Exercises You Should Avoid If You Have Neck Arthritis

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Exercising can help relieve arthritis pain by strengthening muscles that support joints and increasing blood flow to improve mobility and decrease joint stiffness. While exercise is one of the best options to manage pain and other symptoms of arthritis, certain exercises can cause increased inflammation and irritation when the joints are strained.

The neck, or cervical spine, is made up of seven different bones called vertebrae. Cervical spondylosis, or neck arthritis, can occur over time from aging or injury, causing cartilage breakdown between the vertebrae. The resulting pain and stiffness of the neck is common as the vertebrae are unable to glide smoothly due to the cartilage degeneration.

Symptoms can increase by looking up or down or by holding the head in the same position for extended periods of time, and may include grinding or popping in the neck, muscle spasms, and in severe cases, cervical radiculopathy. Any exercise that places increased strain on the neck and surrounding muscles can increase pain and other symptoms of neck arthritis and is best avoided.

senior woman performing crunch exercise

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Sit-ups

Sit-ups help strengthen the rectus abdominis, the outermost and visible layer of the abdominal muscles. To perform a sit-up, you will lie on your back with your knees bent and feet flat. You can place your hands either across your chest or positioned behind your head to help you lift your head as you sit up from a lying position. You will bring your spine into flexion, or forward bending, as your head, shoulder blades, and low back will lift up from the floor.

Crunches are performed similarly to sit-ups, but instead of bringing your body all the way up to a seated position, you will only “crunch” your body halfway through the range of motion by bending your body forward and contracting your abdominal muscles. Your shoulder blades will lift up from the floor, but your low back will remain in contact with the ground.

Both sit-ups and crunches can be problematic for people with neck arthritis because each exercise can put excess strain on the neck. Positioning the hands behind the head can strain the neck into forward bending as it is common to use the arms to pull the head and neck forward to assist with the execution of both sit-ups and crunches, especially when your abdominal muscles lack enough strength to perform the movements properly. 

While positioning the arms across the chest can help avoid pulling on the neck from the arms, performing sit-ups or crunches with the arms across the chest can also strain the neck as the neck flexor muscles have to contract extra hard to be able to lift the head off the floor to perform the exercises.

Exercise Alternative: Reverse Crunch

An alternative exercise to activate the rectus abdominis muscle without placing extra strain on the neck is a reverse crunch. A reverse crunch is performed in the same position as a sit-up or crunch by lying flat on your back with your knees bent and feet flat. You can place a pillow under your head to support your neck. 

Rather than bending forward to bring your body closer to your legs, you will contract your abdominal muscles to lift your feet off the floor and bring your knees closer to your chest. Your head, neck, shoulder blades, and back will stay in contact with the ground, but your hips will slightly lift off the ground as your knees come closer to your chest. 

A reverse crunch accomplishes the same motion of spinal flexion, or forward bending, and activation of the rectus abdominis muscles, but occurs from the bottom up rather than from the top down, avoiding strain on the neck.

Military Press

The military press, or overhead press, involves pushing a weighted barbell overhead from shoulder height. This exercise can be performed either standing or seated, and is often performed in front of a squat rack for ease of setup, to position the barbell at shoulder height. Alternatively, a pair of dumbbells can be used for each hand instead of a barbell.

Overhead pressing movements can be problematic for people with neck arthritis because extension of the head backward is often needed in order to clear the weight past the shoulders and up overhead. Without moving the head and neck back, your face or chin will hit the weight with movement of the barbell straight up. 

Whether using a barbell or dumbbells, the added load of pushing weight above the head also places extra strain on the neck and surrounding muscles, especially the upper trapezius, as the muscles try to stabilize the neck under increased pressure demands.

Often people who experience neck pain lack strength and stability in their periscapular muscles, the muscles around your shoulder blades that help maintain good postural alignment and stabilize the neck, upper back (thoracic spine), and shoulder blades (scapulae). 

