Continuing our discussion of Therapy Balls and headaches from last week, Alexa Kim weighs in on potential positioning problems and the benefits of massage to the lymph system:

If a student lying on his back cannot swallow because his neck creates an arch large enough for a Smart Car to drive through, he needs a block, bolster, folded blanket or some combination of the three under his head to avoid hyperextension of the cervical spine.  Adding height to the thoracic spine with balls or rollers while the head is unsupported and the neck is hyperextended will affect blood, lymph and electrical flow and may sprain anterior ligaments that normally serve to stabilize cervical vertebrae.  The anterior portion of the neck is a crowded house of major arteries, veins, organs and nerves (including the vagus) as well as the trachea.  If along with hyperextension, the sternocleidomastoids (“SCM”) are contracted or passively shortened, it has implications for the jugular veins, carotid arteries, and vertebral arteries (that are the main blood supply for the brain stem) – all of which lie behind the SCMs.  Additionally, in a body that is upright and at rest, the internal jugular veins are kept almost empty by gravity.  These veins fill up when we lie down.  So a normally crowded house becomes more like a pressure cooker when the cervical spine pushes into the front of the throat.


With respect to improving lymph function, YTU Therapy Balls are most effective at removing adhesions around the muscles and improving blood flow. Because the lymph system does not have its own pump like the cardiovascular system, the current scientific view is that lymph flow relies on changes in pressure supplied by the surrounding tissue – particularly muscular activity.  Massage techniques that change the pressure mechanics around lymph vessels influence lymph flow. But there is a goldilocks effect with respect to lymph circulation:  “Any factor that increases the interstitial tissue pressure by 2 mm Hg tends to increase lymph flow in lymphatic vessels. Conversely, if the interstitial tissue pressure is greater than 2 mm Hg above atmospheric pressure, then lymph flow may decrease as a result of compression of the lymphatic vessels ….  To achieve a continuous local lymph output, external intermittent compression of the lymphatics is essential from: (i) contraction of muscles; (ii) movement of body parts; (iii) arterial pulsations; and (iv) compression of the tissues by forces outside the body.”[1]

Discover the Yoga Tune Up neck pain relief solutions

Watch the QuickFix Neck Video Online

Learn more about the YTU Therapy Ball Products


[1] Disorders of the lymph circulation: their relevance to anaesthesia and intensive care. A. Mallick and A. R. Bodenham, Br J Anaesth 2003; 91: 265–72.


Alexa Kim

I teach because I love thinking about the complex and simple ways of the human body. The body's needs for optimal health are incredibly simple; how the body compensates for damaging habits is extraordinarily complex. I love assisting students distill functional movement to its most simple - so that students can restore, strengthen and protect their own bodies in any situation. I am certified to teach Yoga Tune Up ™ and am also a certified Restorative Exercise ™ Specialist and Healthy Foot Practitioner.

Leave a Reply

28 Comment threads
0 Thread replies
Most reacted comment
Hottest comment thread
28 Comment authors
Kara Stafford

The visual on this was so helpful! I will use this information to help my students feel and find the most optimal placement of their tune up balls. I appreciated the crowded house analogy and the explanation of what’s happening in the lymphatics.

Mel C Russo

This was very helpful. I’m constantly trying to stop students from throwing their heads back in both cobra and upward facing dog. I usually tell them the Cervical spine is delicate and continued pressure on it won’t end in a healthy spine. It’s nice to have some new language to use when teaching those poses. Thank you.


Thanks Alexa for this article. Most of my students support themselfes with a blanket, when resting on the ground. But on the other hand they literal throw their heads backwards when practicing cobra or even “cat- cow”. Now I can explain to them , why it is important to keep the neck in a “neutral” position to the spine.


This post is a good reminder for me to pay attention to my body position when rolling so that I am not causing further problems. This also inspires me to spend more time explaining how to use the balls at home to my students.


This is a helpful reminder to watch out for this hyperextension of the neck– and not only when rolling on therapy balls! I see this posture in many students during Savasana and I am often hesitant to offer a blanket. My fear is that I will disturb the student or unnecessarily burden that person with the idea that they are doing something “wrong.” However, the physiology may necessitate that a student find better alignment.


I like the crowed house analogy and the cervical spine pushing into the front of the throat.
It paints a picture …. Very good way to explain why the cervical spine should not be in hyperextension while lying on your back .

Erika Belanger

Very interesting! Love the clue with the swallowing. Easy to explain to students! Thanks

Heather Dawson

This was helpful in explaining to student why they are in hyper flexion and the benefits of using the balls and a prop.


