Neck posture and dive trim

[bluebanded goby]

Some of you may recall earlier messages about my saga involving nerve sensations I experience in my left arm and hand, some of which have emerged or been exacerbated after diving and have been confused with DCS. I'm still awaiting an MRI, but the evidence seems to be pointing to an issue with the nerves where they run into the spine in the neck.

Today I saw a physical medicine specialist who also happens to be a diver. He thinks that one reason these symptoms sometimes emerge after diving is because of the way the neck is typically extended in diving. I.e. if you have what's normally considered good trim, you are horizontal in the water with your neck arched back so that your line of sight is in line with your body. He showed me with a model of a few spinal segments how this might cause stress to one of the nerve bundles coming out of the spine.

This may be more of a dive technique question than a dive medicine question, but given this interesting theory, is there any good way of minimizing flexing the neck this way? I suppose the answer might be just to sort of fudge it, bringing the body up into somewhat non-optimal trim and bending back the neck as little as possible. But if anyone has any observations on dealing with a tricky neck while diving I'd be very interested to hear them.

 

[rcohn]

I have this problem. I find exercising the neck muscles helps me. Also being careful how you sit on airplanes and on the boat or land. There isn't much you can do in the water if you dive with decent trim.

On week long dive trips the condition will slowly worsen day by day and it will take me several weeks of exercise to get back to normal after I return home. I've just returned from a week on the Caribbean Explorer and since I was pretty careful out of the water, the problems are less than on previous trips, but I had slight pain in my shoulder toward the end of the trip and some tingling now in my left finger tips when I lean my head back. I can usually tell it's not DCS because it will be relieved if I shift the angle of my neck.

Good luck.

Ralph

 

[bluebanded goby]

Ralph, thanks for the comments. Have you had a diagnosis? Is there an understood cause of the condition in your case (i.e. neck injury, etc)?

Also, just out of curiosity, what kind of neck exercises do you do? I've been advised at most to do simple front-back-left-right extensions, but no twisting.

 

[rcohn]

I'm not sure what the cause was. I did land on my head in a bicycle crash in 1976, but they saw no damage at that time. A recent MRI revealed several thinned disks but my doctor wasn't very concerned and said that it didn't appear to need any intervention.

I discovered from bicycling on a road bike that the effort to hold my head up is very painful at first (and my hand/arm gets rather numb) but after a short rest it disappears and I'm fine for the rest of the ride. After a few rides the problem goes away. Strange that holding the head up while diving cause problems while holding it up on the bike corrects them. I also do lifting exercises with a weight, up-down and side to side, no twisting. Note this works for me and my unique problem, I have no idea whether it will help or hurt you. Some movement therapy like the Alexander technique migh help to learn to avoid stress in daily activities.

One thing I forgot before, it helps to find a mask that has minimal to no obstruction when you roll your eyes upward to look forward. This minimizes how much you must lift your head. I find a Scuba Pro Frameless mask works very well for me.

I find I have no neck problems on weekend dives, just on week long dive trips.

Ralph

 

[bluebanded goby]

Ralph, thanks for the additional info. I was curious about your experience but, absolutely, I wouldn't assume that something that works for you would be appropriate in my situation, as our cases sound a bit different. My symptoms don't seem to appear as immediately as yours, or to get alleviated as easily -- after I do something that I belatedly realize stressed my neck, it may take an hour for pain to emerge in my arm, and I really haven't figured out anything to speed up how quickly it subsides.

At any rate, I'm currently on a wait-list for an MRI, so the results of that should be enlightening. Meanwhile I'm just trying to stress my neck as little as possible.

 

[rebelrph]

partly inherited and partly from old injury... I also do exercises to strengthen supporting muscles and increase flexibility.

None of my symptoms are like yours mine usually is a post dive killer headache.

I first thought is was my breathing pattern - I don't classify it as skip breathing , but others might - BUT I have always breathed the same way and just the last year or so started having these headaches...

On my Thanksgiving dive trip after the first dive I had the headache. The next morning I loosened my mask strap and NO MORE HEADACHES. I can't imagine it being that easy, but the results were there. I made 10 dives over 5 days and no headache. So, I don't know, but at this point I don't really care... I'm just so happy not to have the headaches.

This is not to be confused with medical advice,,, but I think having a doctor who is also a diver will be helpful in finding cause/solution.

Good luck and keep us posted...

posted.. get it?

todd

 

[Louie]

A couple of years ago, after a week long liveaboard, I returned home and experienced numbness and tingling in my arm and fingers. I had one of those "s*&#, is it DCS?" anxiety moments but after consulting a dive specialist, it was revealed to be a trapped nerve.
A visit to the physiotherapist confirmed this diagnosis and I had a couple of sessions of massage and he recommended an exercise of lying down on a rolled towel across the shoulder blade for ten minutes per day for the next week.
The physio also advised me to avoid anything strenuous around diving (like donning gear) and to avoid sudden or jerky movements.

I think it's helped

 

[bluebanded goby]

Hi Louie, thanks for the post, interesting story. Some questions:

-- If you can remember, precisely what test or piece of information revealed to the dive specialist that your problem was caused by a trapped nerve?

-- I gather from your mention of the rolled-up towel across the shoulderblades that the location of the nerve trapping was the neck/shoulder area? Is this the area that you had massaged, resulting I gather in some improvement?

-- When you say "I think it's helped," is that to say that it's not 100% better, and you still have some symptoms?

Needless to say, I won't conclude that any of your experience has any bearing on my own situation, but I'm just curious about how it went for you.

 

[Louie]

It was following a lot of questions from the physio, lifting arms, holding limbs and a bit of his rubbing my upper back that he came to the conclusion. He told me that the numbness and tingling at certain arm angles and the pain and stiffness in my back all pointed out to the same thing.
Yes, the left shoulder blade area was massaged to great improvement.
It did help. I felt 100% recovered but as my job involved sitting for long periods in front of a computer, I had a slight relapse. But it hasn't been serious (pain in my left arm after strenuous exercise) and I'm certain another trip or two to the physio should do the trick.

Hopefully, you'll get a quick and accurate diagnosis from the scan and a good doctor is able to sort you out once and for all.

Also, I forgot to mention this before but a diving instructor friend of mine has informed me that I should have a good hard think about my equipment and how they're arranged for the dives (BCD fit, weight positioning etc).

All the best and happy diving