(Rachel Donen teaches Physio-Rehab and the body alignment training from Yoga to relieve Chronic Pain. Toronto locations: Little Italy and Roncesvalles.)
For many of us who have been in pain we want to be able to do what we please without being worried of a flare-up or re-injury. We just want to go and do. And if something does come up, we want to be able to bounce back quickly. We want to be resilient.
It is easy to know that there will be some physical training/rehab to gain this resilience. What we might not know is that there is also a mental training component that goes with re-building resilience.
So if we are going to build resilience, we will need to identify what it is. What words come to mind when you think of being able to do whatever you want, to not have to worry about injury, and to be able to bounce back quickly from any set-back? For me things like freedom, robust, courageous, adaptable, renewable, and supple come to mind. You will have your own words. Now what is the opposite of this? What comes to mind? For me, words like limited, brittle, scared, unwilling, dangerous, unsafe, and stubborn.
Right now, if we are wanting to be resilient, then it is something we feel we are lacking. That means we are not feeling those things like freedom, robust and renewable, but are likely sitting in the opposite of resilient. If I were to sit in those words of being brittle, scared, unsafe etc… it feels bad. If we go further into this, and identify the thoughts and beliefs that come with lacking resilience, what do we find? “I can’t”, “I’ve tried everything and nothing helps”, “I’m angry at my body for doing this, I’ve tried to help it, it’s the problem”, “I’m never going to get better”, “there’s something wrong with my body” “It’s not going to be o.k.”, “I’m in danger”. Now, some of these thoughts you may not even know are there. At it’s basic level, you will know you are in pain and don’t want to be.
If we are going to build resilience, we are going to have to get really good at identifying what it is and what the opposite of it is. Why? Because then we can choose to move towards those things that are resilient and move away from those that are the opposite. When I say move away, I don’t mean repress, or that is bad and you shouldn’t… I mean lets make a choice. If I have allowed myself to fully experience what is not resilience, and from that experience I know it makes me feel like crap, then it is my choice to stay or to make a new choice. Am I going to keep sitting in this, keep living this pattern, or am I going to choose something else? It’s a choice. Sound strange?
Internally, I can choose to live in the thoughts and beliefs that re-enforce not being resilient or I can start to learn and build resilience, the thoughts that accompany it, and the feelings that come with this.
If we are feeling like we lack resilience THEN we will need to do a practice of resilience. We will need to explore what it looks like, feels like, sounds like, what thoughts come with it, etc. We will have to re-discover this so we can once again be that source of resilience internally. Now this doesn’t mean your body is going to be better from this, for some it is the key, for some we need both physical and mental training. It just means, that if we so desire this resilience then we have to find all those moments, and create as much of those moments, so we can sit in the thing we so need and are asking for.
For me, resilience comes from knowing that no matter what, no matter if my body gets better, no matter if I get rich or lose my job, I know that nothing can affect me at the core. Nothing will affect that thing that is inherently kind, insightful, loving. Nothing can touch that thing that is uniquely me that goes beyond my body, my financial situation, the thoughts I think, whether I live or pass away. I know that at the core I’m going to be o.k. no matter what happens. This settles me so I can make choices from the feeling of resilience rather than the lack of it.
(Rachel Donen teaches Physio-Rehab and the body alignment training from Yoga to relieve Chronic Pain. Toronto locations: Little Italy and Roncesvalles.)
So often confidence and trust in our body is lost when dealing with constant pain. There is almost a feeling of a great betrayal… especially once you have exhausted almost all avenues to try and help… and it just doesn’t seem to get any better. It’s let us down. It’s the reason I can’t do so much of what I want to do. It’s frustrating. I’m ready to quit on getting better because nothing I do makes it better…. That’s tough.
The good news is we can regain that confidence and trust back.
First we have to see where the trust was lost… or at least understand the idea behind that lost trust. For me I can remember being in a yoga class. Yes! a yoga class. My knee kept twinging during one pose. I didn’t know what to do about it. I wanted to keep practicing so I kept doing that pose over and over like that never asking for help…you could say I was subconsciously aware that something was wrong but the goal of doing “yoga” was more important so I ignored it. (Of course this is not what my teachers taught me to doJ). This thought process happens within seconds and for many of us it is MISSED or BARRIED…. Like I did.
