Proper suboccipital strengthening as well as cervical extension & rotation

The suboccipital muscle group is quite misunderstood. These muscles' "overactivity" often blamed for headaches or upper cervical misalignment, but this is an utter myth and could not be further from the truth.
The suboccipitals are important stabilizers of the craniocervical junction as they prevent hypermobility of the atlantoaxial and atlanto-occipital joints due to their unique, proximal configuration. Further, the muscles are "full" of receptor cells, due to their important task in synchronizing the movement of the head in relation to the eyes, i.e. in maintaining a horizontal outlook. These muscles are happy when they are strong and thick.
When weak, car and sea sickness, occipital and ocular headaches or dizziness are common sequelae. The most common causes of weakness are poor cervical posture as well as inability to extend the neck without "hinging".
In this video I show how to recover normal upper cervical articulation as well as how to properly strengthen the suboccipitals. NB: I do not imply that you need to - at all times - move your neck like this, but the inability to do so due to longstanding poor cervical posture, is common, resulting in dysfunction.

[@Faolain_]

I had headaches about 300 days of the year, for several years. And couldn't turn my head left for more than a few seconds without sharp pain. This exercise essentially cured all of that. Headaches only return about once a week, or less. Many thanks. For anyone who has occipital neuralgia, be persistent with this exercise.

[@HN-Anonymous]

For how long have your done these and how often?

[@Faolain_]

@@HN-Anonymous I noticed relief after only a day or two. I do it a few times a week, but should probably do it more often. I can't say it's a perfect cure, but my symptoms have diminished massively.

[@HN-Anonymous]

@@Faolain_ interesting, I also used to get headaches like 4-5 times a week and now it’s like 1-2 times a month only , after doing these exercises. I knew my specific headaches were from Suboccipital area because it would start in that area deep within

[@d-hg5jy]

updates? still seeing improvements?

[@Faolain_]

@@d-hg5jy Gradual improvements. My headaches are infrequent.

[@ryanmcdonald3314]

Finally a video on strengthening these muscles, everything i see is about stretching but I feel this is what I need, subscribed!

[@OlufemiOlaleye]

28. About a decade of tightness in part due to scoliosis. This adresssed alot of my tightness. Highly recommend

[@vicariousannotations]

Ultra-Nordic bro, you have saved me from what was perceived as a life cast with eternal suffering and seemingly endless clenching. This was such an incredible find-I waited a week before commenting and can assure you that through simple repetition, alongside the application of gradual resistance, I have seen incredible results. Thank you, good sir. Please know that you have helped an American through the beauty of simple instruction and informative demonstration. The AlphaGods shine upon thee!

[@altyaltyalt]

You are a genius please make more videos

[@shaynaformity1384]

Thank you for giving such specific instructions! I could really feel those muscles working, and my shoulders have so much more ease now.

[@jeanine219]

Your advice to avoid maladaptive “turtle neck swing”, “hinged neck” positions. I love you Kjetil🤣Your videos stand alone, and have helped me so much.

[@joakimandersson574]

Its a shame you dont have more followers. This video helped me alot! Keep it up :)

[@MSKNeurology]

Happy to hear that!

[@J1283-s1k]

It's been a while since we had our session Kjetil but these videos continue to help so much. They're so damn concise and efficient.

[@lyricsvevo2893]

I have this same exact thing and I haven't driven my car in a long time. I can literally feel the discoordination between my eyes and head while walking and it only improves temporarily when i massage those suboccipital muscles using my fingers.

[@raphaelschannel]

You have the best videos on the net for this stuff as far as I'm concerned. That said if you want to get your view numbers up, include the symptoms typically treated in the title, the description, and when you talk in the video. You'll see pretty dramatic improvement in view numbers (assuming this matters to you). As for me, I wish I could be treated by you. I'm 16 years into my recovery and find myself needing to learn at a physiotherapist level because qualified care is so hard to come by. Thanks again for posting these.

[@MSKNeurology]

Good advice, thank you!

