07/11/2026
When working with persistent neck and shoulder pain, one of the most useful observations is also one of the simplest:
What happens to the client’s breath when they move?
Ask them to turn their head, reach forward, raise an arm, or shift position on the table. Then watch for the small details.
⚠️ Does the breath stop before movement begins?
⚠️ Does the upper chest lift and remain fixed?
⚠️ Does the jaw tighten?
⚠️ Do the shoulders rise?
⚠️ Does the client rush through the movement?
These responses do not automatically identify the cause of pain. They do, however, tell us something about how the client is organizing the task.
Breath holding and muscular guarding can be appropriate when a task is heavy, difficult, or uncertain. But when the same strategy appears during a small, low-load movement, the nervous system may be using more protection than the task requires.
Rather than telling the client to relax, try changing the conditions:
✅ Support the weight of the arm
✅ Make the movement smaller
✅ Slow the pace
✅ Allow a comfortable breath between repetitions
✅ Ask whether the jaw can remain easy
The clinical question becomes:
❓Can the shoulder blade and arm move without the neck preparing for danger?
This does not replace strengthening, manual therapy, or rehabilitation. It helps the practitioner identify whether excessive effort is interfering with those approaches.
If you’d like to learn more, check out upcoming NCBTMB Approved Continuing Education Courses here: https://www.somaticsolution.com/cecourse