Protect Your Brain : Strengthen Your Neck with Pilates

Further to my previous blog on why Pilates should be incorporated into the training regime of elite athletes, protecting the brain is an important aspect.

Concussion is an ongoing area of concern in many different high impact sports - hockey, basketball, soccer, rugby, etc., and particularly for female athletes who suffer more concussion in sport.

Because male athletes tend to have a larger neck girth (circumference) than female athletes, it may appear that neck girth is what we should be focussing on in the weight room to protect the head as studies have shown that neck strength contributes to the prevention of concussion. Exercises that target the neck and shoulder girdle (sternocleidomastoid, scalene, levator scapulae, rhomboids, upper trapezius muscles) via chin tucks, shoulder shrugs, high rows, lateral raises, etc., all contribute to neck girth.

Focussing on girth as a predictor of strength and stability is limited though (and maybe more so for a female athlete who may not build a large amount of mass - and I don't know a huge number of female athletes who aspire to having no neck due to enlarged musculature, tbh). The reason being that although a large neck girth may have a protective appearance, when an athlete is unable to anticipate and brace for impact, the muscles of the upper shoulders and the lateral neck musculature (that assist in rotating the neck and stabilizing the shoulder girdle and shoulder blades), are often incapable of adequately stabilizing an athlete’s almost 20lb head as it whips back and forth, putting the brain in grave danger of a concussion injury.

The muscles that run along the cervical spine - the deep anterior neck flexors - can play a crucial role in stabilization but they are not usually addressed in the weight room.

This is where Pilates comes in. Many supine Pilates mat exercises require neck flexion - a lifting and tipping action of the skull using the longus colli (primarily) to transfer the weight load of the head forward, looking between the legs rather than “up,” which would activate the SCM’s - the neck’s rotators.

In exercise classes, people who cannot hold their head off the ground (lying supine) without neck pain often due to weak neck flexors are often told to support the head with a hand at the back of the neck, rather than treating the cervical flexors like any other muscle group and regressing the exercise and load by either decreasing reps or time under tension until they are sufficiently strengthened. The exercise shown in the video is an isometric head lift. It’s a little more advanced because scapular mobilization is being performed concurrently. (Also, I was not talking to myself at the start here, the video is cropped 🤨)

Because of the higher statistical risk of concussion for female athletes, these kinds of exercises are important in any sport where the risk for collision is high. We have put a lot of focus on the prevention of ACL/MCL injuries due to the high incidence of this with female athletes - and this is important and should continue - but an athlete can rehab a knee much more easily than the brain. And in the most severe cases a knee joint can be replaced but as we have seen, severe concussion can be a life sentence of memory and concentration problems as well as other life changing symptoms such as fatigue and depression.

Getting athletes to buy in to doing Pilates exercises on a mat may be challenging. It doesn’t seem like a very exciting activity for people who enjoy gross motor movement and competitive sport, but having to contemplate quitting sport and potentially physical activity altogether due to brain injury is a scenario no one wants to consider. Ultimately, this may be the easiest way to get athletes on board with adding Pilates at least a few times a week to their training (once a week is not enough, just as any other fitness training once a week is not enough for an athlete to get any kind of benefit). Sport bodies have insisted that athletes wear protective head gear and padding, on the physical preparation side some attention should also go to strengthening the anterior neck flexors.

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