#43 - Neck Training Solutions with Iron Neck, Part 1

Factor, spelled F-A-K-T-R, stands for Functional and Kinetic Treatment with Rehabilitation. Over the past decade, this unique approach to treating pain and dysfunction has been utilized by healthcare providers on 6 continents, serving as a framework that guides clinical decision-making in patient visits around the globe on a daily basis. With this podcast, our goal is simple: to bring the best and brightest in clinical education to the forefront and empower practitioners with cutting-edge, evidence-based content that improves patient outcomes and inspires healthcare providers to continually evolve their approach to treatment. In each episode, we will feature a training or interview with some of the top minds in healthcare in a short format that is easy to digest with actionable information that you can implement into practice right away. Let's get started. Hi guys, welcome to a new episode of The Factor Podcast. I'm your host, Jessica Riddle. If this is your first time tuning in, welcome and thanks for listening. Today we kick off a new course Titled Neck Training Solutions with Iron Neck. If you're like most practitioners, neck pain is a common complaint that you see in your office. Many providers treat whiplash injuries and text neck, along with more serious issues like chronic migraines, cervicogenic headaches, and concussion, all of which can stem from dysfunction, trauma, or weakness in the cervical spine. And if you treat neck pain in your office, you've more than likely heard of Iron Neck. Iron Neck started with a controversial idea: what if neck strength could help reduce whiplash and in turn reduce concussion risk in athletes? Their initial goal was to get Iron Neck devices into NFL and NCAA weight rooms. What started with a focus on athlete safety has evolved into a modern approach to fixing the crippling posture of modern society. And now, these wearable neck training devices are utilized in private healthcare clinics, hospitals, and by the sports medicine staffs of 40+ NFL and NCAA programs. In this 2-part training, we will answer the question, what does it take to have a strong neck, and why is this important for your patients? In this course, we'll take a practical look at evaluating training and finding possible solutions for strengthening and rehabbing the neck and its support system. And who better to speak to this than Jacob Nelson, Director of Education for Iron Neck? Jacob Nelson is a kinesiologist, strength and conditioning coach, and athlete who holds a lifetime obsession with strength and learning. He currently works with Iron Neck as Director of Education, Programming, and Regional Manager, and is also the Head of Strength and Conditioning for the American Raptors rugby team. In both positions, the goal is to blend functional neurology, with standards of practice in order to make a performance-based training program that enhances all biological systems. Jacob began his career as a strength and conditioning assistant at Humboldt State University, where he received his degree in kinesiology with a teaching/coaching emphasis. He also went on to receive his Strength and Conditioning All-American and CSCS designations from the NSCA, as well as completed an internship at NSCA headquarters. In over a decade in the field, he has worked with youth, high school, college, professional, and Olympic athletes as a strength and sports coach. In addition to his CSCS, he holds certifications in functional movement screening, the Weck Method RMT, and is a licensed coach for USA Weightlifting, USA Kettlebell Lifting, and USA Rugby. With all of that being said, guys, this is a fascinating topic and one that you should definitely tune into if neck pain is is something that you commonly see in practice. Let's cue the intro music and dive right in.