Good periscapular strength is needed for shoulder and neck stability with overhead lifting, and without it, the upper trapezius, the muscle responsible for shrugging the shoulders up, often overcompensates for the weaker muscles. Tight upper trapezius muscles can pull on the neck and cause further complications such as increased pain, tightness, and decreased joint mobility of the cervical spine.

Exercise Alternative: Front Shoulder Raise

While the military press requires use of several muscle groups surrounding the neck, shoulders, and shoulder blades, the main target of overhead pressing is strengthening the deltoids, specifically the anterior or front portion of the muscle. An alternative exercise to strengthen the shoulders and increase activation of the anterior deltoid muscle that decreases strain on the neck is the front shoulder raise. 

Holding a pair of light dumbbells at your sides with your palms facing toward the sides of your body, squeeze your shoulder blades together and lift your arms straight out in front of you. Bring the dumbbells up to shoulder height, hold for one second, then slowly lower them back to the starting position. Your elbows should stay extended the entire time while performing this exercise.

Bridges

Glute bridges are an excellent exercise to strengthen the gluteus maximus, a crucial hip muscle that provides strength and power to the lower body and helps with balance and stability of the hips. A glute bridge is performed lying down on your back with your knees bent and feet flat. From this position, you will keep your back straight and use your glute muscles to push your hips up toward the ceiling, creating a “bridge” with your body.

While glute bridges are excellent for strengthening the glutes, they can place increased strain on your neck into forward bending as you lift your hips up, especially if performed incorrectly by overarching the low back.

Exercise Alternative: Prone Hip Extension

An alternative exercise to activate the glute muscles that places less strain on the neck is prone hip extension. To perform this exercise, you will lie in the prone position, or flat on your stomach. From here, you will squeeze your glute muscles, tighten your quadriceps in the front of your thigh to keep your knee locked out straight, and lift one leg up toward the ceiling. Hold your leg at the top position for one second, then lower your leg slowly.

Lat Pull-Downs

Lat pull-downs are one of the main exercises to strengthen the latissimus dorsi muscle, the largest muscle of the back that extends across the shoulders behind the body. Most gyms have a traditional lat pull-down setup that involves a seat underneath a bar attached to a cable column. While sitting down and reaching overhead to grab the bar, you will pull the bar down, drawing your shoulder blades together and elbows toward the sides of your body.

Like the military press, lat pull-downs can be problematic for people with neck arthritis because you need to move your head and neck backward into extension to allow a path for the bar to travel up and down in front of your body.

Lat pull-downs should also never be performed behind the head, as this position not only places increased strain on the neck into increased flexion but additional strain on the shoulder joints and underlying network of nerves called the brachial plexus. This position has a mechanical disadvantage that does not allow the muscles of the shoulder to activate properly, and does not improve activation of the latissimus dorsi any more than other lat pull-down variations.

With increased time sitting at computers, desks, televisions, while driving, and while using cellphones and other electronic devices, many people already have a forward head posture, which causes the normal curvature of the cervical spine to flatten as the head is pushed forward. This posture weakens the muscles of the neck, upper back, and shoulder blades that help maintain upright posture and provide stability, so any exercise that increases this positioning of the neck only causes more harm.

Exercise Alternative: Lat Pull-Downs with Bands or Cables

To avoid straining your neck with a lat pull-down, this exercise can be performed with a resistance band anchored at a high point or with individual cable column attachments held in each hand. By using a band or individual cables rather than pulling a straight bar down, you can achieve the same movement and activation of the latissimus dorsi muscle without having to move the neck forward or backward to accommodate room for the path of a moving bar.

A Word from Verywell

Stretching the muscles of the neck and performing strengthening exercises to provide support and stability can help relieve arthritis pain. Not all exercises are created equal, though, and some can actually cause more harm than good due to the increased strain they place on the cervical spine and surrounding muscles. If you continue to experience ongoing pain from neck arthritis or if it gets worse with certain exercises, a physical therapist can help correct your posture and form with specific exercises and guide you as to what exercises should be avoided to prevent increased symptoms.

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