Neck and shoulders
How to release shoulder and neck tension, beyond the stretch
Stretching alone is the usual advice for a tight neck and shoulders. The Cochrane review found no benefit from stretching alone, and benefit once strengthening for the neck, shoulder and shoulder blade was added.
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
Before you start
Get assessed rather than exercising for weakness, numbness or pins and needles in an arm or hand, clumsy hands, an unsteady walk, or neck pain that followed a fall, wakes you at night or came with fever. Stop and speak to a clinician if a movement brings on sharp pain, dizziness, or symptoms that travel down an arm or a leg, and seek urgent care for any loss of bladder or bowel control or numbness around the saddle area.
This is the version everyone gets. Yours is different.
Start your first sessionThe finding that reorganises this page
The Cochrane review of exercise for mechanical neck disorders found that when only stretching exercises were used, no beneficial effect was found. It found benefit when combined neck, shoulder and shoulder blade strengthening and stretching were used together, with the usual caveat that no high-quality evidence was found.
None of that is an argument against stretching. It is an argument against stretching alone, so the sequence below opens with the stretches and adds the shoulder and upper back work behind them.
What the guideline adds
The American Physical Therapy Association's neck pain guideline recommends scapulothoracic and upper extremity strengthening in the acute stage, neck and shoulder girdle endurance exercise in the subacute stage, and a mix of stretching, strengthening and endurance work for chronic neck pain. In plain terms: the shoulder blades and the upper back are part of the neck's treatment.
A small signal for yoga
A 2017 review of three randomised trials in 188 people with chronic non-specific neck pain found pain and disability lower with yoga than with usual care in the short term. Three trials is three trials, and it is a signal rather than a guarantee.
The sequence
- 1
Seated upper body warm-up · 60 seconds
Easy shoulder and arm movement in a chair, so the stretches that follow start from a moving shoulder.
- 2
Upper trapezius stretch · 30 to 60 seconds each side
The stretch most people came for: a broad pull along the side of the neck, held without forcing.
- 3
Slow neck turns · 30 to 60 seconds
Slow turns through a comfortable range, so the neck keeps its movement without being pushed.
- 4
Shoulder circles · 30 to 60 seconds each side
A slow, controlled circle through the shoulder's available range, which is where the neck muscles often over-work.
- 5
Seated cat cow · 60 seconds
Moves the upper back behind the neck and shoulders, with the arch aimed between the shoulder blades.
- 6
Thoracic extension over a chair back · 45 to 90 seconds
Opens the upper back backwards over a support, taking load off the neck that sits on top of it.
- 7
Chin tuck · 10 seconds, 5 times
A small, low-load hold for the deep muscles at the front of the neck. It is not a stretch and should not feel like one.
The stretches are meant to be felt; the chin tuck is not. Keep everything comfortable, and a few of these most days beats the whole list once a week.
That sequence was written for everyone with this. Yours would be built around your answers.
Start your first sessionWhat the research says
The American Physical Therapy Association's neck pain clinical practice guideline, revised in 2017, sorts neck pain into four categories and recommends different exercise by stage: scapulothoracic and upper extremity strengthening in the acute stage, neck and shoulder girdle endurance exercise in the subacute stage, and combined stretching, strengthening and endurance exercise in the chronic stage.
The Cochrane review of exercises for mechanical neck disorders, 2015, found that combined cervical, shoulder and scapulothoracic strengthening and stretching improved pain and function, and that when only stretching exercises were used no beneficial effects may be expected. The authors found no high-quality evidence.
A 2017 systematic review with meta-analysis of yoga for chronic neck pain pooled three randomised trials in 188 people and found neck pain intensity and neck pain-related disability significantly lower with yoga than usual care in the short term.
Sources
- 1Gross et al., exercises for mechanical neck disorders (Cochrane Database of Systematic Reviews, 2015)
Combined cervical, shoulder and scapulothoracic strengthening and stretching improved pain and function, while when only stretching exercises were used no beneficial effects may be expected; no high quality evidence was found.
- 2Blanpied et al., Neck Pain: Revision 2017, APTA clinical practice guideline (Journal of Orthopaedic and Sports Physical Therapy, 2017)
Neck pain is classified into four categories, with recommendations including scapulothoracic and upper extremity strengthening in the acute stage, neck and shoulder girdle endurance exercise in the subacute stage, and mixed cervical and scapulothoracic exercise combining stretching, strengthening and endurance in the chronic stage.
- 3Cramer et al., effects of yoga on chronic neck pain, systematic review and meta-analysis (Clinical Rehabilitation, 2017)
Across three randomised trials in 188 people with chronic non-specific neck pain, neck pain intensity and neck pain-related disability were significantly lower with yoga than with usual care in the short term.
- 4McCartney et al., cervical radiculopathy and cervical myelopathy, diagnosis and management in primary care, British Journal of General Practice (2018)
Lists neck red flags as new symptoms before age 20 or after 55, weakness across more than one myotome, sensory loss across more than one dermatome, malaise, fever, unexplained weight loss, and pain that is unremitting or disturbs sleep, and describes cervical myelopathy as clumsy hands, reduced dexterity and an unsteady gait.
Common questions
How do you release shoulder and neck tension?
Pair gentle stretches with movement and strength for the upper back, shoulder blades and the deep muscles at the front of the neck. The Cochrane review found no benefit from stretching alone and benefit from combined strengthening and stretching.
Why are my neck and shoulders so tight?
Long stretches in one position, such as a desk or a phone, load the same muscles for hours. We cannot say what is behind yours from here, and tightness that is new, severe or comes with arm symptoms deserves an assessment.
Is stretching enough for a tight neck?
The Cochrane review found that when only stretching exercises were used, no beneficial effects may be expected, and found benefit when strengthening for the neck, shoulder and shoulder blade was added.
Does yoga help neck and shoulder tension?
A 2017 review of three trials in 188 people with chronic non-specific neck pain found pain and disability lower with yoga than usual care in the short term. The evidence base is small.
Should it hurt to stretch my neck?
No. Aim for a comfortable pull. Pins and needles, numbness or pain travelling into an arm or hand is not a tight muscle lengthening, and the answer is to stop and have it looked at.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called how to release shoulder and neck tension, how to relieve neck and shoulder tension, neck and shoulder tension exercises, tight neck and shoulders stretches, how to release tight shoulders and neck, desk neck and shoulder exercises. Movements are drawn from the clinically authored Vinys library. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.