I kept practicing like that and my knee kept twinging… eventually I developed tendonitis in a few of the muscles in the inner knee. I went to physio. I had to stop practicing yoga for 2 months. I was pretty depressed. I had crutches for a while. Afterwards I couldn’t even go for a walk without it hurting and I couldn’t go for long. I was pretty sad about things and uncertain about my movement future. It was scary. Eventually I got mad at my body.
I tried everything all the time to help it and it just didn’t seem to recover. I tried doing yoga poses, I tried walking again, I tried massage, I tried cranial sacral therapy…
For whatever reason one day it clicked. Why don’t I do a restorative yoga practice (basically like lying down with all kinds of cushions to give you a supported posture without any work) and do a breath awareness practice. I wanted to at least do the things that I could do. I at least wanted to enjoy the things I could do. So I did this for months along with my physio exercises. This became my yoga practice. Instead of trying to get back to “yoga” or walking or dancing or any of it I just stayed with what was possible. What I could do and enjoy. This was pretty transformational to my view.
I realized that I would rather enjoy one moment of ease and comfort in my body than ever return to a yoga practice or walking or dancing or any of it. So my new focus became just enjoying what I could do and taking time to enjoy those moments of ease and comfort when they did come. I stopped forcing the goal to get back to yoga or walking or to be pain-free or the things I couldn’t do.
Regaining trust in your body is about:
- Clarity (when your body asks for something, identify it and then act from this clarity). If we do this we will never break our trust with ourself again. It means that we will commit to slowing down and listening… and if something arises that is of a real imminent danger we will remove ourself from this… and if something arises that is kind you will move towards it.
So the criteria of “no pain” is not when trust comes back. It is when we see that the body is not deceiving us. The body is not to blame… and neither are we. It’s to see that for whatever reason we chose not to remove ourself from imminent danger (danger that will actually lead to injury) and this is where the trust was lost. That we allowed ourself to be put in danger… perhaps over and over again (Be very kind and gentle with this person). Now that we know this we will agree no longer to put ourself in danger. We agree to remove ourself from imminent danger or suffering when we see it. We agree to act from kindness and clarity, not blame or force. This will ensure that we know we will always be there for ourself. We can again trust that we will do all we can to choose the action that will keep us safe when its needed.
With chronic pain you will have to get really skilled at knowing when you see actual danger of injury and you need to remove yourself… and when it is just a pain pattern arising over and over again that has no actual danger to you and it does not need your attention. It just needs to run its course until it gets that we know we are not in danger and it is not needed anymore.
(Rachel Donen teaches Physio-Rehab and the body alignment training from Yoga to relieve Chronic Pain. Toronto locations: Little Italy and Roncesvalles.)
There are many reasons for muscle soreness and the headaches as a result of this soreness… and that means many solutions for each. One reason for soreness and then the subsequent headache, which we may not know about, is lack of nutrients to help the body maintain or rebuild muscle. Whether you are starting from a weakened state and/or are doing exercises to strengthen, the body needs the right nutrients to get stronger/maintain muscle… if it doesn’t get them this may be the reason you are constantly feeling sore (or one of the reasons).
First, we must understand that if we are to keep the muscle we have, or want to get stronger, we need to provide the body with protein/amino acids so it can rebuild. Remember two things: 1) if we lack the nutrients like our daily amount of carbohydrates and fats to fuel the body we will start to break down muscle for fuel… and if we don’t have enough protein intake as well, well the body will keep breaking things down and we loose muscle mass, body weight, tissues become brittle, we get tired…. which all leads to soreness! 2) if we are getting enough carbs and fats in our diet but lack the protein to rebuild muscle mass when exercising to strengthen the body, we will be constantly sore. So you will need to look at your recommended protein intake (check the internet for general recommended amount as well as recommended for those exercising, male vs. female) and compare this to one day of what you eat (check the internet again for protein content of foods) to see if you are getting enough.
You may need to supplement your diet with a protein supplement to get your required amount. There are many different types. Hemp, rice, whey. It will come down to what taste you like and you can also look at the protein content and amino acid content for which would be best (e.g. higher protein content means less scoops of protein and a variety of amino acids means better nutrients to help rebuild).
I am not an expert in nutrition, so if you have the chance to work with a nutritionist to get the right intake that would be beneficial. If not, try playing around with the amount you take (e.g. consuming the required daily intake or slightly more, when you take it: after workouts, when you feel sore). For me, taking a protein supplement is the same affect as taking an Advil, my muscles relax, the headache goes away… and over time for me it provides a solution rather than symptom relief… along with not having the side effects of meds. Easing of muscle soreness from nutritional supplements might not work for everyone if the reason for your soreness has nothing to do with protein intake. So the best thing to do is just see…. Does it help?
