Head and Neck Placement

Hello everybody. I'm Jonathan Oldham here at Peloton anytime and it is my good privilege to share with you my take on head and neck positioning. We spend so much time and PyLadies putting the pelvis in place, the tailbone, the sacrum, the ribs, even the clavicles that the head and neck is really the last thing we get to. Fortunately, we can position in such a way that it, uh, is not a problem and it is really important to position the head neck properly for many reasons. First of all, if you've ever taken CPR, one of the first things you have to do is look at the airway, make sure that your victim is breathing, and if they're not you, you reposition the head to improve the flow and the airway. Think of all the other things that flow through that conduit we call the neck circulation, hydration, nutrition through the esophagus.

The nerves that go through and all of the neuronal flow and the lymph and even the cerebral spinal fluid needs to be able to flow through the neck. And with positioning properly, we can emphasize, we can reinforce that flow. Another important reason we placed the spine properly is to set the client up for success or set ourselves up for success. I like to think of the concept of passive insufficiency. Passive insufficiency is when you have a muscle that goes over two joints.

If you have one of the joints in its full excursion, then the other joint won't function as as well or the other joint will be restricted. So one place we can see that as in the wrist. If I have my wrist in a neutral position and I make a fist, I can easily recruit. I can easily generate force to make a good grip. However, if I extend or flex my wrist and try to make a fist, it's difficult and what I would say is the same kind of thing happens in the body. If the head neck is not positioned wells', if the head is back, you're setting yourself up that you can't really engage the muscles and recruit the muscles to the body. So it is really important to set, set for success and place the head neck as well as you can. I have Amy here and she's going to help me demonstrate how I like to position a the head and neck on the reformer and then we'll look at it in some other positions as well. Amy, thank you. So I'm just going to ask Amy to lie down on the back and I'm going to take the head rest down first. Go ahead and just make yourself comfortable.

And one of the things we see, you know, especially if if the body's not warmed up, is there does tend to tend to be lawsuits of different positions that, that, that, that the head and that can be in the landmarks that I use are first of all, just the simply the profile of the face. And you want the profile of the face to be parallel to the floor. Other landmarks you can use or the TMJ, the jaw, the jaw has relationship to the cervical spine, c too. And the clavicle also has relationship with, with the cervical thoracic junction. So the, those, those two lines need to be parallel. The line from the jar to c two and the lie line from the clavicle to the [inaudible] cervical junction or it's difficult thoracic junction. What is it?

I don't know. I don't know right now. And the other line, it happens to be in the, from the ear, from the whole of the ear, the external auditory meatus and that should be just, uh, just post Steria or to the clavicle. Most of us tend to be anterior to that. That's what we call the forward head. So we're going to just try some different positions for Amy to see what, uh, what's most comfortable for her. Now normally we would just have the head rest up for Amy. She's healthy and strong and I like to believe that that incline of the headdress that Mr Palladino put on his reformer, he did with, with specific goals in mind.

And that is to challenge the deep muscles of the neck to hold, uh, a posture to hold a more ideal posture. But that incline does not give as much feedback or input to the skull. There's not as much tactile input into the skull. So it's a little harder to know. Plus when that inclined tends to bring people into that kind of forward Chin tuck position, especially if if the teacher's standing here and, and we want to make eye contact so you need not make eye contact.

I will not think you're rude. Islam and just you want to develop that cervical Lordosis, that cervical uh, curve that is natural. So this is beautiful. If it's too hard though, or if it's uncomfortable, that's when we go to pillows and I usually use a two inch or a one inch. And what I'm going to ask, I'm going to take your headrest down here, Amy.

And so I'm going to ask you to lie back, see what that one feels like. And if I'm not sure, maybe she just needs one inch. I'll take this one inch pillow here and go ahead and lie back. And if I'm still not sure I'm gonna ask Amy, which one did you prefer? Number one or number two? Number one.

So it's just like going to the eye doctor, you kind of know where it's better and yeah, and it looks better. And I can see it's better just by looking at Amy's face because all of a sudden there's just this kind of relaxed, peaceful countenance when the head is put in the right position. Very good. Unfortunately, if someone's had a whiplash injury, then there's a real loss of that cervical lordosis. There's a loss of that curve because the, that, that, that whip of has, has injured the muscles, the deep muscles of the neck and the deep, uh, ligaments and, and perhaps even the disks. So that's when we, uh, might need to even put a little bit more underneath the neck. We weren't need to, uh, support the neck even more specifically.