[@kzrlgo]

This information and presentation is GOLD. Thank you.

[@michalparyzek848]

Hello Kjetil, to me you are a genius in your field and first I want to thank you. According to your method, my back pain is gone, now I train posture, neck and jaw to remove tinnitus. I noticed when I do an ear lift (the same as when we are smiling) and hold it for a minute or so, It is a similar feeling as training suboccipitals. Also have a better vision. Would you explain how this could be? Thanks again.

[@jasondalebourke]

Hi. Thank you for your video. What would you suggest if, when doing this exercise, you find that the muscles on one side (say the left) of the neck feel thicker, seem to be doing the work, and that those on the other side feel "thinner" or "missing", and don't feel much if any contraction (relative to the other side) / don't seem very active?

[@bearisok]

I was injured on the right side of my neck in a rollover crash and now my right eye vision warps downward when i turn my head to the left. very odd condition. i am hoping with time and strengthening i can get rid of this maddening condition! nobody ive seen can tell me what is going on, so im glad to have found your channel.

[@MSKNeurology]

Book a session and provide imaging. Text-tips won't help you.

[@bearisok]

@@MSKNeurology booked. i'm guessing you call me? i didnt see your skype name anywhere.

[@fdauti_ca]

@@MSKNeurology can chiropractic manipulations (neck cracking) damage these muscles, the suboccipitals in particular?

[@MSKNeurology]

@@fdauti_ca Tends to damage the scalenes and cause TOS. Sometimes causes vertebral artery injury. Be careful

[@Asif49858]

How are you? ​@@bearisok

[@rachelelizabeth8516]

I have severe nausea from back of neck, dizziness, spasms/tightness in throat and severe upper chest pain. Sliding chin backward helped improve all and stabilised neck. Chin tuck (stretching back of neck and bringing chin under) made chest more inflammed and made throat so tight and breathing worse...

[@MSKNeurology]

Yep. Never chin tuck.

[@ryujin2999]

What do u mean sliding chin backward? Csn u explain that

[@biokeratingold3878]

yes pls explain

[@scnager1]

You are probably banging your styloid on your atlas, cutting off your jugular vein when you do this. I could be wrong though

[@carltonjimburton9026]

Do you(TOR) have a clinic that treats cervical instability and chronic pain ?

[@2biicoachingformndkarlotto317]

Great video thank you🙂, short question for you: Do you think you can get tinnitus from having an unstable Cervical spine with pressure on nerves and veins?

[@manjotbains1532]

Are cervical extension exercises okay? Do they contribute to cervical hinge? Are cervical flexion exercises (particularly the neck curl) okay? Do they contribute to compression of cervical artery? Are lateral cervical flexion exercises okay? Are neck exercises in general necessary for a strong and muscular neck, or will simply having proper posture be enough for a strong and muscular neck? Does having a muscular/thick neck contribute to sleep apnea?

[@markpape6565]

Yeh when i untwisted those muscle's i gained better eye sight in my left eye, still need glasses but my eye's improve, the more i fix it, even the right eye has improved, i think cause of the tention in the right muscle of my neck.

[@Mangaluvr247]

I am making notes on these videos. Want to be pain free for once. Have had headaches 24/7 for long stretches since I was 16 from going on the computer too much and recent physio says I got hypermobility. My first physio just kept reccomending stretches which made things worse. Going to do what my physio says but also mix in your tips such as (do not pull scapula back and down *which all of them seem to recommend).

[@scnager1]

I think the mistake I was making was flexing and extending too fast. Probably targeting the traps and SCM instead. I find the slower the rep, the more effective since it really exacerbates the dizziness

[@gracehalstead4526]

Thanks so much for your video. I have been doing chin tucks in PT for neck issues for almost a year with little to no improvement and no pain relief. I was in a car wreck that knocked my atlas and axis severely out of place & my suboccipitals atrophied to essentially nothing. :( I just tried these exercises and I was able to properly engage my suboccipital muscles without pain - these will definitely become a part of my recovery routine!