And don’t worry… you are not going to gain a tone of muscle! If you wanted to gain large amount of muscle you would have to be doing crazy hard workouts…. Which is great but not something general strength training will accomplish. It will be more that you feel the difference in the strength and stability of our body… not as much in the size. If you do want to build a lot of muscle mass that’s a different discussion.
I’m sure most of us know that some form of physical rehab is likely needed to get better. That part of relieving pain we get. I would say where we don’t have a clear picture is how awareness of thoughts and beliefs and reactions to pain are also part of relieving pain. This is where I see some people plateau in there recovery… when we have taken the physical steps needed to recover but now the other stuff is getting in the way.
Everyone has a “psychological” part of pain because that’s part of who we are. There is no separating the body from mind and etc. So if you are ready to relieve pain, then you may need to know how to work with the psychological part of pain to recover. Now, what does this mean?
How about a common example? Its very common to think that its only when I get out of pain will I get to do the things I love to do again. For many this will seem so true. What we have to see is what parts are true and what parts aren’t. So, sure, perhaps before running a marathon again rehab needs to be completed. I get that. But is it true that I won’t get to have the things I love about running, how it makes me feel, perhaps the distressing aspect of cardio, etc… I won’t get to have this until after rehab? This is where we have to question this belief.
If I love running because one of the things I get is a great sweat, and when I sweat I feel so relaxed afterwards, is it true I can’t have this now?… Even though I can’t run and I’m in pain? This is what we need to explore. We have to ask… what would give me the same feeling of sweating and relaxation now? Think about it. How about an infrared sauna…ever tried one? This will give you the same experience of profusely sweating and the great sense of relaxation afterwards without running a step. So yes, it is possible to still have some aspects of what we love in our life now. I can still sweat my pants off and feel great afterwards.
Now, if we hear ourself say, “oh but it’s not running” after this… catch this. What are you going to do? Do nothing because you are going to deny yourself anything that feels that way because you will only accept the one thing? If so, this is a self-imposed barrier to having things you love in your life, it is not an externally imposed thing. Just be clear. See if you can let yourself try these other things that come close to what you love and you can actually do. Toss away the image of what you should be able to do or what you use to be able to do… because that is not true right now. Don’t agree to judge yourself now on things that are not true or possible right now. If you can do this, trust me great compassion will come up for that person who is recovering, as well as peace an quiet from the constant wrath of judgment of what is happening now colliding with what should be or was.
There are many beliefs like this underlying pain: “There’s something wrong with me”, “I don’t have time to do my exercises”, “I need to always protect my bad side”, “Pain means damage”… etc.
If in some way we can have a glimpse that these kinds of beliefs exist, that’s the first step. If we can then allow ourselves to question it, kindly without blame, that’s the second. This will bring you back to having the things you love in your life even when you are recovering from pain. We just have to learn how to kindly get out of our own way and learn how to support the person who is here right now.
I KEEP TRYING EVERYTHING TO HELP MY BODY GET OUT OF PAIN. BUT IT JUST KEEPS HURTING. HOW CAN I NOT BLAME IT FOR WHAT’S HAPPENING?
HOW CAN I NOT BLAME IT FOR WHAT’S HAPPENING?
Injury or constant pain is very difficult. Days can seem dark. Can seem never ending. Scary and hopeless.
I can see why frustration or anger can come up towards our body when this happens. Especially when we feel we are doing everything we can to help it.
It’s like our body is deceiving us. We can’t trust it anymore. There is no sense of stability or confidence. We have been betrayed.
One of the most important things we can do is hear this. Allow yourself to hear this. Allow yourself to breathe with this. Allow yourself to give support to the person who is feeling this. Allow it to be expressed and heard fully. Why? If we can really allow ourselves to sit with this, feel it, understand it, not push it away, we can identify what is going on and what we are needing… asking for.
When we have this deep frustration, anger, hatred, fear, unkindness towards our body we are sitting in blame, and that never feels good. We may not know that we see it as “our body is doing this to me”. That we have separated ourselves into two parts: the body is one entity and us the other. That we have chosen to take on the role of the victim and the body the victimizer. This takes a tremendous amount of energy on our part: 1) Trying not to be blamed for any of our pain or suffering and 2) the continuous anger directed at our body as the “victimizer”.
