Craniocervical "tucking", a biomechanical fallacy and common cause of extracranial IJV stenosis
Biomechanical, extracranial stenosis of the internal jugular vein (IJV) is an increasingly commonly recognized problem (Larsen 2018c, Gweon 2011, Dashti 2012, Higgins 2015, 2017). It frequently occurs between the atlas and styloid process, and may occur as a sequela of forward atlantal subluxation (Larsen 2018c) as well as due to intermittent, positional obstruction (treningogrehab.no/atlas).
Continuous neck tucking will cause the styloid process to translate down and backwards, narrowing the atlantostyloid interval (ASI) which the neurovascular bundle (IJV + CN9-12) transmit through. Compression of these structures may cause intracranial hypertension, chronic fatigue, orthostatic disorders, vision impairment, audiovestibular disorders, and more (Jayaraman 2012, Higgins 2015, 2017, Larsen 2018c).
Thus we do NOT want to tuck the chin fully , and especially not in tandem with craniocervical extension as this may further narrow the ASI. We want to "elongate" the neck (Osar 2012, Larsen 2018c) without overly extending nor flexing the craniocervical junction (head), to maintain/promote a broad ASI.
Intracranial hypertension may often remain occult. It has been shown that many may have this problem despite normal lumbar punctures and cerebral MRI scans (Higgins 2015, 2017, Larsen 2018c). The subsequent chronic venous congestion may burden the dural membrane to such extent that it perforates, resulting in CSF leakage and intracranial HYPOtension. This may cause depression, severe fatigue, orthostatic headaches and tachycardia, etc.
Habitual cervical hinging and chin tucking is detrimental and should not be done.
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Chin tucks are promoted by so many physical therapists. I had significant Neuro symptoms and occipital pain as a result. You are presenting essential bio- mechanical information that is ignored or unknown by the many McKenzie chin tuck promoters on KZread. Thank you so so much for sharing your knowledge and EXPERTISE with us.
It's good to see this finally being talked about as it is waaaay over-prescribed. Particularly by McKenzie credentialed therapists.
Excellent video Kjetil, hope that you are keeping well. Under the spotlight of the establishment at the moment, so have been bolted down. When this is all over I still want to come up and visit you. Hope all well, Mike
This video has helped me immensely. Every therapist I worked with taught me the wrong way to do chin tucks. And they had me doing it wrong 100x/day and then blamed me for not doing enough reps! Your advice was a game changer
I personally attest to the fact that after I started doing McKenzie chin tucks and keeping chin tucked during the day, I started to have dizziness and pressure in the back of my head. Neck hinging in the back was adding to my problems. Very harmful exercises promoted by almost all so called experts. Big thanks to Kjetil for his work.
I started doing chin tucks to fix my forward head,but it only gives me tensions around my neck,which were never before.
my neck tenses up like crazy when I dont sit with the chin tuck
That´s a really interesting discovery. I´ve experienced just that. Fatigue, dizzyness and high tension in the suprahyoid muscles when sitting a lot at my computer. Will definitely try to change that and see what happens. Great info Kjetil.
Love this guy!! I keep referring back to his videos over the years he’s the only one I trust!
Can you please make a photo at least of the correct position, it was really hard to follow and understand as you switch from position to position too fast
you sir might've literally saved many lives including mine with this video. i can't thank you enough !
Great video! I only had a styloid on my right side from a childhood whiplash injury. I have had chronic vascular and neurogenic symptoms for the past 46 years and my symptoms always got worse with posture correcting therapies. I just had my styloid removed in February 2023 and finally getting relief. Just the cognition increase and end of brain fog has already been amazing.
My god, your videos are simply top quality! Thank you!
I think you have just saved my life no joke I've had vision impairment for years now and no real understanding as to why I'm an electrician and I tend to do a lot of things with my head in this posture as I'm always doing this with my hands on top of that I had a fear when I was young of people thinking I was looking down my nose at them very strange I know i also used to do Calathenics which emphasizes the chin tuck I've had a problem with my voice also for a very long time this was in no particular order the point to my message is to say thank you so much!
Alexander technique teaches the position as cue
great video i love this stuff ive been researching everything on facia and muscles and congestion for a few years now and the way you described how you sat and the feeling you got was easy to understand and to the point not confusing loved it!
This is me to a T.... years and years of doctors no relief and diagnosed with the Thoracic outlet syndrome neurogenic arterial and venous all combined:/
bro I love you lol. its good to finally see someone with just straight up critical thinking skills instead of someone just taking from a textbook and regurgitating it.
THANK YOU SO MUCH! I was over correcting my forward resting head position.. I knew it had to be somewhere in between because I couldn't breath when in over corrected tuck position..but still want to fix my fhp!!! Thanks, man! YOU are bright!
I could cry rn. Thank you so much