[@HN-Anonymous]

Wow hope these help u good luck

[@melodyebuskin5490]

I had whiplash w tinnitus and atlas-axis adjustments which helped some. How are these exercises working for you? Thanks in advance.

[@HN-Anonymous]

@@melodyebuskin5490 Yes it works!! Most of my symptoms r gone just after a week of these everyday plus the strengthening of the deep cervical flexors (longus capitus and longus colli muscles) using his other video

[@melodyebuskin5490]

@@HN-Anonymous thanks so much for replying. I’ve shared with a few other ppl in my T group on Messenger.

[@melodyebuskin5490]

@@HN-Anonymous can you tell me and my Messenger group friends how many reps per day and how often and could you please supply the link to the other video? Much appreciated.

[@swissoricantcg]

I found this really helpful, and even learned something! Thank you!

[@mrk2K10]

Hi Kjetil, I have one question: do you have any recommendation or intuitive sort of cue on how to contract these posteriors muscles and making sure at the same time that you don’t push C1 forward (obviously, the anterior ones have to engage, but for those with weak core neck muscles, it is a bit hard to achieve). Also, how can you find the right balance between the anterior and posterior groups. Many thanks in advance and for all your videos.

[@alainbrunner6658]

What do you think about trigger point therapy? I have very active trigger points in my suboccipital area, radiating to my forrehead/frontalis area when I press on them. Will these trigger points disappear automatically once I strenghten the suboccipitals properly or do you have to actively release these trigger points to get rid of the pain? In other words: Can a strong muscle still have trigger points that cause pain, which need to be released actively?

[@siggeboda]

Which ones of these muscles can give balance issues and vision motion issues?

[@johnsmith22334]

Your older video on this exercise from 2016 ("Exercise for the suboccipitals" - also the one present in your atlas misalignment writeup) has much more cervical extension. Is this now the preferred version at 30 degrees of extension instead of more?

[@amandameldrum5347]

Thank you for explaining this so well!

[@scnager1]

I'm seeing that a tell tale symptom of suboccipital weakness besides headaches, dizziness, and sinus pain is apprehension when flexing the occiput. If they get symptoms with nodding the head "yes", the muscles are weak

[@tushargopalka4905]

Really good video. Quite informative and helpful.

[@JustME-ft4di]

How do you release the muscles enough to be able to have the ‘long neck’ position at all? My neck is pulled back and down from base of skull to upper thoracic. T2/3 have fused together and have ‘hump’ and rigid lumps in upper trapezius in against neck. Have tried everything. Neck rigid and weak.

[@myla6135]

Thank you. I learnt something very interesting as someone who feels extremely nauseous on any boat even in the calmest waters! On a very windy wet day I was on a ferry. I absolutely could not stay under cover and had to go and sit on the deck and get very wet. I had to have my eyes on the horizon which I could only just make out. Thank goodness it wasn't night time. Also in a cinema I was watching a film where a ship was in very choppy waters. An internal shot so nothing to line my vision onto I suppose. I felt so bad I had to close my eyes. Same in a theatre where the scene changes were rapid and circular. Uuuugh! I may not know what a chin tuck is,, but when you say a long neck with a double chin created, isn't that a chin tuck? Sorry if that's a dumb question. I know you don't like those 😉☺

[@kristiniandolo3809]

Will this help with cervical instability and occipital neuralgia?

[@cecetolove]

I would like to book an online session with you. How can I get in contact with you?

[@MSKNeurology]

mskneurology.com/booking

[@neavychaos]

Do you recommend chin tucks? When I do chin tuck, dizziness increases very much. Should I do this exercise instead? Thanks,

[@MSKNeurology]

Never!

[@alainbrunner6658]

For someone with years of pain and tension (trigger points) in the frontalis muscle (forehead), could you theoretically get rid of that pain by strengthening the frontalis muscle? In your blog you said a tight, painful muscle is usually weak. Wouldn't that logic also apply to the frontalis muscle? Thanks!

