Question:

Many years ago I had a pinched nerve in my neck and we used therapy to lessen it. The physical therapist told me not to do any exercises where the weight was over my head (such as military press, incline bench press, etc.). However, I do not know if that was only during recovery or forever. I don’t want the pain back so I have not done these exercises. But I am curious if these exercises might bring the issue back. Also, are pull-ups considered over-the-head?


Answer:

Thank you for reaching out, I’m happy to hear of your previous success with Physical Therapy. Unfortunately, without doing an evaluation I can’t comment at length on your injury and exercise prescription, but we can discuss some general principles that hopefully answer your question and feel helpful to you.

When rehabbing nerve related issues it’s common practice to avoid aggravating motions as the initial goal is to get the angry nerve(s) to calm down. Performing overhead exercises can be irritating to an already angry nerve as they are demanding tasks for the spine and shoulders. While this may have been your Physical Therapist’s thinking at the time, engaging in overhead motions and activities is an important part of rehabilitation as these are functional movements we encounter in everyday life; avoiding overhead motions altogether is not practical.

Furthermore, if you experienced this injury many years ago and have not had any symptoms since then, you can be confident that the initial injury has resolved. This, however, does not mean symptoms are not liable to re-occur. We as Physical Therapists commonly encounter patients who develop movement patterns after an injury that compensate for a weakness or restriction that may have developed after the initial injury. In the short term these dysfunctional patterns may not present as painful, but when repeated over time they can lead to future injuries. For this reason I recommend consulting with a fitness professional before re-engaging with heavy overhead lifts. Performing (light) free weight exercises below shoulder height, such as front and lateral raises, are a good introductory exercises before progressing to overhead lifts. When transitioning to overhead lifts, such as military press or incline bench press, be sure to start with a light weight to ensure both proper form and that they’re not aggravating in any way. Should you develop pain after starting a new fitness routine I would recommend scheduling an evaluation with a Physical Therapist to help identify and address any restrictions or dysfunctional movement patterns that may be occurring.

P.S: Pull-ups are considered an over-head exercise!


**This reply is for informational purposes only. It’s not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, physical therapist, or other qualified health provider with a medical condition.