So often I'll just put one of these, I'll do a towel roll. You can use a little thing like this if it's comfortable. Again, I just try out different things. A lot of times the first time I'm working with someone, I will bring all sorts of pillows and just trails. It's different things. And then we decided together what's best. So I'm going to ask you now, Amy, to lift up and I'm just going to give you this little towel roll underneath your neck. Good and lie back and you just want to have enough, uh, it, and again, it just provides, it's probably not providing a lot of support, but it's more providing tactile feedback. Probably giving a little sense of comfort like you're taken care of so that that's something you can start with that said, you want to develop in such a way that you can eventually go to that normal headdress. I mean, who wants, the more stuff you have to deal with it.

It just gets, it's better to just be able to lie down, just go to work. But sometimes we need these tools. A good thing is that some variability is acceptable. So if it's, if it's 10 degrees this way or the other way, it's probably still going to be fine and functional. It's still going to have, you're not going to have that, uh, phenomenon of passive insufficiency. The, the disks are also related. So if you think about the, the intervertebral discs, one thing we know is that as we're upright and moving about through the day, the disks dehydrate in desiccate and it's when we lie down and sleep that those discs rehydrate at night.

But that only happens if the muscles of the neck are relaxed. So again, it's another reason why it's so important to position the head and neck properly. Let's look at some other positions of the head and neck. So I'm gonna ask you to go ahead and stand up. And first we're gonna look, I'm gonna ask Amy to life chrome. We're just going to grab this box and so prone, it's just grown up. Speak for on your tummy. So Amy, I'm going to ask you to lie on your tummy. This is tummy time for grownups and the hands just go on the bar just for comfort.

I call this position when the neutral position of the head and neck in prone, I call that the aero position. And what's important about an Arrow is that it does have a head and the placement of the head is very important. So Amy, I'm going to ask you, is it okay if I put my hands on your head and neck? So I'm just, I, I'm just going to gently bring my hand and just very lightly give some feedback here. And even sometimes just by putting my hands here, I can feel that the body becomes informed and almost corrects itself. And so I'm just going to ask you to just have that head and neck in line with the spine. We can look at the same landmarks as supine face is parallel and then the line of the jaw and the line of the clavicle to the CT junction are parallel ear slightly in front of Calavo call. So those are the landmarks we look for.

And then from here we can move. This is the centered position, the aero position. Same thing happens in a four point kneeling in quadruped head. So go ahead and step off and we're just going to do some nice stretch positions just to look again at what I learned from my teacher Ron Fletcher. He always said the head and neck follow the line of the spine. So if you're in a centered position like that Arrow, it follows the line of the spine.

Here's a curve around the spine and then the head and neck follow the line of the spine. And I just very delicately may make a little adjustment. Or even just put my hands here, I'm not necessarily doing a correction, but just helping Amy to feel where her head and neck is, are in relationship to her spine. So this manual queuing can really help a, and then you're going to extend the back. So you're gonna go to that though. Our, the position, the head and neck follow the line of the spine. So here we've got an even curve going through the whole body, up into, up into the neck.

Everybody's agreed to extend just a little bit. Every single segment has agreed to extend. So it's hard to feel where that head and neck is in relation to the spine. So that's why I put my hands here or, um, because if I, if, if we had a mirror that Amy would look into, if she would have looked into the mirror, she'd already be in the wrong position. So that's, that's the challenging thing about finding this, this position. So through using these kinds of cues through verbal cues, I can help Amy to find her position. Another way to, uh, go ahead and step off.

Another way to look at a position or another way to check your spinal position is to use the voice. So if I am in my chin talk position, my voice sounds like this. Or if am I in my Chin Pope Position? It sounds like this. So you can just, if you're just by yourself, you can kind of play with that and see where you want to be to find that neutral position. Maybe sing a song, have a c, place your feet. Okay. Same thing. Just look at the same, same landmarks ear slightly in front of Clavicle, facial profile. Now perpendicular, looking at the line here from the jar to see to and looking here from the clavicle to this point here. So we, we know just intuitively how the spine, how the, how the spine should be placed. But when we, uh, when we have these specific cues or specific landmarks to look at, you can just be that much more specific. And the more specific you can be, the better output, the better, the better your, uh, your output of your exercise will be.

So if you combine your intuition with your specific placement, you're going to be successful in all your movement. And that's our, we're going to do with that. Thank you.