My name is Jacob. I'm with the Iron Neck. I also do professional strength conditioning for professional rugby teams. So neck training has been a big part of me as an athlete and then also for my athletes currently. So what we wanted to do today is, I assume a lot of us are working with people with neck issues or have quite a bit of information on neck training, the anatomy of the neck. So we'll go over a few things at a very high level, and then we'll fill in with some details as we go along and there's any questions. So today we're looking at just a sort of an overview of the neck, significant structures and things that we need to know as coaches and trainers and physical therapists, and then some safe training modes and methods, and then assessing range of motion and dealing with pain. So that would be sort of where we sort of stick to our scope of practice and what sort of tracks that we're in. So we'll begin with some of the things that we do to get neck pain passively. Not every neck issue comes from dealing with sport or sport injury. Obviously, those are very acute injuries. We'll get into some of those as well. So what we've seen today in the modern era is a lot of passive neck pain. So Forward head posture. Upper cross syndrome, where we sit slumped and sort of turned. We get one side very tight and an agonist side, and then an antagonist side quite loose. That creates big issues in our posture and in our gait and our day-to-day. Tech or text neck, however you refer to it, but it's a lot of looking down at the screen, looking down at work, riding on a bus or a train or a car, getting that kyphosis exaggerated into, into where we lose function, get pain in our neck. Rounded shoulders, and then any sort of genetic factors like scoliosis or other sort of spinal conditions that lead to debilitating neck pain. So acute injuries, we touched on that very briefly. So these are accidents and incidents that happen, very prevalent in America. There's something like 30+ million car accidents a year. So that's obviously a big problem. And what we see from that is whiplash, which I know some chiropractors that deal Only with that, that incident. So there's quite a prevalence in that in our country with the amount of like commuting and driving that we do. Strikes or impacts to the head or body. So that's more, again, like more sport-oriented. Lots of different sports and sports sometimes we don't always think about. So one of the number one concussed sports in America is actually female soccer, heading the ball, long durations of running, even like trips and falls in there. Volleyball is another one where We don't really think about it when the neck is craned up to look at an 8.5 or 9-foot net, and then we catch a ball or we sliding around on a gym surface can be obviously quite painful to the head and neck. Sprains and strains. So this could be anything from like a trip or a fall to something like that. And then concussions, which we'll touch more on because the Iron Neck was originally invented to help prevent and mitigate concussions. So we've got quite a few stats and data on that. You can see a lot of like axonal nerves tearing brain tissue that's physically damaged, right? So this is stuff that causes the, the body to react in an autoimmune response and release things that it's trying to keep your brain from getting further damaged. And the swelling and autoimmune response actually makes it worse. And then there's just some notes in there, right? Like things that we know that concussions do to people, loss of consciousness, memory and coordination, lack of concentration, and your emotional state. So those are more symptoms of the problem. Some of these concussion figures, these are in practice and in play. This is info from the CDC for folks that are looking for information on concussions. So we see my sport, rugby, is on the top of both lists, unfortunately. And then American football, ice hockey, and soccer. And those are from here in the States. Obviously rugby and soccer is very big across the world. Ice hockey's played in certain areas of the world more fervently than here. But we're looking at per 1,000 participants, which would be pretty average size. High school in the United States, in some places we're looking at anywhere between 1 and 3 kids dealing with that every season. So this is some of the, the more gritty stuff here with, with CTE. And again, this is the original inception of the Iron Neck in 2012 was dealing with this. The, the co-founder— sorry, the founder and co-owner of it, Mike Jolly, was a UCLA wrestler and football player and decided that The NFL wasn't for him, and lost buddies over the next two or three decades to CTE. And what we know about it right now is that CTE can only be diagnosed through autopsy. But through the Iron Neck research development programs that we're doing now, as people are looking for biomarkers, right? Being able to track and and see down the line if this is happening to people early on, so that we can either tailor. Your career around not dealing with that, or maybe we should end the career early before things get worse. But this is a big stage right now that people are working on to try and get into these biomarkers to predict this, right? And again, I, I don't have to go through every one of these, but the stages are, they start off with similar to concussion. There are confusion, disorientation, headaches, emotional state, and then it progresses very quickly. And it's unfortunate fact that like 4, you're 4 times more likely to develop stages 3 and 4, things like ALS or things like other chronic diseases based on your high rate of incident for contact sports. So NFL and rugby players are now, as your 20-year career ends, you're dealing with more and more of these things. So for long-term effects, what I'm, what we're gonna talk about a little bit more is this Just even like just general neck pain. So these are even the strains and sprains, things like tech neck and other things like that, the passive ways that we get them. And in addition to acute, acute is very easy for us to identify, like I slipped and fell and hurt my neck. But long-term effects of sitting and looking at the screen or having extreme kyphosis. Again, like this group knows that the kyphosis is just the kyphotic shape of your spine is important and it's designed a certain way and it's supposed to have curves in it in certain areas. But when we easily pull the head down and stay there, the physics takes over and adjusts and moves our spinal pieces around. And that's what we're talking about in these long-term effects, right? Is systemic and chronic inflammation, which causes endocrine system issues and it causes posture and pain, loss of range of motion, which I guess if you're on a computer every day, maybe it's not essential to your job, but you probably want to be a normal human and walk around and drive and back out of the driveway. And you may have extracurricular activities and things like that, picking up the kids or whatever it might be. Obviously a lot of pain and discomfort in your cervical spine or your thoracic spine not being in, in total alignment. And then physical therapy is— most people in America would benefit from being able to see a physical therapist, see someone for manual manipulation. But the way the insurance setup is right now, the way that pandemic has sort of Put on hold a lot of our disposable income. Those are the sort of things that go away first, unfortunately, for a lot of people. So it's, it's an, an added cost to just living your life and going to work, unfortunately.

