Neck exercises for Long Covid-- Part Deux
My N=1, not medical advice. Don't do anything that causes acute pain!
Lymphatic massage could be beneficial for anyone with Long Covid, whether they have neck pain or not! Here is a link to the routine and tips which I do regularly (Especially at night, right before going to bed, and in the morning):
This is the science behind why Lymph/glymph massage is beneficial for Post-Covid.
Understanding the complex anatomy and a theory of how occipital movement/posture/exercises affect the flow of cerebral spinal fluid. The TLDR of the video:
My Notes:A. The occipitals are an important part of my issues. However, there are other issues (TMJ, bloodflow, lymph flow, etc...).
B. Posture while doing this simple exercise is important.
C. This is deceptively easy. However, if you decide to try it; start with one rep!
D. Doing any and all neck exercises with a specialized PT will give you very valuable feedback on posture, rhythm, breathing, relaxation, etc...
E. Do slowly, with slow, diaphragmic breaths, at about 70% effort, while focusing on relaxation! (Thoughts have an affect on the muscle tension! It should be meditative, relaxing!)
A link to the video (for information -- the anatomy and theory):
Her video on Neck pain.
Do you have MTD?My problem seems to be a kind of subconscious tension from the ANS (self-diagnosis). Made worse by poor technique and being a teacher (straining my voice for years with poor technique and even while sick!). This is an interesting video about doctors that mis-diagnose MTD as "being in your head." Sound familiar?
(based on extensive research and my N=1 experiments in this #LongCovid journey. I may be completely wrong 😜...)
You can get the blood flowing to muscles,
& You can strengthen the muscles,
& You can improve posture, speaking technique, etc that exacerbates the issues,
& You do brain training to reduce the amount of ammunition the damaged, negatively biased, ANS has to use against you...
& Take care of your diet so you reduce inflammation, acid reflux, etc...
Then it seems possible to heal! I am at about 85 or 90% recovered from all neck issues (about 70% in general recovery).
7. The problems...
Healing is slow.
Most people (even specialized physios) will not understand the complexity of this issue and many don't understand PEM... even when explained. To many physios, understanding PEM is almost impossible since movement+pain within tolerable limits is their bread and butter.
Exercise can lead to reperfusion injury (PEM). Each person has to adapt the exercises (I prefer the term "movement") to their abilities. Stay within your envelope. I stopped my daily breathing exercises to have time and energy to work on my neck problems.
Healing requires blood flow/lymph flow. However, this causes reperfusion injury which can lead to PEM and or Pain.
So how can we heal with the catch-22 of PEM?
1. We have to stay within our personal energy envelope. This might be different each day.
2. I like the 80% pacing rule. Do enough physical and mental movement daily to be "tired" enough to get good sleep, but leave 20% for the body to heal. Going near 100% might avoid a crash but it will not let the body heal. Going over 100% will lead to a crash (Boom-bust cycle).
3. Sleep and diet are key to recovery.
4. Monitoring data trends sleep quality, HRV, Step count, Heart rate, etc. can help tell you if you are on the right track. But listen to your body first and only pay attention to the data when it shows positive trends. Otherwise, ignore it. Even the best devices' data are too inaccurate to overrule what your body is telling you each moment. (I tried a muscle relaxant for a few weeks. I felt bad and the data was negative so I stopped taking it.)
5. Start small. Do one rep or three-second holds to start. Then slowly add reps and length of holds. I call this Pacing-dependent, micro-GET (TM) 😜. Normal GET can be dangerous for people with PEM, but the "micro" version that is led by the patient and staying inside the pacing "spoon allowance" is a way to slowly build strength, and energy, improve sleep, etc.
6. Self-compassion was key for my healing journey. I am only at about 70% now (Feb 2023), but I have come a long way. I am working, walking as much as 10,000 steps, doing some socializing (not much), etc... without overdoing it. My inner voice laughs at me when I start off an exercise routine with 1 to 3 reps:
Inner voice: "Come on you weakling! Push yourself more! You bench pressed 100kgs when you were 15 years old! You ran a marathon in the mountains in your forties! Just a bit more!"
Me: Laughing outloud. "You have kept me in the boom-bust cycle too long! You don't understand ANS dysregulation, the physical dammage that is slow to heal, and PEM! I am finally pacing and getting stronger without crashing!"
Am I crazy? Maybe, but I am slowly getting better. And each bit makes the next bit easier.
