From the Guidelines
Hyperextending the neck is generally not safe and should be avoided. Excessive backward bending of the neck can strain muscles, compress blood vessels, pinch nerves, and potentially damage the cervical spine, as noted in studies such as 1 and 1. This position puts undue pressure on the vertebrae and discs in your neck, which may lead to injuries like muscle strains, herniated discs, or even vertebral artery compression that could restrict blood flow to the brain. Those with existing neck problems, arthritis, or osteoporosis should be particularly cautious.
Key Considerations
- Hyperextension of the neck has been associated with carotid artery dissection, as discussed in 1 and 1, which can lead to serious neurological complications.
- The risk of vertebral artery dissection is also increased with sudden or excessive neck movement, as mentioned in 1 and 1.
- Maintaining a neutral neck position during exercise and daily activities is recommended, keeping your ears aligned with your shoulders.
- If you need to look up, consider moving your entire body rather than just tilting your head back.
- For neck stretches, gentle movements within a comfortable range are preferable, stopping before you feel strain.
Important Precautions
- If you experience pain, numbness, tingling, or dizziness during neck movements, stop immediately and consult a healthcare provider for proper evaluation and guidance.
- Activities that may cause sudden or excessive rotation or extension of the neck, such as contact sports, weight lifting, and chiropractic manipulation of the neck, should be avoided, as advised in 1 and 1.
- Patients who have experienced a cervical arterial dissection should avoid future activities that may lead to neck injury, extreme straining, or excessive force and motion on the neck.
From the Research
Hyperextending the Neck: Safety Considerations
- Hyperextending the neck can lead to various injuries, including cervical spine hyperextension injuries, which may show minimal radiographic abnormalities despite being severe or unstable 2.
- Studies have found that hyperextension soft tissue injuries of the cervical spine can result in occult lesions beyond the musculoskeletal structures of the neck, and improvements in medical imaging techniques may allow better definition of these specific injuries 3.
- Computational models have been used to examine the effects of muscle activity, torso constraint, and pre-flexion on the loads experienced by vertebrae in the neck under compressive impact, finding that increases in pre-flexion resulted in the largest increases in peak loads and the expression of higher-order buckling modes 4.
Surgical Treatment and Complications
- A study on the surgical treatment of neck hyperextension in myopathies found that the operating technique used proved to be safe and effective, with no major surgical complications occurring and significant clinical improvement of posture in all patients 5.
- Another study found that percutaneous tracheostomy can be safely performed in trauma patients without cervical spine clearance and neck extension, including patients with stabilized cervical spine or spinal cord injury 6.
Injury Prevention and Treatment
- Prevention of hyperextension injuries appears to be the most effective way to reduce related disability, with improvements in automobile design, such as head restraints, potentially limiting the cost to society of this common and disabling injury 3.
- Further research is needed to develop more appropriate treatment for hyperextension soft tissue injuries of the cervical spine, with a focus on addressing occult lesions and improving medical imaging techniques 3.