But how do we drop blame?
First we must see it is there, experience it. Then we must take responsibility for our part…our reactions, our choices that lead to sitting in anger, hatred, fear, unkindness, blame. We must no longer agree to sit in this. We must no longer agree that we are separate from the body, we are the victim and the body is to blame. We must reunite body with person and understand that when we blame our body, when we get angry at our body, when we are unkind to our body… we are directing that at ourselves. This can be a lot to take in… feel perhaps embarrassed or at fault but please just support, love and accept that person who has chosen to sit in blame. They most likely didn’t know. They probably thought it was helpful.
We must forgive our body, and most importantly ourselves for the choices we have made or not made in the way we talk to ourselves. For choosing to be unkind or hateful or not knowing what was going on. We must forgive and choose to now support, love and care for whoever is there, no matter what sensation comes up. If this is not possible at first, see if you can at least find out what would happen if you didn’t respond with anger each time, if you didn’t blame. If you just sat with the pain instead of reacting. That’s a good first step. Once we have this then we can see what it would look like to be loving and kind to ourselves. If we can do this, blame will be gone and we can just deal with the pain that is there from physical injury or weakness or misalignment… that’s the easy part…
I’m sure by now if you have taken a yoga class or have been part of a meditation group or read something on this topic you will have heard something about the importance of “slowing down”. This will usually be accompanied with something about paying attention to your natural breathing and it will usually end with something like “now let go of thoughts, emotions, and sensations as they come up”.
Probably being part of this experience produced a feeling of relaxation, ease, and comfort. Which is great. This can be a result of slowing down, paying attention to our breath, and “letting go”. But the whole point of slowing down is not only for relaxation purposes. So if it is not the only reason, then what are we actually talking about?
When we invite ourselves to slow down, we can see how things evolve psychologically to produce certain outcomes: how certain thoughts lead to certain emotions which lead to certain sensations and certain beliefs. When we can see how something started psychologically, and evolved to an outcome, we have tremendous choice. Why? Because if I know the source of the outcome I can choose to do something different if it is the cause of suffering. But I first need to know the source.
What we are doing is starting to see how we are the creators of all of this. How we are responsible for our view of the world and how we respond to things as they come up. So slowing down becomes incredibly important because it means I know my role in the thoughts, emotions, and sensations I experience. I also know I can have ultimate freedom of anything that is causing me to suffer from this view. But these patterns form so quickly we likely won’t even know they are in play. We probably don’t know we have any choice in them. We need to learn how to slow down to catch them.
So what’s an example?
Let’s take a super easy example. Let’s say I’m a girl. And I like a boy. We have been communicating almost every day by email for the last month. We really like each other. Then he doesn’t write for 3 days. All of a sudden I’m thinking he must not like me that much. If he really liked me he would write everyday. So I get annoyed. I want someone who really likes me. Now, if I slow this down for a moment I may see something. So I slow it down. The first thing I feel is how much I like this guy. Very nice. The next thing that comes to my mind is how much I have enjoyed emailing with this person. O.k. The next thing I see pop into my head is how I felt sad when he didn’t write me. O.k. stay with this a second. What part of him not writing me is making me sad? Hmmm don’t know yet. So I wait to see what pops into my head….
And this is what pops into my head “Is it really true that when someone doesn’t write me it means they don’t like me? Or does it mean they just didn’t write to me for three days and I have no idea why”…. Ahhh.
With slowing down we can start to see how quickly a thought can lead to an emotion and then probably a physical sensation… and if we don’t catch this pattern… a belief will be formed. How many times someone writes to me is just how many times someone has written to me. That’s it. O.k…now I have choice. Do I want to continue this assumption or do I chuck it (“let it go”). Well I know this isn’t true and when I keep it makes feel like crap so it’s a no brainer. Bye.
Now, what am I left with? Well if I am someone who wants to share in a process of open communication daily… it is a need….well then I have to see if that person is interested. If not, then I know its time to move on.
Of course there were other things in play in this example but I think you get the picture.
This same slowing down process can be applied to pain and our reactions to pain. They happen so quickly that it is likely you won’t know these webs have formed. But if you give yourself the chance to do slow down, allow a teacher that can help guide this journey, you will have tremendous freedom from thought patterns that lead to certain emotions and sensations that are of no benefit to you and your health.
