In my physiotherapy 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 horse riding and many riders admit that they suffer from headaches. Riders 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 generic means origin of), so cervicogenic means that the headache starts from the neck and is caused by the neck joints and muscles. The top two joints are the main cause of headaches because the nerves supplying the head, temples and eyes are related to the top two neck joints.

Headaches originating from the neck are caused by the nerves being pinched or pressed by joints and/or muscles in the upper neck. There are many other causes of headaches. This article only talks about cervicogenic headaches (starting from the upper neck), not headaches from any other cause. It is important to be evaluated by a physiotherapist and/or a doctor to determine if your headache is cervicogenic or not.

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

So what is the relationship between the rider and headache?

The ultimate bad neck position comes from the round shoulder position. A person with round shoulders on the ground will have round shoulders in the saddle. When the shoulders are forward and so-called round, the neck will be in a forward chin position. This posture puts the upper neck in an extended position and this squeezes joints, nerves and muscles. Over a period of time, the joints become stiff and painful, the muscles shorten and the nerves become inflamed. The nerve then refers the pain into the head as a headache. The increased pressure by riding in a round shoulder position will increase the pressure and thus nerve pain. Riding is a major cause of headaches. All other activities related to horses can also put pressure on the neck.

Unfortunately, the attitude of many teenagers is the norm. Their shoulders are slumped, their chin juts forward and their upper neck is in a locked position. Many do not use any of their postural muscles and just hang from their joints. Many people spend many hours in a similar posture. Driving, computer work, homework are just some of the activities that reflect this attitude. As riders, we adapt the same attitude in the saddle. Riders are told to sit up and put their shoulders back.

How do you fix it?

The simple, quick answer is to straighten up, correct your posture and manage your mobility. The long answer is to educate yourself and handle it with knowledge. First of all, see a physiotherapist and get a professional assessment. Learn how and why you hold the positions you do, then become educated in how to fix yourself and manage your pain with posture control. Not many therapists will be able to relate your headache to riding unless they know about the riding position. Very few therapists can relate to the muscles used in riding or the amount of skill required to ride well. Remember that it looks so easy to the rider who is not a horse. You just sit there!

Managing headaches as a rider can be easy.

The control of headaches in horse riders is the same as for all people; but I place increased emphasis on special features of the treatment, because I am a rider. If you have been assessed and your problems are not too severe, but are of a chronic nature, meaning they keep coming back, these simple exercises will help. This must be regarded as basic advice only. To control headaches, the upper neck joint must have mobility. Your muscles must have strength and endurance. You must have strong core stability as well. The deep core muscle strength will reinforce the correct upper neck position. I start with the core muscles on every patient I treat for headaches. The success of management without this knowledge and strength is always limited. This is why chiropractic care (and or other) is very much back and is coming back.

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

Simple stretches to gain neck mobility

Stretch 1

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

Stretch 2

Stand tall, close your eyes and turn your head so that your chin moves towards your shoulder.

Stretch 3

Push the chin with the opposite hand to force the stretch more. Feel a stretch and or some pain in the neck. Don’t increase the headache pain with this stretch. Obviously both sides do, and if it makes you worse, go see a physical therapist. Hold for 10-20 seconds, switch off and repeat. Do these stretches little and often and do them when you’re healthy, don’t wait for stiffness and headaches to return. Treat good mobility and keep pain away.

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