[@alexmarshall9291]

I hear clicking, what does this mean?

[@DavidDorenfeld]

thanks so much for sharing, this helps clarify!

[@tushargopalka4905]

Are there isometric exercises to strenghen the Suboccipital muscles?

[@TaxEvasi0n]

I get a popping sound in my right ear every time I do this movement. Repeats every time. And if I go to a deep chin tuck after, I get more crackling sounds.

[@mindymay3]

Would you recommend progressive muscle relaxation and body scan meditations?

[@mathiasneeraas4043]

Hi, would you use a rubber band on the upper neck extension, light rubberband and biting on it. Or would the clenching of the jaw “disturb” the upper neck activation?

[@markpape6565]

Intresting moved eye's at same time as pressing thier on neck and shrugged my trap'd tenseing them up and clunk, again cause i've had load's as thing's grow. But yet another, so improvement.

[@xTeleXx9]

It seems my rectus capitol is firing instead, no matter what I try. I’ve progressed my neck musculature to being able to handle full cervical flexion but I still can’t extend the occiput and I don’t wanna keep trying and failing because it exacerbates my symptoms so much.

[@jdssurf]

I have major tension and it causes dizziness from the right side occipital area......no headaches just the nausea and dizziness, it ruins my life. They say those upper vertebrae have some arthritis and such......i've had three rounds of botox there, occipital devices i will lay on, lots of stretches, but no real exercises. Please give me all the advice you got.

[@Achala148]

Is there anything that can be done for kyphosis as everything is out of alignment including posture and makes movement difficult and different... ?

[@jassimalsafwani]

Best video and demonstration

[@amgnico]

Are there more exercises? This doesn't really work on the suboccipital for me

[@tiffanyfett1159]

Can you do a video on chiari 1 malformation and proper neck posture for relief

[@Panjshirwarrior]

My friend i have poor english writting But i will try to explane I have been laying in my bed and always used a round pillow shaped like a ball or 2 medium pillow so my neck had always been bowe forword towards my phone and now for a week i have feelt headeache a litle eye burning and somethimes it release pain and headeache and somethime worse when i massaje Rectus capitils major muscle DO you think my bad habit having my neck forword like that have something to do with this headeache?

[@ilitree6267]

Is it possible for the mandible through tongue posture to retract back enough to hit the styloid process or to shorten the space enough to cause all kinds of problems, such as tinnitus, neck pain, fatigue, ear pressure etc?

[@MSKNeurology]

No

[@ilitree6267]

@@MSKNeurology apparently they claim it is as the temporalis is the muscle that needs to wake up during mewing to illicit all the good changes. In Mr. Mew’s forum they have a thread addressing that and how now half of them have a lightbulb head. Terrible, just terrible.

[@MSKNeurology]

@@ilitree6267 The temporalis pulls the jaw back and worsens TMD and trigeminal neuralgia. It makes your head look bigger and the jaw line look smaller.

[@ilitree6267]

@@MSKNeurology I guess then I should keep my tongue down because keeping it up keeps my temporalis bulging. If I stop mewing, my temporalis gradually shrinks. Oh well.

[@livinglifetoofullest]

thank you so much

[@rogerpacheco3600]

Do recommend for occipital neuralgia ?

[@HN-Anonymous]

Is this good for alar ligament laxity? Thanks u r the best!

[@MSKNeurology]

Very good for alar laxity.

[@visualsnow7173]

Hey, its work for alar laxity?

[@HN-Anonymous]

Yes it works!! Most of my symptoms r gone just after a week of these everyday plus the strengthening of the deep cervical flexors (longus capitus and longus colli muscles) using his other video

[@snbrains9341]

@@HN-Anonymous what were your symptoms?

[@brendanschroeder1862]

Hi sir, what type of pillow do you recommend for people with neck issues?

[@cecetolove]

Does this workout work for hypermobile neck?

