Scapular Depression

Five Exercises for Head, Neck, & Shoulder Pain


The main contributor to head, neck, and shoulder tension/pain is mostly due to poor posture. Poor posture can develop from working an office job that requires prolonged sitting. The over utilization of technology such as computers and smartphones leads to poor posture, as you can imagine, with the head down, shoulders forward, and rounded back. Participating in sports and activities that require the body to be in different positions such as cycling, for example, can also be a contributor. Furthermore, it could be from an old injury that was sustained in the past that may have forced the body to compensate in a way that allows the body to continually function on a daily basis.

For example, if you injured your right shoulder, you may subconsciously hike the shoulder up towards the ear, keep it close to the body, and under utilize the shoulder throughout the day. This is the body’s way of being intelligent and finding ways out of pain to protect itself. However, there comes a price. If the pain or issue isn’t being addressed, the body will continue to adopt or maintain a posture that is structurally unsound.

If we go back to the right shoulder issue, pain could manifest from hypertonic (abnormal high muscle tone) upper trapezius, from elevating the shoulders, for instance, which creates tension, locally, but could also affect other areas of the body such as the neck and head.

The body starts to develop overly tight muscles and muscular imbalances. Sometimes nerve entrapment occurs due to tight muscles compressing on nerves when it’s in a certain position for long periods of time or has developed over the years.

There is a condition called upper crossed syndrome that depicts a posture which manifests in head, neck, and shoulder pain. The common symptoms associated with upper crossed syndrome are listed below:

Common Symptoms:

  • Forward head posture
  • Rounded shoulders
  • Hunched (Kyphotic) upper back
  • Headache
  • Head, neck, and shoulder pain

One reason head, neck, and shoulder pain develops is when the anterior muscles are short and tight and the posterior back muscles are long, tight, and weak.

Short and tight refers to muscle that are in a prolonged contracted state, which causes the muscles to be tight, overtime, a process called adaptive shortening. The agonist muscle overpowers the antagonists muscle, which prevents the antagonist muscle to do its action, optimally. The muscles that are short and tight that prevent the scapulae from retracting are listed below:

Short & Tight Anterior Muscles:

  • Anterior deltoid
  • Pectoralis major
  • Pectoralis minor
  • Serratus anterior

These muscles pull the shoulder(s) forward and scapula(e) away from the spine.

Long and tight refers to muscle that are typically weak and in a lengthened state. The agonist muscle is overpowered by the antagonist muscle in the pectoral (chest) region, which prevents the agonist muscle to concentrically contract effectively. Consequently, this will cause constant tension in the muscle and will cause it to be tight.

Below are five exercises that help strengthen the back muscles and anterior neck to help alleviate and hopefully eliminate the pain completely. The main muscles we are targeting to strengthen are listed below:

Note: Be sure to warm up before performing these movements by using a foam roller, a lacrosse ball self myofascial release (SMR), and/or dynamic stretching for the upper body.

Target Muscles:

  • Sternocleidomastoid
  • Anterior Scalene
  • Mid & Lower Trapezius
  • Rhomboids

1. Supine Cervical Flexion

Keep the chin tucked towards the chest

Supine Cervical Flexion Position 1

Lift the head up while the chin is tucked towards the chest

Supine Cervical Flexion Position 2

2. Prone W’s

Retract both scapulae towards the spine. Keep chin tucked.

Prone W Position 1

Pull both arms off the floor. Continue to squeeze both scapulae together.

Prone W Position 2

Another view. Pull both arms off the floor as high as possible.

Prone W Front View

3. Prone A’s

Retract both scapulae towards the spine. Keep chin tucked.

Prone A Position 1

Pull both arms off the floor. Continue to squeeze both scapulae together.

Prone A Position 2

4. Scapular Depression

Keep arms straight. Retract both scapulae towards the spine. Bring shoulders close to the ears.

Scapular Depression Position 1

Keep arms straight. Pull shoulders away from the ears.

Scapular Depression Position 2

5. Prone Reverse Row: 2 arm

Keep chin tucked. Squeeze both scapulae together towards the spine.

Prone Reverse Row Position 1

Pull elbows towards the ceiling. Roll shoulders back as well.

Prone Reverse Row Position 2