4 Test Protocol to Evaluate the Neuromuscular Causes of Neck Pain

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Neck pain is one of the most common reasons patients seek physiotherapy. It affects both sedentary individuals and athletes and is closely linked to prolonged postures, repetitive movements, and muscular imbalances.
The clinical challenge? Often, the root cause isn’t just joint dysfunction or postural, it’s neuromuscular: muscles that should be stabilizing are inhibited, while others overcompensate.

Being able to identify these patterns is key to designing effective treatment plans. In this post, you’ll learn how.

This post provides a step-by-step protocol for evaluating the synergy between the sternocleidomastoid (SCM) and upper trapezius, two of the most commonly involved muscles in neck pain, using clinical tests and surface electromyography (sEMG).
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⏱ Timestamps
00:00 Introduction
00:52 Why SCM and Upper Trapezius?
01:35 1. Supine neck flexion
02:07 2. Shoulder flexion
02:31 3. Alternating cervical rotation
02:56 4. Postural control in sitting
03:26 Conclusions
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KEYWORDS
activation pattern
Neuromuscular Causes
Neck Pain
muscle synergies
muscle factors
activation deficit
excess coactivation
training
muscle activation
shoulder activation
muscle assessments
muscle assessment
neuromuscular analysis
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