PROGRAM OVERVIEW
Welcome to the EverAthletle neck rehabilitation program for the desk worker. This program was especially designed for the person who tends to spend long hours sitting or standing at a desk for work. We will guide you through 5 progressive phases of rehab to help you manage and improve your pain. We will also cover all potential factors that feed into your neck pain including stress management, sleep hygiene, posture and ergonomics.

Before we begin, it is useful to gather some baseline info on how you are doing. That way, you will be able to track your progress overtime and know which area may still require work. Please click on Baseline Testing for guided videos on how to perform the tests.

SESSION STRUCTURE
Each phase comprises a soft tissue, mobility and therapeutic exercise routine. The soft tissue and mobility routines should be done daily and the therapeutic exercises should be performed 3-4x weekly unless stated otherwise. Each full session should last approximately 20 to 30min.

EQUIPMENT
Lax ball, foam roller, elastic bands, dumbbells (light/medium).

FOCUS
This program is designed to help you neck pain from long hours sitting or standing at a desk. Initially, you will mostly work on soft tissue and mobility in order to reduce pain and restore full motion. The program is progressive in nature and each phase builds on the strength and mobility acquired in the previous one.

This program is for educational purposes only. You should consult your physician prior to engaging in this program.

In this section, we are giving you the tools to obtain objective measurements of the movement capacity of your neck. Pain will obviously be an important factor and it is probably the main reason you are here now but it is only one part of the equation. We wanted to bring to your attention to some variables that strongly influence the overall health of your neck and ultimately your pain. You will be able to track your progress from one phase to another and hopefully it will keep you motivated.

Please click on each video to receive instruction on how to perform the test and write down your scores for future reference. The Perceived Stress Scale is a validated tool to assess stress. Click on the link to access an online version.

Perceived Stress Scale

https://www.das.nh.gov/wellness/docs/percieved%20stress%20scale.pdf

PHASE OVERVIEW
Phase 1 is all about reducing pain and improving mobility. If you find that one or more exercises increases your pain too much, you should skip it for now or reduce the duration of it. 

Before your sessions, check out the movement videos.

EDUCATION
Stress is an important element to consider when dealing with pain and especially neck pain. To put it simply, stress makes us more vulnerable to experience pain and can sometimes be the most important factor to consider. So if it turns out you have an elevated stress score, you should implement strategies to reduce it. Refer to our guide on strategies to reduce stress.

Posture. You probably have heard it many times by now, “bad posture causes pain”. It turns out that it is not supported by the research so you can stop feeling guilty every time you catch yourself being in a slouched posture. Rather than trying to maintain that elusive “good” posture all day, you should make sure you take frequent short breaks from your sitting/standing position. Walk around the office, go to the bathroom or do some light stretching, etc. Bottom line, do something different than what you do all day already.

ACTIVITY MODIFICATIONS

1. Work to reduce stress if elevated on the Perceived Stress Scale.

2. Improve sleep duration to 7-8hrs if under 7hrs.

3. Implement 5 min movement break every 30-45min while at work (see movement break tab).

4. Implement ergonomic change to work station if necessary (see ergonomics tab).

PROGRESSION CRITERIA

1. You have spent at least one week on phase 1.

2. You see progress in the chin to clavicle and thoracic rotation test.

3. Your pain has improved.

STRATEGIES FOR STRESS REDUCTION

• Don’t be alone in the fight against stress. Talk to your family, manager, co-workers, or friends about it. They may be able to help you and if they play a direct role in your stress, do not feel afraid to communicate your needs/concerns to them.

• Practice breathing techniques to reduce stress such as a 1:2 inhale/exhale ratio (Check out the video below).

• Take time for yourself. Consider taking a day off from work or other activities in order to do something you love. It can also be useful to take that time to run the errands you have put in the back burner and are beginning to accumulate and potentially contributing to your stress.

• Take a walk in nature without your phone and try to be present during it. Notice the trees, the wind, the sun, the animals and flowers you encounter. It does not have to be long and it does not have to be in a spectacular place. Research has shown that walks in nature is one of the best things we can do for our wellbeing.

ERGONOMIC RECOMMENDATIONS

SCREEN + MONITOR

• The top third of your monitor/screen should be at eye level and set at about arms length from you.

• Limit fatigue by reducing glare with a glare screen and use the 20/20/20 rule - look 20 yards away for 20 seconds, every 20 minutes.

CHAIR SET-UP

• If you use a chair with arm support but make sure the arm rests are short enough so that you can get close to your work station.

• Set the backrest in a position that allows your spine to stay upright with your head/ear in line with your shoulders

• Your elbows should be bent at about 90 degrees in line with the shoulders when your hands are on the keyboard. Forearms should be parallel with the ground.