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Just really quickly, anatomy review, just so we have it and everyone knows it, right? It's 7 cervical, 12 thoracic, 5 lumbar, and 5 sacral. So again, like the Iron Neck was, neck training sort of gets lumped into that top 7, which is very important. But we all know that the roots of the tree come all the way down to the sacrum. So we'll talk a lot about just general health, general spine health, and Like if the top 7 are working great, that's fantastic. But usually there's an issue, it gets affected later down the line. Just again, another quick anatomy review. When we're talking about neck, I try to think about the neck as all these things, like in the picture on the right here, looking at the trap and some of the subscapular and other things like that that create basically a shield. For athletes, we talk about building up this shield or the yoke and making the neck Very difficult to move when you want it to be. When you're, when you're going into contact, we want to have a high amount of isometric strength. It's slightly different for someone that's working on a computer for 8, 10, 12 hours a day. Like, that's also an isometric strength issue, being able to retract your neck and pull it into a good position, a long-term position. So it's not just these pictures on the left here, is a lot of things like levator scapulae, which is very important muscle It's the only one in your neck that attaches to the shoulder blade and directly to the head and neck. But all these muscles play a role in creating linear and lateral flexion and rotation at the neck. So for athletes, we talk a lot about the support system, being able to protect yourself that way. But all these things are important for anyone that's going to be sitting upright working for long periods of time. Common therapy modalities. This is a lot of things that, that everyone in here is probably doing on a daily basis with lots of people. So chiropractors and physical therapists, you guys are trying to work on physically realigning some pieces and trying to get inflammation under control and get pain down for people. And then again, like according to our poll, 66% of us that took the poll are using hand isometrics, manual rotation, traction, some sort of manual exercise to get range of motion back into cervical parts of the neck. Some more things that we do: acupuncture, spinal decompression, massage, and then in-range isometrics, which we'll talk a lot about again as a key principle to, to any rehab program, but especially what we'll be chatting about later. So these are just more like therapy modalities and work, right? So neck training is— Iron Neck didn't invent neck training. We feel like we've done a pretty good job of making a very versatile tool for us. To use in like a therapy modality all the way into elite sport. So these are some of the things that I've done before using the Iron Neck as a strength coach and some things that strength conditioning coaches use all over the world. So neck isometrics and bridging are some of my least favorite now. Now that I'm 37 and I've played contact sports for 24 years, some of these things are great tests of strength, like being able to do it, being able to survive it is a good thing. I don't know that all of them are necessarily the best way, an optimal way to train. But all these things here are, are active modalities for people that are looking to either improve range of motion or strength or both. So we'll just quickly go through again, like some anatomical planes, getting back into your— and this is more of like how Iron Neck plays in some of these planes, right? So frontal plane, we've got figure 8s where we're actually making an infinity sign in and around about the cervical spine. So we're getting Touching on bits of lateral flexion, retraction at the chin, engaging, and then rotation. Protraction and retraction. This is a clip of me, unfortunately. I'm the guy on the website and all these videos that I've gone through and designed. So again, like a thoracic CAR or controlled articulate rotation. So what we can do there is actually use the Iron Neck and its high lever point there to sort of traction out things. So in this one, I'm trying to get T10 to T12 in the middle of the back there into a big, big stretch. And then I'll use all that posterior chain to retract and pull myself back, hopefully not elevating at the chin too much and keeping that thing in line. And then this is another foundational movement for Iron Neck, which is locked neck body turn. And all we're trying to do there is go through that transverse plane. We're trying to get hips and ankles involved a little bit. So