OUR BODY’S NATURAL STATE IS ONE OF HEALING… HOW WE CAN EASILY FORGET THIS WHEN STRUGGLING WITH CONSTANT PAIN.
When everything we do seems to lead to pain it is very easy to forget that our body’s natural state is one of healing… because it doesn’t feel that way! It just seems like our body hates us, is punishing us, will never get better. If we can step out of that thought pattern, that reaction to pain, for just a moment, we will have space to discover this healing state again.
Now I’m not saying that just because it may click again that our body is always trying to heal, to get back to a balanced state, this doesn’t mean you will instantly feel better. BUT if we can give ourselves time to discover this truth, this will begin to calm our mental and emotional reaction to pain.
This is not something I am asking you to believe me on. I need you to actually discover this for it to click. So let’s take for instance a paper cut or a scrape we might of once had. Remember back to that paper cut. It really hurt for that moment. There was that little slash in your finger… maybe with a little blood. I bet you don’t even remember how long after that paper cut healed. It just did. When the body is injured like that it sends a signal to our brain and then our body that something has happened that needs our help. It rushes blood to that area of the body. It clots bleeding so the wound stops. We grow new skin to heal that area. We won’t even be able to see where we once had that paper cut.
If you can remember this process of having a paper cut and then not… you will start to see how our body’s natural state is truly one of healing.
Now why doesn’t this happen to our back or neck? Why would I be having constant pain if my body’s natural state is one of healing? Just think of the analogy of picking a scab, over and over and over and over again. What happens when you keep doing this… the area doesn’t have a chance to heal, it keeps bleeding, it’s raw. It keeps having to tell the brain and body it needs help. It keeps having to go through this emergency reaction. Our natural response is no longer the solution because of this added factor of picking the scab. Staying in an emergency reaction physiologically is also very stressful emotionally and mentally at a larger injury level.
Even though we did not mean to “pick the scab over and over” when it comes to our back or neck or whatever area of your body is in constant pain… this is what has happened. So the natural physiological healing process isn’t enough now. We need to bring in an expert to diagnose what’s going on and what needs to happen. Once we do this, we will get our body back on track again. It will respond quickly to the solution and you can once again see our natural state is one of healing. Remember, this doesn’t mean we will never have pain like that again. But with the help of an expert that will teach us theoretically and experientially about why this is happening and what needs to happen to get better, we will learn how to respond to the body and it’s needs in order to heal.
So let yourself rest in the deep knowing that our natural state is one of healing and have a physical rehab expert help you actualize this.
Sometimes with chronic pain it feels like any little thing you do could lead to a flare-up of pain. Put us out of commission.
Our natural instinct to this is to try to do something for our body to help. We try everything. If we feel tight we stretch the area. If it hurts we massage the muscle. We might try to strengthen. Something to help. And these things may bring us some relief, but still it just won’t go away.
Then comes the phase where are body feels like it won’t let us do anything, so we stop doing activity. We are almost forced to sit around because everything we try just causes pain. It feels like we are trapped. Nothing helps.
This can feel pretty hopeless.
So what do we do?
If we put aside the physical rehab part for a moment, we can look at how to respond to this cycle of “nothing works”. How to respond to a scenario that seems hopeless so we don’t get lost in this feeling.
What is important to catch is our response to pain. It will likely be either to protect or to attack. For most, at the beginning I think we kind of attack. We try to do something to get rid of this pain. Then when the pain doesn’t go away from the things we are doing to help we go into protection mode because we feel we are always under attack. Both of these patterns produce a lot of tension in the body. And in turn can maintain or exacerbate pain levels. It also expends a lot of energy, always having to be on guard to attack or protect. It’s tiring.
I’m not sure what you do when pain comes up but see if this feeling of attack or protect comes up. If you can catch this you will have choice. Choice to continue this pattern or choice to no longer agree that one must attack or protect to be free of pain.
This is where we will need courage. Courage to stand still when pain is threatening us with bad things. It will take courage to trust yourself that you will know what to do when pain comes at you. Trust that you will know if there is a real threat or this is just a pain pattern repeating itself. If you are not in danger of injury or a flare-up then you will need courage to dismiss the pain coming at you as needing your attention. You will need courage to trust your body will tell you when it is in real danger. If you can do this you will have moments where you can relax. You can trust your body will know how to take care of itself and know when to ask for help (e.g. protection, relaxation, assertiveness…). This will allow for your energy to return as you no longer ALWAYS need to be in protection or attack. You will just deal with the pain that actually needs your attention.
