Neck Strengthening Exercises for Long Covid


Image created with Dall-E 2 by D. Troy Roach, "Bust of a strong man in the style of MC Escher." 


Since my second SARS2 infection in April of 2021, my main physical symptom (not counting fatigue, PEM, etc...) has been neck pain. Nothing I did seemed to help improve this symptom; stretching, weekly PT, Chiropractor, different pillows, muscle relaxers, etc were all a bust.

Luckily, in June 2022 I found some isometric exercises which have made a big difference over the span of two to three months of doing them almost daily. My neck issues have reduced by 70%.

My problem, as diagnosed by a specialist PT, is probably neuromuscular. It affects my occipitals, SCM, TMJ, throat, tinnitus, etc. It seems to be a kind of CCI (Cranial Cervical instability) that was caused by the Spring 2021 flavor of SARS2. 

Note: Before these exercises, I took Gabapentin for 5 weeks and then Pregabalin for three weeks. Both seemed to help my neck, Pregabalin more than Gabapentin. Three weeks seems to be a good amount of time. Taking it at night helped me sleep the first week. And it was easy to wean off it during the 3rd week. My N=1, not medical advice.

This self-diagnosis of "CCI-light" seems odd since I am anything but hyperflexible (a common correlation/cause of CCI). However, it seems that the damn bug caused neuromuscular damage, leading to constant tension in the muscles, which then leads to weak & damaged ligaments and poor support of the big bowling ball above my neck.

My theory is that these isometric exercises help because they are strengthening the muscles which take the load off of the tendons, ligaments, and joints. Blood, glymph, lymph, and nerve signals can all flow better. The whole process also helps with posture, relaxation, and sleep!

There is also the theory floating around on the interwebs that the physical damage done by the bug to the nerves and nervous system is the cause of CCI and or Chiari... which leads to cyclical issues in the ANS (autonomic nervous system)... which lead to all the other health issues downstream. In summary:

I do not know if this theory is true, but it makes sense and there is probably no "1" cause/ solution for most people in this heterogeneous disease.

The links to the exercises below have been of great help to me. It has improved about 70% of my neck issues so far. It may be helping some other issues downstream, but I am not sure yet. However, I have not noticed a jump in energy or my baseline. 

Disclaimer: I am sharing this n=1 experiment with others in the hope that it will help more people and for me to learn from the comments from others. I am not a doctor, PT or Chiropractor. Do these exercises within your own limits and don't take any risks.

Some things I have learned along the way:

1. Isometric exercises are "safe" and they don't require much energy, but it is best to start small and build up slowly. Some videos tell you to "push as hard as you can", but I suggest working up to that.

2. There are 42 face and 26 neck muscles (1)! Making slight adjustments of angle while doing many of these exercises will work different muscles! You might want to repeat similar exercises, but with small adjustments to posture, chin tuck, etc.

3. It is strange to think about it, but... The back of the jaw and the occipital region at the base of the back skull where the C1 and C2 are located are all very close. There are lots of nerves, arteries, the ear canal, etc...all packed into a tiny space that is also very flexible! 

4. This has improved sleep quality (Deep sleep continuity) especially if I do some of the strengthening & movement (occipital lifts) exercises right before going to bed at night. Tiring out the muscles right before sleep seems to help blood/glymph flow!

5. For some reason, I tense my jaw and my neck/ doing physical labor as a type of compensation. I need to be mindful to not do that and to strengthen other muscles in my body to avoid this compensation. That is my next step. Slow going with pacing.

Has this improved other symptoms? Mostly sleep quality and brain fog. I also see a large drop in "hypersensitivity" to sudden loud noises. And sometimes I do not have tinnitus, which is nice to have a break from the constant noise (I had tinnitus before LC). My posture has improved and I feel like I have some "control" over my recovery. Are these improvements related to the neck exercises? I think so. The increased blood flow, better sleep, and reduced inflammation should be helping overall healing. 

Below are the videos in the order that I found them. However, I suggest doing the fourth one first since the exercises are lighter. The second video is probably my favorite. The mixture of movement to get fluids moving and strengthening feels fantastic!

1. This video is good for strengthening the neck while stretching. But it might not be the best video to start with since the "after-effect" can be strong, but good.

2. This video is my favorite all around. The movement exercises really help blood flow to the brain. It is obvious in my sleep data (deep sleep continuity clearly improves). 
I have an elastic exercise band that works fine for the exercises, but a towel would be OK.

3. These videos are jaw strengthening and stretching exercises.  The first video is deceptively easy. It matches my throat muscle symptoms well. The second is an intermediate jaw (TMJ) exercise and the third video with the cork can be quite intense.

4. Maybe Start with the exercises in this video! This is the lightest, for beginners, but you can build on it with repetitions, angles, etc. She has another "part 1" video, but I did not watch that one since the level in this video was good for me.  

I hope this information is useful for someone else in my situation! 

Anything that makes me feel better and improves my sleep is a good thing. Now, I am testing red-light therapy in hopes that it will reduce the "winter crash" which seems to come with Long Covid.

Leave any comments or doubts in the comments, especially if you have more insight to help me or others in the community.

Take care of yourself, and if you can, someone else too! --Stephen Dubner

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