Neck Strength Test: Protocol and Why It Matters

The neck strength test is an uncommon assessment outside of contact sports, but it carries huge relevance for preventing neck injuries, especially in rugby, American football, martial arts, or sports with a risk of head impact.

What does this test measure?

It measures the maximum isometric strength of the neck muscles in their main directions of movement: flexion, extension, and lateral flexion (left and right). Strong neck muscles improve the ability to stabilize the head against impacts or sudden accelerations, reducing the risk of injuries such as whiplash and potentially contributing to a lower incidence of concussions.

Equipment needed

• Handheld or pull dynamometer
• Optional: a neck harness with weights or pulley system, or dedicated neck strength devices

Step-by-step protocol

1. The person sits or stands with good posture, head in a neutral position
2. The evaluator places the dynamometer against the person's head in the direction being tested (forehead for flexion, back of the head for extension, side of the head for lateral flexion)
3. Ask the person to push against the dynamometer with maximum force for 3-5 seconds, in an isometric contraction (without the head moving)
4. Record the maximum value in kg or Newtons
5. Repeat for each direction (flexion, extension, left and right lateral flexion), resting between attempts

Common mistakes

• Not keeping the head in a neutral position at the start of each measurement
• Allowing actual head movement (the test should be isometric, with no displacement)
• Not comparing both sides for lateral flexion, missing information about asymmetries

How to interpret the results

Direction	Expected relative strength
Extension	Usually the strongest direction
Flexion	Generally weaker than extension
Lateral flexion (both sides)	Should be symmetrical between sides; asymmetries > 10% deserve attention

There aren't standardized universal tables like for other strength tests, so the main value of this test lies in individual longitudinal tracking and comparing directions and sides within the same person, rather than comparison against population values.

How this test relates to others

The neck strength test relates to other prevention-oriented tests:

• Grip Strength Test (Dynamometry) — another general strength marker useful in prevention assessments
• Isokinetic Strength Test — for a more precise assessment of neck muscles if isokinetic equipment is available

Track your progress

In contact sports, cervical strength is an increasingly common component of injury prevention programs. With Movalytics you can record the strength in each direction (flexion, extension, lateral flexions) and track symmetry between sides and progress throughout the season.

FAQ

In which sports is this test most relevant? In contact sports or sports with risk of head impact: rugby, American football, martial arts, ice hockey, among others. Does strengthening the neck reduce concussion risk? Evidence suggests a relationship between greater cervical strength and lower risk or severity of some cervical injuries and concussions, although it's not the only factor and should be combined with other prevention strategies. What exercises are used to improve cervical strength? Isometric exercises with manual resistance or resistance bands in the four directions (flexion, extension, lateral flexions), progressing intensity gradually.