Question for those with military/straight neck (loss of cervical lordosis)

Interesting question. My wife frequently sees me raising my arm above my head on my more symptomatic side while I am sleeping - straight up and back. It likely relieves some pressure from something being compressed.

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My theory is that when a muscle gets spasmed and shorter, it’s natural for the body to avoid stretching it.
In this case, lifting the arm up while in bed possibly takes tension off the rhomboids, levator scapula and upper trapezius muscles.

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I had extremely tight upper pecs and couldn’t lay my arms flat, they would be about 30 degrees above the flat surface. Now I can almost do the “angel wings”, but it took quite a while and lots of daily stretches…

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You are our “poster child” for determination to help yourself resolve some serious health challenges you have, vdm! You’ve done your homework & it’s paying off for you & hopefully for others on this forum who have similar problems. Time & patience are so very key to most successful recoveries.

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@Stella mentioned about her military neck, so I’ll update my opinion on this condition and its relation to the Eagle’s here.

In some cases (definitely not all), according to my speculations (based on “common sense”, a bit of knowledge of human anatomy and lots of online and offline resources), the military neck and elongated/thickened styloid processes might be related in the following way…

  • long sitting ours, immobility, poor posture, imbalanced use of equipment (e.g. smart phone), OR incorrect exercising, using “power” muscles for keeping the posture, lack of recovery after exercising and many other factors impact our mobility, especially: neck, upper back, shoulders, scapulae, lower back
  • decreased mobility or “wrong” mobility creates stiffness and spasms in various muscles and joints (due to lack of proper blood and nutrients flow, lubrication, inflammation etc.)
  • spasms in certain muscles and weakness in others provoke body’s response to “stabilize” and “strenghten” weak points to avoid endangering critical structures, i.e. brains and the spinal cord. One of the ways to strenghten a connection between two bones is to put the muscle into spasm, another – deposit calcium into the ligaments and tendons going between those bones.

Now, here is my opinion about the calcification around the styloid processes…

  • stiffness in thoracic spine and neck are possibly reinforcing each other. The neck and head by design act as a “balancing mass” to keep the body straight. If thoracic (or lumbar) spine is stiff, likely the neck eventually becomes stiff too as it doesn’t need to move much around anymore, plus some muscles in the back become chronically stiff too. In that case eventually the thoracic and cervical spine become “straight” and “locked”, permanently changing the distances between various muscle attachment points, and making them more static than constantly varying when the body is moved. That causes stiffness in various neck and shoulder muscles
  • stiffness in shoulders and shoulder blades creates a lot of pulling force on the neck, which affects neck’s mobility
  • loss of mobility (especially rotationally around horizontal and vertical axes) in the neck’s lower segments and the thoracic region, also loss of mobility in the rib cage leads the person to move their head more around and “up/down” using the top two-three vertebrae, i.e. the weakest, most mobile and least resisting part of the neck.
  • increased forces on these C0-C1, C1-C2, C2-C3 vertebral joins are “identified” by the body as a “threat” (“identified”: a - increased force on various tendons and ligaments, b - constant chronic re-injury of suboccipital and other muscles attached to various anchors around) to the spinal cord (as if the head might fall off the spine and injure the spinal cord), and the whole area is “strenghtened” (possibly via inflammation mechanism) by calcifying various structures in that area (bone spurs, osteophytes on the vertebrae, calcified ligaments and so on).
  • these changes (ossifications) might start impinging various nerves, blood vessels and muscles
  • the area becomes painful and that pain plus referred pain discourages the person from using the painful and stiff area at all . And that is exactly what prevents oxygen and nutrient supply to the affected muscles to relax them, thus reinforcing the whole cycle again.

Now, my personal opinion about reversing the military neck… Honestly, I don’t know, but I’d like to believe it’s possible at any age, given there are no congenital conditions and no irreversible conditions (e.g. acquired or surgical spinal fusion, or mounts of osteophytes everywhere). I am quite confident it’s possible without enormous efforts until the age of ~25, i.e. while the body is still “growing”. Later it becomes more difficult with every year passing, but from what I have heard, improving spinal mobility might be possible up until the age of ~60-70, given there are no serious underlying medical conditions affecting the tissue. Just wondering whether hypermobile people might have some advantage here.

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Obviously it’s too early to draw any conclusions, but it seems that my theory about the military neck being possibly caused by loss of upper/mid thoracic spine mobility might be correct at least in some cases.

A month ago I had an upright MRI which showed desiccated and slightly narrowed T discs. I had long suspected that even before because of the stiffness in the upper back. After the MRI, I started focusing on upper/mid back mobility, as before that I was trying to restore the C lordosis by more focusing on neck’s mobility.

So the results are…

The last pre-thoracic-spine-physio Xray was from 2022 May, the latest was just a few days ago.