• Your feet should be touching the ground with your knee at about hip height. If that is not the case, consider using a foot rest. High heels will affect your sitting position so correct accordingly.

MOUSE + KEYBOARD SET UP

• Your mouse and keyboard should be placed directly in front of you.

• When your hands are on the keyboard/mouse, your wrists should be level with your elbows or slightly below. 

• Consider the use of a gel pad for your keyboard/mouse to support your wrist.

STANDING DESK

• The same recommendations apply, minus the chair. You should aim to be standing in a straight position, shoulders relaxed with your elbows at your sides, forearms parallel to the ground.

• Consider using a soft mat on the floor to limit fatigue.

• Consider insoles or supportive shoes if you are new to a standup desk and not used to spend that much time on your feet.

Taking a short break on a regular basis will do your body and even your productivity a lot of good. Not all breaks are equal however. Merely stepping away from your work station to go sit or stand somewhere else and look at your phone is very different than even walking for 5 minutes. While taking a short walking break is a good start, we think there are better ways to approach this. Below is an example of a purposeful movement break that will ensure you move some body parts that you otherwise not move during the work day.

PHASE OVERVIEW
In phase 2, we are adding additional exercises and begin to work on the muscles involved in supporting your neck during the day.

EDUCATION
Nothing happens overnight, especially when it comes to stress management. Continue chipping away at it and don’t be shy with sharing your feelings with others. You would be surprised how many people also suffer from stress. You do not have to be alone.

In this phase, we are starting to add a bit more strengthening. Don’t worry if this feel difficult and you don’t feel like you cannot perform all the reps. These are guidelines and something to aim to achieve eventually before moving on the next phase but are by no means set in stone. You are encouraged to reduce the number of reps if it is too challenging.

ACTIVITY MODIFICATION

1. Continue working on your stress if it remains an issue.

2. Continue to improve sleep duration and hygiene.

3. Maintain the 5 min movement break every 30-45min.

PROGRESSION CRITERIA

1. You have spent at least one week on phase 2.

2. You are able to perform all exercises with good form and without pain.

3. You are seeing progress in all tests.

4. Your pain has improved.

PHASE OVERVIEW
In phase 3, we are progressing the exercises to continue to gradually challenge the supportive muscles of your neck.

EDUCATION
Continue working diligently. You should have experienced some meaningful reduction in pain by now but sometimes it takes a long time. We tend to get caught on the day we started experiencing pain or the day it became intense enough for us to do something about it. The reality is that unless there is a trauma, your pain was likely developing for a long time. Picture a jar that is slowly being filled drop by drop. One day it reaches its capacity and overflows. That the day you begin to have pain or decide it is time to do something about it. Once it overflows it can be difficult and lengthy to stop more drops from coming. The program is designed to make the jar bigger so it can contain more water but also to reduce how much water falls into it. It can take some time but you will get there.

ACTIVITY MODIFICATIONS

1. Continue to work on your stress if it remains an issue.

2. Continue to improve sleep duration and hygiene.

3. Maintain the 5 min movement break every 30-45min.

PROGRESSION CRITERIA

1. You have spent at least one week on phase 3.

2. You are able to perform all exercises with good form and without pain.

3. You are seeing progress in all tests.

4. Your pain has improved

PHASE OVERVIEW
In phase 4, we continue our exercise progression. As the exercises become gradually more challenging, pay attention to your form to maximize the benefits.

EDUCATION
If the prone Y and T is giving you some issue such as tightness on the sides of your neck, make sure you slide your shoulder blades down toward your back pockets and place a rolled hand towel on the ground to rest your forehead on it.

ACTIVITY MODIFICATIONS

1. Continue to work on your stress if it remains an issue.

2. Continue to improve sleep duration and hygiene.

3. Maintain the 5 min movement break every 30-45min.

PROGRESSION CRITERIA

1. You have spent at least one week on phase 4.

2. You are able to perform all exercises with good form and without pain.

3. You are seeing progress in all tests.

4. Your pain has improved.

PHASE OVERVIEW

In phase 5, we push the progression even further so continue to pay extra attention to your form and make sure it does not break down as you accumulate the reps.

EDUCATION

Congratulations on reaching the last phase of the program. Your jar is now bigger and with less water getting into it. However, if you stop everything now, the jar will become smaller and more water will get into it again. Consider going through the routine twice weekly to maintain your progress or check out our general conditioning programs to level up and become healthier.

ACTIVITY MODIFICATIONS

1. Continue with the previous recommendations and aim to maintain those in the future. They will be helpful in keeping any future neck pain at bay.

PROGRESSION CRITERIA

1. Before graduating from the program, make sure you complete the self assessment tool one last time to make sure you have hit all the benchmarks. Stay with it a little longer if that is not the case.

2. You have spent at least 1 week on phase 5.