the spine doesn't actually change any range of motion whatsoever, right? I'm locked in from the top of my head all the way down to my sacral spine, and I'm going to rotate sort of about the lower body. So I can get iron, I can get training, isometric training all the way around my neck without actually having to physically move my neck. And we'll talk again, like that's more in-range isometrics and looking at training the neck safely and what's appropriate for some people. Clearing tests. So this is one where we'll start to, we'll have a chat, right, about I'm not a physical therapist. I'm not allowed to take someone's head and twist it around and say, hey, you're all right, or you're not. And I know that and I respect that. So the clearing tests are more, I think, like a lot of people, you will be right, like you will be cleared to take someone through and assess their pain. But it's important that if you're not right, if you're not cleared to do that, that it's, that you know that, right? And that we find someone to help us with that. So these are just from the Canadian C-spine rules, which are generally accepted guidelines. And a lot of us probably use them on a daily basis, right? So. They are available online for free. They have graphs and very detailed instructions on how to follow them and they make it very simple, which I think is great. So that's why we've used these here. So high-risk factors include things like a motor vehicle accident over 30 miles an hour or a fall from more than 3 feet. If you're over 65 years old, any of these things, right, that, and you're having issues with your head, neck, and spine, those are high-risk factors. And if you don't have any, you can proceed. Right. And that gives us a chance to get into training or seeing a physical therapist or having someone adjust you manually, right? And if not, then the ideal scenario is that you go and get checked out on a radiograph. So that's X-ray, MRI, and CT scan. Low-risk factors, same deal, right? Like if you're at any of these low-risk factors, then you need to get sorted out before you start working out. Weight training or resistance training, anything like that, I think is fantastic for humans to do. If we have poor patterns and we have painful patterns, like unfortunately what resistance or training will do is set those poor patterns in concrete, right? Like right now they're sort of wet, but the more we do them, the more that we get into resistance training, we can set ourselves up for failure by reinforcing poor patterns. So that's all we're looking to do here, right, is make sure that we're free and clear, that we have someone that is qualified and capable to clear us so that we can get into exercise. And the last one is just rotating actively, right? And I think that literature says you should be able to go 48 degrees from the center line. So from here, I wanna be able to turn left and right pain-free in 48 degrees. And that is, you're no longer at risk for that sort of stuff. And if you can't, or we have bilateral issues between left and right, we got great right side turn and a poor left, then again, like our basic Evaluation of that would say that we would, we would prefer to have maybe less rotation on both sides so that it's similar and congruent rather than have one really great side and then have a very poor side, especially if we're dealing with athletes that are going to be running around and using their body.

That's it for today's episode. Be sure to tune in for episode 44, where we wrap up part 2 of this course. In our next episode, we will discuss the latest innovations in training technology and modalities for the neck and its support system. We'll talk about evaluation practices and clear lines in scope of practice, and examine peer-reviewed, incredible research on neck strength and its effect on all populations. You won't want to miss it. Episode 44 drops in 2 weeks. You can subscribe to The Factor Podcast on Apple, Spotify, iHeartRadio, or the podcast app that works best for you. Give us a 5-star rating to help us grow the show. Every little bit helps. And last but certainly not least, be sure to visit our show notes for a link to sign up for our special end-of-year deals. We are offering some unprecedented savings on in-person and online course offerings, Factor products, and more. But only for those who take the time to click the link and get all of the details. Don't wait, guys. Visit the show notes now, click the link, and take advantage before the ball drops and 2023 arrives. We promise you'll be glad you did. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-O-R dot com. pr-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.