[@MSKNeurology]

Yes

[@kallievangas9730]

What are your thoughts on muscle weakness on the once side of the occipital nerve impingement . Left side weak ( pinched side/ muscle weakness) Right side thick/ normal

[@brendanschroeder1862]

That’s what’s up with me. Can happen for a variety of reasons

[@ShainaWeisinger-pn4si]

Could stim be used to strengthen suboccipitals?

[@stevansmith9582]

So I have a question that I need help with. So I use to do this stupid thing that I thought reduce wrinkles by putting my hand on my forehead me pushing my head forward and down aggressively and now the back of my skull where muscles are suboccipital and neck is in pain. Do you got any suggestions on how you can help me?

[@kevinnicholas6721]

I suffer from this,and I am getting a lump forming on the lower neck,top of spine,it is also feeling like the corners of my inside eye Linda are being pulled tightin at the top of my nose and it's making me feel sick and giving me bad headaches,I am actually starting to get like small bruises under my eyes so there is obviously skin being pulled 🥺🤮🤯, what do I do??? I'm getting stressed about this and need someone to help me.

[@Chs3__1234]

What if they are really tight do they need to be released first?

[@davefinch7660]

If bad enough can this cause balance issues and rapid eye movement? Great video!

[@MSKNeurology]

I would suspect other issues. Probably cerebrovascular

[@davefinch7660]

@@MSKNeurology ok great...Ive had several MRI with contrast and "they" say all looks OK other than a slightly smaller vertebral artery on my right side but still shows OK flow. Would suggestion still be to strenghten the neck? Thank you from the U.S!

[@MSKNeurology]

I would have to see the images. They are almost always reported as normal, so that means nothing.

[@davefinch7660]

Neck rotation to the right is very limited up high somewhere around the mastoid process.Thank You for the response! Best way to work with you from the US is Skype? Thanks for helping so many!!!

[@ryanlie6250]

doesn't this strengthen the longus colli instead?

[@sallysublime]

Thank you!

[@alisonruth3947]

Thank you

[@jamietherooster]

is there any benefit of doing this exercise with a slight 30 degree rotation with the same principles? would it target the diagonal muscles more?

[@MSKNeurology]

Personally I'd change the pulling trajectory, but you might be able to isolate it more like that as well. You'd have to try.

[@mgs33]

thank you!!

[@ianhenson724]

Im currently waiting for an MRI scan to prove this, trouble is its taking to long, the doctors couldn't give a shit about you here in the UK. And the waiting lists are to long, unless your an illegal, wish me luck. Thanks for video.

[@Asif49858]

So, did your Atlas align?

[@tanjastarke4796]

Thank you! I have been suffering from a military neck since I have been a child. I never knew this. I will try to strengthen my muscles. I looked this up while having another nauseating headache with my turned vertebrae. When this happens, how do I get relief?

[@brendanschroeder1862]

This will not help with military neck. It won’t hurt Perse but at the same time you’d be putting your upper cervical into extension

[@joshuajnygaard]

Do you have any suggestions on how to strengthen the Rectus Capitis Lateralis? I was reading your article on the atlas on your website but the video for that exercise was listed as private so I could not view it.

[@MSKNeurology]

Don't touch that

[@joshuajnygaard]

@@MSKNeurology That's very compact and ominous answer... I'm guessing by that you mean that it's dangerous to try to train directly because of the possible harm done between the Atlas and surrounding structures?

[@carltonjimburton9026]

Hello Mr Kjetil Larsen

[@thestuffedvegan9471]

Such great info☆ thank you.

[@tamarafield5074]

Does this actually strengthen the muscles?

[@Bejbyjustice]

Hey !:) you should put resistance also in extension or only for flexion?

[@MSKNeurology]

Concentric and eccentric

[@JoaoSiebinho]

What about the horizontal suboccipitals? They aren't targeted in this excersices isn't it?

[@MSKNeurology]

The inferior oblique no, the superior oblique somewhat yes.