2022 early May

2022 late July

It’s worth mentioning that the spine, neck, shoulders hurt like hell. And as I mentioned earlier, it’s too early to celebrate. Now I need to strengthen all the back muscles.

Upd: this one is from 2020 June, when things weren’t that that bad yet.

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Wow, a big difference! Well done Dr vdm! :grinning:

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AMAZING!! I’m working on mine neck too. Jury’s still out because I’m being inconsistent. You’ve motivated me to get back on the wagon by your images @vdm. It looks like your shoulders are a bit rolled forward in the images, but note that you mentioned you’ll be working on strengthening your back muscles so that will help correct that posture.

You’re practicing what you preach & it’s paying off! Great work!! :+1: :clap:

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Shoulders are rolled forward because that’s explicitly asked by the radiographers when taking neck x-rays.
I actually have difficulty to move them forward enough to touch the board…

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Crazy positioning. I should have known better than to say something w/ all the work you’ve done to correct your posture, you’re probably the posture poster child by now!! I’m aiming for that title myself. :rofl:

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So there is a thing called clivo-axial angle.

When it’s too low (normal is typically >150 degrees in neutral), there is a risk to compress the spinal cord. The CXA angle of course is different in flexion/extension.

https://www.researchgate.net/publication/330271077_Cervical_medullary_syndrome_secondary_to_craniocervical_instability_and_ventral_brainstem_compression_in_hereditary_hypermobility_connective_tissue_disorders_5-year_follow-up_after_craniocervical_redu

Here is an interesting presentation on CCI mentioning importance of clivo-axial angle. And on general, that’s a one cool presentation I found on one of the FB groups.

My theory suggests that loss of cervical lordosis caused by loss of upper thoracic mobility also significantly increases use of C0-C1 for flexion (because the other segments of the spine don’t flex so much anymore), which in some cases may increase irritation, inflammation, leading to calcification of various ligaments (and possibly leading to the :eagle: syndrome).

Also, the military neck in standing or supine position would possibly decrease the CXA (not going to the details here, but if you imagine a skeleton with a straight neck caused by the straight(er) thoracic spine vs a skeleton with normal curves, you probably will realise that the head of the “normal” skeleton is slightly protruded forward in comparison to the “straight” skeleton simply to maintain the balance. Not talking here about forward-head posture which is another extreme)

Tomorrow I will check how my CXA changed over time. I believe I have neck MRIs from 2014 and then every two years or so, maybe x-rays too.

Upd:forgot to mention. I suspect that eventually elongated styloid processes may lead to increased translation of the clivus on the C0 because the styloids, ramming into the C0’s transverse processes, prevent the normal horizontally rotational movement of the C0-C1 and start acting as a lever causing translational movement. And that increased translation would cause some of the effects mentioned in the presentation above…

P.S. Of course I’m not a doc, and these are pure speculations.

Other resources
https://journals.sagepub.com/doi/abs/10.1177/1971400921998982

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You continue to confirm through your research how intricately our bodies are put together & with what precision, @vdm. It’s truly awe inspiring & near miraculous that our bodies work as well & for as long as they do w/ so much potential for “parts failure”.

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THANK YOU so much for all your research! You really seem to be onto things and I am grateful you are willing to share what you are learning. All of your input is so helpful for me as I have just had my second styloid/jugular decompression surgery two weeks ago and have also recently been diagnosed with AAI.

I would love to know if you are currently doing any specific exercises for your military neck? Thank you again and I hope you are having a good week!

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So my CXA seems to be a bit tricky to find because… The clivus is unusually shaped. Like a raindrop. But it kind of varies between 145 and 150.

Hi @Eagle1

Well, unfortunately for the specific exercise isn’t that simple with me… I just try to listen to my body, see what might be wrong and do slight gradual adjustments there by various stretches…

If you are keen to see my “toolkit”, it’s here

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Thank you!

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Okay. Before the bilateral styloidectomy I was unable to laterally flex my neck. The styloids would stab into the tissue and cause pain, inflammation, and more pain.

Since the surgery… I realised that I can do it. Flexing the neck laterally still hurts but … It hurts differently. More muscular pain/ache than stabbing/pulling pain.

After two weeks of lateral flexes ant gentle side rolls on the pillow, I noticed that my scalene muscles are getting more and more relaxed.

It seems that my theory about scalene and other neck muscles spasming so that they could hold the head in the least affected/painful position does work after all…

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Good observations, @vdm! Thx for sharing them.

Another important diagram that shows the muscles contributing to stiff spine, neck, shoulders, ribcage, military neck, forward head posture, and pulling the head backwards thus increasing tension on IJVs, carotid arteries etc.

They easily can get stiff if one spends long hours prone, leaning on elbows or one elbow with head up and scrolling for hours.
Ergonomics…

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Great anatomical image & explanation of its relevance. Much appreciation @vdm!