When your head feels too heavy for your neck to carry
What to do to help this heaviness and fatigue.
The weight of your head is around 10-12 pounds for an average adult. Included in that weight is your brain which weighs around 3 of those pounds. There are 26 muscles that surround the cervical vertebrae and connect the skull to the vertebrae, the hyoid bone, the clavicles, the sternum, the rib cage and the shoulder blades as well as
muscles that connect each vertebra to the ones above and below. These 26 muscles do not include the muscles in the face.
All of these muscles help keep our eyes parallel to the ground. They allow us swallow and talk. They lift the rib cage when we inhale. They turn our head, nod up and down, lean our head side to side, and move our collar bones and shoulder blades. They support and stabilize our spine.
With all of this support, what makes your head feel too heavy for you to carry? I’ve seen this after whiplash injuries, neck surgeries, prolonged periods of immobilization(from wearing an external neck brace), prolonged static postures, and with people who have chronic neck pain.
Whiplash injuries occur typically during traumatic events like car accidents or falls. The head gets quickly moved to extremes of motions and the muscles get overly stretched beyond their normal ranges. Sometimes, this leads to muscle spasms and guarding as well as weakness from the excessive range of motion and overstretching.
After neck surgeries, I have seen people have muscular weakness. I remember one person in particular who came in to see me after she had a cervical fusion because of a problem with a pinched nerve. The nerve pain was gone, but the after-effects of healing from the surgery had made it hard for her to sit without head support, drive for more than 15 minutes, cook a meal, look down to read, or work at the computer for more than 10-15 minutes. She would get headaches, and excruciating pain. She always felt like she had to prop her chin up with her hands whenever she was sitting or standing. It took a lot of focused neck strengthening, but she was able to recover, regain her strength and get back to her normal routine after a couple of months of therapy with a structured home program.
If you stay in a prolonged static posture, you may develop muscular imbalances causing some muscles to be overused and others to be underused. With an imbalance, this can also cause your head to feel too heavy for you to hold up.
I don’t see this much anymore, but I used to see people who would come to therapy wearing those soft cervical collars. When you use external support to hold your head in place, the muscles weaken over time because there’s no demand for them to be active. It’s kind of like wearing a corset. The muscles weaken because the corset is the external support. We don’t utilize the internal support if we always have external support.
How do we help this heaviness and fatigue? My suggestions are:
Move often and avoid staying in one position for a long time
Move through your full available range of motion. Look up, down, left and right as well as moving your head in all ranges as pain allows without using force.
Practice this- laying on your back, tuck your chin but not too much. If you can’t swallow, you’re tucking too hard. Then, while keeping your chin tucked, lift your head a couple of inches. See how long you can hold this position. If you can’t keep your chin tucked while your head is lifted, then come back down and rest. If you feel shaky or if your head bobbles and wobbles, come back down. Functional strength for this is holding of the head with a chin tuck is 2 sets each for 30 seconds. I’ve seen it take up to 6 weeks to work up to this if your muscles are weak, so be patient and give yourself time with consistent, daily practice.
Connect your eye movement with your neck movement. There have been studies that show there is a delay in activation of cervical muscles with ocular movement after injuries such as whiplash, concussions, and pain that is chronic.1
Certainly, one exercise is not the answer, but this can give you an initial understanding of how your neck muscles might be functioning.
I would also suggest to see a physical therapist for a personalized assessment and exercise plan if you fatigue quickly with holding your head up.
I’d love to know-did you try the chin tuck/head lift? How long can you hold your head off the surface you are laying on?
Take good care,
Sharon
Della Casa E, Affolter Helbling J, Meichtry A, Luomajoki H, Kool J. Head-eye movement control tests in patients with chronic neck pain; inter-observer reliability and discriminative validity. BMC Musculoskelet Disord. 2014 Jan 14;15:16. doi: 10.1186/1471-2474-15-16. PMID: 24423109; PMCID: PMC3893395.