[@HN-Anonymous]

@@MSKNeurologycan you do a video on how to strengthen them? So all the suboccipitals can be strengthened

[@dimitar2367]

thank you friend really helpful !

[@suchirotturu2503]

Hi. I did this excercise and when in posture, I felt an improvement in my head posture. But my eye area and the back of my head hurt a lot with sharp pains. Why does this occur?

[@MSKNeurology]

You probably trained too hard. Watch my "sets and reps" video.

[@zk6066]

Do you think C1/C2 instability can cause facial pain, TMD like symptoms?

[@joshayers3410]

Do you keep the chin tucked during the whole movement? And how many reps/sets per day? Thank you

[@MSKNeurology]

Head never retracts, this will worsen the situation

[@petlover345]

MSK Neurology It would be helpful to know how many repetitions to do per week or day so we don’t do too much or too little.

[@sothatsit3033]

What makes clicking sounds when doing this? Clicks when lifting.

[@sweetvuvuzela4634]

Muscle bands rubbing

[@discojoe3]

Can weakened suboccipital muscles lead to a perpetual drunk/dissociated visual feeling?

[@MSKNeurology]

No, but pain in the back of the head/upper neck is a common vascular symptoms that is often misidentified as suboccipital myalgia. This vascular problem can cause such symptoms

[@discojoe3]

@@MSKNeurology I see. Thank you for your time.

[@lingvemulo]

@@MSKNeurology Do you know what sort of specialist to see in order to test for vascular issues in the neck?

[@69birdboy]

Can you provide any ideas on how to deal with POTS, CFFs and migraines? Anyone would be great! I read your piec on M.E and found itfitted me really well. Do you do skype work?

[@MSKNeurology]

If you read my ME piece then you already know what my suggestions and ideas are.

[@69birdboy]

@@MSKNeurology Thank you , i have been in toucvh with you..ive watched the vids, if thats what youre referring to. Thanks for the reply

[@SueT55]

Thank you, I lost your page a few months ago and so glad I found you again. So very helpful.☺️

[@I_Ace]

I thought u are supposed to loosen then because they are tight with forward head posture

[@MSKNeurology]

Fallacy

[@melodyebuskin5490]

@@MSKNeurology wow! Same with periformis syndrome. Chiros n PTs told me stretch. Got worse. Three years. Dr. Charlie on KZbin says strengthen and it works. Clamshell exercise. No more hip pain. So neck strengthening sounds right.

[@ryujin2999]

Kjetil my entire right side of the neck has been injured. And I have dysphagia as a result. Would u have any idea how to fix this

[@elizabethw.454]

How are you now?

[@ryujin2999]

@@elizabethw.454 better but I think I may have to get surgery

[@CherryPickingMoney]

you are abs right!!!

[@playermartin286]

So keeping your occiput extended in posture is advisable?

[@MSKNeurology]

No

[@shirelleferre3460]

@@MSKNeurology what is then? I definitely have a forward head and hinge neck going on with a constant 7 year headache as a result. Working hard to correct it but I’m co fused of my occipitals are tight and overly developed from my forwardhead or weak needing strengthening. When I pull up gently on the back of my head I get instant relief but when I touch the sub occipital muscles I get an increase of my headache pain… I’ll do whatever it takes whether it’s to strengthen the occipitals or loosen them but I’m getting mixed messages.. also working on strengthening my deep cervical extensors

[@stevansmith9582]

And my scalenes are not tight and my SCM

[@jonathangetahun2078]

Does this help with spasms, sometimes my head will jerk to the left or right when turning my head in the opposite direction? It used to happen a lot and now less frequently, I've begun suspecting its due to these muscles and heavy computer usage. How often do you recommend doing this exercise?

[@aby9x]

Have you had any improvement? I have the same condition using too much computer

[@lazlokonia8237]

Where have my questions gone ?

[@markpape6565]

Or use an ems.

[@ogun9645]

How much sets and reps to do and if it can be done daily ?

[@pestcontrol7249]

I feel tension

[@JD-tk1ci]

Can you do a Skype video?