The horse rider and the management of headaches

In my physical therapy practice I treat hundreds of patients a year for headaches. Many of these have recurring neck pain and stiffness, as well as headaches. I teach horseback riding and many riders admit to having headaches. Cyclists tend to get neck pain and headaches after riding at the end of the day. Unless there is a medical cause, most headaches are what we call ‘cervicogenic’ (cervico means neck and gene means origin of) so cervicogenic means initiate the headache in the neck and are caused by by the joints and muscles of the neck. The two upper joints are the main cause of headaches because the nerves that supply the head, temples, and eyes are related to the two upper joints in the neck.

Headaches that originate in the neck are caused by nerves being pinched or pressed by joints or muscles in the upper neck. There are many other causes of headaches. This article only discusses cervicogenic (starting in the upper neck) headache, not headaches from any other cause. It is important that you be evaluated by a Physiotherapist and/or a Doctor to determine if your headaches are cervicogenic or others.

Poor neck posture and general poor posture will almost always result in a headache, given enough time. Repetitive behaviors and postures that result in the neck being in a bad posture will lead to headaches. These postures are the positions we use in our daily work and in our driving posture.

So what is the relationship between the rider and the headaches?

The last bad neck posture comes from the round shoulder posture. A person with round shoulders on the ground will have round shoulders in the saddle. When the shoulders are forward and therefore round, the neck will be in a chin-forward posture. This pose places the upper neck in an extended position and this tightens the joints, nerves and muscles. Over time, joints become stiff and painful, muscles shorten, and nerves become inflamed. The nerve then refers to the pain in the head as a headache. The increased pressure from riding in a round shouldered stance will increase the pressure and therefore nerve pain. Horseback riding is one of the main causes of headaches. All other activities associated with horses can also put strain on the neck.

Unfortunately, the position of many adolescents is the norm. Her shoulders are slumped, her chin juts forward, and the top of her neck is in a stuck closed position. Many don’t use any of their postural muscles and just hang by their joints. Many people spend many hours in a similar posture. Driving, working on the computer, working at home, are just some of the activities that reproduce this posture. As riders, we adapt the same posture in the saddle. Riders are told to sit back with their shoulders back.

How do you fix it?

The quick and easy answer is to straighten up, correct your posture, and control your mobility. The long answer is to educate yourself and eat it with knowledge. First of all, go to a physical therapist and get a professional assessment. Learn how and why you adopt the postures you do, and then learn how to heal and manage your pain with posture management. Not many therapists will be able to relate their headaches to horse riding unless they know the riding posture. Very few therapists can relate to the muscles used in horsemanship or the amount of skill required to ride well. Remember that for those who do not ride a horse it seems so easy. Sit there!

Managing headaches as a cyclist can be easy.

The control of headaches in horsemen is the same as for all people; however, I place a greater emphasis on the particular characteristics of the treatment, because I am a horseman. If you have been evaluated and your problems are not too severe, but are chronic in nature, meaning they keep coming back, then these simple exercises will help. This should be considered as basic advice only. To control headaches, the joints in the upper neck must be mobile. Your muscles must have strength and endurance. You must also have strong core stability. Deep core muscle strength will reinforce proper upper neck posture. I start with the core muscles in every patient I treat for headaches. Management success without this knowledge and strength is always limited. This is why chiropractic (and other) treatment is highly recommended.

I give simple but effective stretching exercises and educate patients on their posture. I advise all my riding students to follow the Applied Posture program.

Simple stretches to gain mobility in the neck

stretch 1

Stand tall, clasp your hands behind your back, and tilt your head so that your ear moves toward your shoulder. This stretch can hurt, so be careful.

stretch 2

Stand up, close your eyes, and turn your head so that your chin moves toward your shoulder.

stretch 3

Push your chin in with the opposite hand to further force the stretch. Feel the stretch or some pain in your neck. Do not increase the headache with this stretch. Obviously do both sides and if it gets worse see a Physiotherapist. Hold for 10-20 seconds, reduce, and repeat. Do these stretches little and often and do them when you are well, do not wait for the soreness and headache to return. Manage good mobility and keep pain away.