Thank you for this! I always prefer having something under the back of my head when lying on my yoga mat, especially when using my therapy balls. I suffer from chronic migraines that often originate from my SCM, but didn’t realize that the need to prop up my head and the problems I have with my SCM could be connected. I appreciate the insight.


Thanks for your post. It is amazing that such a simple act as laying down could be so uncomfortable for some bodies. Your post has reminded me that there is much I take for granted when it comes to more basic postures. I will definitely be looking out for those up turned chin and massive cervical curves. I also can wait to get this massage balls working for people with such limitations.

Alison Pignolet

What a great explanation of the mechanics of the hyper extended cervical spine. Very clear and concise and USEFUL, not just for ball rolling but any time our students are on their backs. Thank you!


Thank you for the well put explanation of the results of having hyperextension in the neck while rolling on the balls. I was just wondering why some times I may get a headache when putting the balls slightly below the occiput?


Fantastic tips to fine tune this divine exercise!

hilton lazar

Can you place 2 balls under the suboccipitals to induce flexion at C0-C1 with a compensatory flattening of the c-spine?

Amanda Joyce

This blog was a fantastic reminder to me that positioning my client’s head goes beyond just musculoskeletal support. Your information about the circulation of lymph in regards to head positioning reminded me, once again, that there’s a lot more going on than just the “meat and potatoes”, so to speak! Great diagrams! Thank you! xo


Great distinction, showing how the head position is so important. The more introverted -looking inward- of the supported neck does naturally bring more relaxation.


Thank you for the images to really show what you are trying to achieve. It is a great adjustment/modification to the pose and something that probably gets over looked in a class, unless the teacher has lots of experience with neck and jaw issues. Having an eye for safety is so important. I wonder if doing some gliding (head nodding) with a Pilates ball somewhat deflated would help elevate the head to the right plane as well as help to mobilize, unstick and strengthen the area. Just a thought

John Greenhow

I love seeing this support work for students. Until I began using YTU balls savasana was very uncomfortable for me without a support.
Excellent discussion of the interconnection between posture and cognitive function. I’ve heard Kelly Starrett discuss this as well but less specifically. I will use this as another way to communicate the benefits of regular rolling and mindful posture!

Kate Krumsiek

Thank you, thank you for the practical question of swallowing while lying down to present to myself and students! It is a simple, graspable idea for finding honest and true alignment while supine. This article offered an enormous amount of valuable information in terms of proper neck positioning and it’s impact on activities deep in the body that can show up as pain, discomfort and disfunction.


Thank you for clarifying. I am a little unsure and confused regarding kyphosis in the neck. I thought a hyperextended neck would be more if a lordotic state. Thanks for the post


Thank you this article is so important because many people have dysfunctional cervical curves. The forward head posture is an epidemic in the USA for sure and causes an absence of cervical curve as well as significant muscular dysfunction in all the cervical muscles.

Michelle Dalbec

Alexa – thanks for such an eye opening article on the delicate eco-system of the neck. I love to learn and I learned so many new things from your article. I love the fact that using the therapy balls addresses the multi dimensional being that we humans are. Rolling takes care so many things physically in the body, but it also addresses physiologically, which in turn affects us energetically and of course mentally as well. Thanks for tying it all together and addressing how important proper positioning is.

Sunina Young

Good timing, I was scripting a sequence for yoga tune up tomorrow and completely forgot to include the head adjustments. Thank you Alexa!


Thanks Alexa! The adjustment makes such a difference!


I feel like due to my sometime bad posture, and my constant hunching over a computer, the back of neck is always a little crunched. When stretching forward with my legs out in front of me, I find dropping the back of my neck the most painful. Finding ways to relieve this tension and increase blood flow is super important to me! Great article!

Diane M

Alexa- I really appreciate reading your articles. I am a science nerd so I want to know the precise scientific reasons and you consistently deliver. Not only is this an important safety article for all of us as teachers regarding neck tissues and position — but the lymph explanation is the most distilled and clearest one I’ve read. I talk about fascia a lot with my students but will incorporate some of the info re: lymph drainage…. Please keep writing! Thanks!


This is very helpful. In the initial years of my yoga practice, Savasana was always a little uncomfortable. Finally one of my teachers suggested folding a towel/ blanket and resting my head on it. in a couple of tries I found my optimal position. This opening up of the posterior cervical area is really well shown in your illustrations.


Thank you for this. My teacher’s instinct has me supporting a student’s head when their chin points to the ceiling in ardha savasana, etc., but your explanation of all the tissues involved and the potential for not only headaches and neck pain, but real damage, will assist me in encouraging the student to take the responsibility to use props for their own benefit.