Did you know that over 50% of the total movement in your ability to turn your head happens between just two vertebrae in your neck?
Let’s start at the top. The C1 or atlas vertebra is the top vertebra in your neck. Its job is to support the weight of your skull (3-5 Kg) and to allow for a nodding movement, up and down. The C2 or axis vertebra is the second vertebra in your neck. Its job is to serve as a pivot point for your atlas and your skull. All the other vertebrae in your neck have interlocking joints that limit their total movement. But the skull-C1-C2 complex, also known as the craniocervical junction, does not.
It is where the majority of all your head and neck movement come from, including your ability to turn your head.
The trade for this amount of flexibility is that your upper neck is not as strong as the rest of your spine. Not to say that the area is unstable - it’s just fine - but what it does mean is that if you suffer an injury to any part of your body, this is the proverbial “weak link in the chain.”
So that is an important distinction to make, and it is not the mega types of injuries that I’m talking about here such as an atlanto-axial dislocation. What I am talking about are the small, but still very significant things that shift the alignment of your neck by a few millimetres, but then where it gets trapped in that incorrect axis of motion.
More on the later, but let’s look at a few more things about why you get pain turning your head.
If you feel the back of your neck at the top just beneath your skull, you will probably able to feel a large, bony bump sticking out in the midline. This is the spinous process of your C2 vertebra. The reason this particular spinous process is so large is because it is the major anchor point for all the muscles that connect your upper back, shoulder and neck to your head.
Rectus capitis posterior major - connects your C2 to the base of your skull, and is very important for your brain’s ability to keep your head balanced and upright
Obliquus capitis inferior - connects your C2 to your C1, and is very important in facilitating head rotation and also your brain’s ability to keep your head balanced and upright
Rotatores, semispinalis and multififus - connect your C2 to the entire rest of your spine, all the way down to your tailbone, and which effectively represent the “core” stabilisation muscles of your back
Erectorspinae - also connect your C2 to the entire rest of your spine, and which allow to you torch and flex your back
Splenius - connect your C2 to your skull, but this time to allow you to move your neck and head in all directions
Trapezius - connects your C2 to the entire rest of your spine and shoulders as a ballast that keeps the entire system balanced.
Here’s the important part you may never have realised before. If you have a problem that affects your C2 vertebra and your ability to turn your head, it is not just a neck problem. It is a problem that has the potential to affect your muscles, posture, and create pain, injuries or other problems in all parts of your body.