribed.

Wondering if you have weak neck muscles that are influencing your pain? Try out this simple assessment to get an idea: lie on your back with your knees bent and feet flat on the floor. Gently flex your upper neck to create double chins while retracting your head into the table, and lift your head off of the floor, making sure to maintain the “double chins.” Hold this position as long as you can and take note on how many seconds until you are no longer able to maintain the head lifted off the table while maintaining the skin folds of your chin. Average hold time is 39 seconds for men and 29 seconds for women.

Try this introductory exercise to strengthen your deep neck muscles:

  • Prop the back of your head up on towels. Perform chin tuck. Maintain chin tuck as you lift head 1 inch.
  • Keep the chin tucked as you lower head back down and then release chin tuck. Repeat
  • Focus on the deep neck flexors and try to keep superficial muscles as relaxed as possible. Progress to performing from a flat surface or including holds.

Give our clinic a call to schedule a consult if you feel this is an area that needs addressing. If you have nagging headaches or neck pain, or experience any pain with any of the above assessments or exercises, give us a call for an evaluation!

Post Author: Erin Reidman

Erin is a DPT, wife, and mom of two wild boys. When not at work, you can find Erin teaching fitness classes at the YMCA or daydreaming of the next mountain biking/rock climbing adventure with her main squeeze.


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