Then the next part is the physical rehab to deal with the pain that does need your attention…
If someone tells us that one of the reasons we are experiencing pain is because of psychological stuff, it can be confusing, annoying and humiliating. “What the heck are you saying!” I think we (practitioners) haven’t done a good enough job explaining what this really means.
I think the first thing people go to when they hear “psychological” and “pain” is its all in my head… it’s not real pain. Please know your pain is real.
It’s important to know that all pain has a psychological element. All chronic pain has more of a psychological element… and remember all of life does. With chronic pain, the question of which comes first the psychosocial stuff or the physical for why I have pain is like the chicken and the egg scenario.
So watch. When we have pain we react internally. “Oh I feel that”, “that hurts”, “I’m so tired”, “I can’t stand this anymore”, “I hate this”, “when the heck is this going away”, “what did I do to deserve this amount of torture”, “Oh god maybe my back will flare up and I will be in bed for two days not able to move”, “I feel old”, “I’m going to die”.
It’s amazing how quickly reactions to pain can lead to severe outcomes… and we might not even know we are actually thinking that. That kind of dread, fear, resistance, blaming, anger, victimized state can play a tole on a person. Especially on your nervous system.
If you have thoughts that stimulate the fight or flight nervous system reaction things like heart rate goes up, muscles become tense to protect, other muscles “shot off” to protect as well, breathing becomes quicker… etc. So, when we keep having cycles of thoughts to pain that increase this reaction we help maintain pain. The body gets tighter, fatigued, weak, drained. When the body is tired, weak, and drained we have thoughts and emotions in reaction to that… and the vicious cycle keeps going.
So then we have to ask which comes first? Is it because I’m weaker, more fatigued, tighter that I have these thoughts or is it the other way round? The truth is it doesn’t matter. It’s just important to know the cycle.
Automatically you may think I need to do things that relax me, right? That’s part of it, but it’s not the solution to the cause of pain that is stimulated from psychological factors. If we can catch the cycles of thoughts that lead to certain ideas or emotions that lead to certain physical responses we will have choice. We will see I can keep reacting like this or I can choose something different. I can agree to no longer have this same reaction. But before you can choose to do this you will really need to allow yourself to feel what it is like to live that pain cycle. Watch it. Welcome it, don’t resist it. Why? Because if you really feel that cycle your choice will be effortless. You will know exactly why you no longer agree to this cycle. You will feel how crapy your thoughts make you feel. There will be no force or effort to change. No “this is bad or this is good” reasons of why you should change. You will move from deep awareness, insight, and connection that what I am thinking is making me feel like crap. You can dissolve your psychological reactions that have no use to you and your health.
So if you aren’t in danger of injury, you are safe, not going to die… you are just in pain then see how it is your choice of how you respond psychologically. It may be really hard not to go into fear mode, or victim mode, but just keep watching so you have choice in how your react.
There can be many reasons for tension in the body. Lets remove the factors like stress and diet and just look at alignment as the cause to understand what to do.
I think many of us can relate to the head slightly forward position and rounded shoulders. The posture you get from a lot of sitting, a lot of computer work. We can feel that. In response to this we try to take our shoulders back and our head to correct the posture. But it feels awkward and never gives us the sustained relief we are looking for. So… you have the right idea of what needs to happen just not an effective strategy.
What you need to know: What changes in alignment happen in your upper body affect the lower and vice versa. So the question really is where is the root of that alignment change? We have to see where is the biggest break in alignment and start with that area of the body to rehab. What I am saying is, just because you have constant tension in your neck and maybe even headaches and pain down the arm, it doesn’t mean this is where you should necessarily start rehab.
In most cases that I have seen the biggest break in alignment is in the pelvis and low back for people who have neck pain and tension. Also the neck has been in so much tension for so long that it is really cranky. Anything you do usually will flare it. So in this case I would start with rehab lower in the body to correct the biggest break in alignment and also to not flare the cranky area. Once the lower part of the body is stabilized and strong I would then move up the body. From this lower body work you will likely see changes in your upper body posture. You will likely get some relief in your neck as well because you now have a foundation to support the upper body from below.
The next time you think you need to get a massage for your neck or that your neck or shoulders are the problem that you need to address right now… see if a physio who has training in biomechanics or a yoga teacher trained in alignment and kinesiology can look at the whole body. You need a professional to assess where you need to start to get relief. It could be your neck and shoulders, but it also may not be.