1. I got the best results when doing these exercises twice a day. Sometimes only once a day.
2. I see the most benefits when doing it right before going to sleep. The difference in deep sleep amount and quality was huge! I still see a drop in sleep quality on the nights I do not do anything!
3. Be mindful and completely evaluate your posture, pillow, sleeping comfort, posture while using a computer or mobile phone, speaking technique, emotional state, needed regular rest breaks, etc... To attack the problem holistically. Anything that will help your body relax, strengthen and heal.
4. Improvements in deep sleep are vital for all stages of healing.
5. If you are lucky enough to have a proper diagnosis for your problem (CCI, Chiarri, etc) from an expert, then listen to them. However, make sure to listen to your body. If they don't understand PEM, don't push yourself just because they said to. And don't believe them when they say it is all in your head.
6. Breathing is key. Coordinate each movement with your exhale. Follow your speed, not the speed of a trainer or video.
7. According to the Adam Fields videos, the "crunching" sound you hear in the neck (not acute pain) when rotating your head or doing occipital lifts is a good sign of blood flow getting to areas that don't get enough blood. Sounds good to me... movement and blood flow are good things.
8. Theoretically, Isometric exercises are "safe." You might feel tightness after some exercises that go away after 10 minutes. There should not be any sharp/Acute pain. And most of the tightness after the exercise should go away after a few minutes of massage with your hands and or a massage ball (roller) etc.
9, You are doing this to gain strength and improve mobility and blood flow. It is normal to notice an effect, but not pain.
10. Lastly, try to smile and relax while doing the exercises. Adam Fields always says "Healthcare is Selfcare" If you are tense while doing them it can be counterproductive. Listen to calming music in the background. Aim to think positive thoughts while doing the exercises to avoid anything negative that will cause tension.
For strengthening. I suggest starting slowly with the videos from this Physio:
CERVICAL SPINE STABILIZATION 1: https://youtu.be/Ya9q-uN6y0A CERVICAL SPINE STABILIZATION 2: https://youtu.be/Hjpcyx4rJ1Q
My favorite videos that do both stretching and some stabilization/strengthening are from the DR Adam Fields' channel:
He has a lot of videos/playlists for the neck, TMJ, throat, tinnitus, sinus, headaches, etc. It helps explore different regions and find specific exercises that work for you. There is some repetition and some unique exercises in each video.
This is one of my favorites to help with my neck:
The concept seems strange. It is deceptively simple and ... odd. I have only been "mewing" for about a month, but it is surprisingly helpful!
I don't do it as a "routine". I just try to be mindful of tongue position, and posture and I randomly do tongue strengthening & swallowing exercises throughout the day. It supposedly has lots of benefits for the face structure, etc... but I do it because it seems to help with tension in the throat, TMJ tension, etc.
Tongue position: https://youtu.be/eh9OqEd5z1k
Swallowing exercises: https://youtu.be/gcI8CvoFxfQ
There are other sources, but these have been the most helpful.
During my research, I came across the concept of scalp massage to reverse balding. Maybe there was something to the whole story about Sampson losing his strength when he lost his hair🤣?
I have incorporated this into my routines to attack the tension from different angles. It gets to the upper part of the head not covered in the other exercises. If it reverses balding, it will be a bonus! Some people get Botox on the scalp to help relax those muscles. This procedure is already used for TMJ. Maybe that would help some people with similar symptoms in Long Covid?
A video interview about scalp tension massage/baldness connection:
I bought a small red-light therapy panel last October. The main goal was to avoid the winter slump. So far, it seems to have helped with that.
It also appears to help with the neck stiffness, killing off germs, "feeding" mitochondria to have more energy and it is shown to help with brain damage in preliminary Parkinson's trials. It appears to help my neck issues. And an extra bonus, some studies show benefits for balding!
Tips: Where eye protection, start slow (one minute per surface) and build up to 5 to 10 minutes per surface. Stay about 15 cm from the device. Stop when you start feeling inner warmth. Doing too much can be harmful. My sweet spot for the neck or back is about 7 or 8 minutes. The scalp seems to need only about 3 minutes. Doing too much is bad! Especially at the beginning! And the NIR light can destroy digital cameras! No selfies 😉!
Keep on Keeping on! One day at a time!
Comments and critiques are welcome! This second part is better in part due to comments from others!
How Long Covid symptoms might be caused by CCI or CCI-like damage:
Take care of yourself, and if you can, someone else too! --Stephen Dubner