Seated neck extension strengthening works the muscles at the back of your neck (neck extensors) against an exercise band. The band goes around the back of your head and you hold the ends out in front, then tip your head slowly back against its pull. Physios usually bring in resisted work like this once moving the neck without any load feels comfortable.

How to do the seated neck extension strengthening

Sit upright on a firm chair with your feet flat and your eyes level.
Loop a light exercise band high around the back of your head, above your ears, and hold the ends close in front of your face with your elbows bent.
Take up the slack so the band pulls gently forward on your head. Keep your hands still from here on.
Slowly tip your head back against the band until your eyes look a little above level. That short range is all the video shows, so stop well before your head goes as far back as it can.
Let your head come back to level under control, without the band tugging it forward, then repeat.

What you should feel

Effort in the muscles at the back of your neck and the base of your skull. It should feel like work, never a pinch or a sharp pain at the back of the neck.

Common mistakes

Leaning your whole body back or arching your back instead of moving the head.
Letting your hands drift toward your face, so the band goes slack.
Throwing the head back as far as it will go. A small, controlled range is enough.
Shrugging, or holding your breath as the band tightens.

How often

Many programs start with 1 to 3 sets of 8 to 12 slow repetitions with a light band, 2 to 3 days a week. Your physio will adjust this.

Stop and check with your physio if

You feel dizzy, faint or unsteady. Stop and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
Things look double, your vision suddenly blurs or goes, your speech slurs or becomes muddled, swallowing becomes hard, your face or lips go numb, one side of your face droops or one side of your body goes weak or numb, you suddenly become so dizzy or unsteady that you fall or cannot stand or walk, your legs suddenly give way but you do not black out (a drop attack), or you get a sudden severe headache. Stop and call emergency services, even if it goes away.
Tipping your head back sends pain, tingling or numbness into your arm or hand, or gives a sharp or pinching pain at the back of the neck.

From the clinic

A light band is plenty. Pick a tension that still lets you move slowly both ways, and take as much care coming back to level as you did tipping back. If moving your neck without any load still hurts, the gentler neck flexion and extension or the holds in neck isometric exercises come first.

Look the band over for small tears before each session, because a band that snaps close to your face can hurt. Keep it high on the back of your head so it cannot slip down onto your neck. If you have high blood pressure, breathe steadily through every repetition and never hold your breath.

Bending your head back can narrow the space around the spinal cord, and the band adds load to the joints of your neck. Ask your physio before you start if you have rheumatoid arthritis or Down syndrome, have been told the top of your neck is unstable, or have been told there is pressure on the spinal cord in your neck. After neck surgery or a broken bone in the neck, check with your surgeon or physio before you start.

If your neck pain started after a recent car accident or fall, get it checked by a doctor or physio before you begin. Keep still and call emergency services if the pain came straight after a high-speed crash, a car that rolled over, being thrown from a vehicle, being hit by a vehicle while walking or cycling, a motorbike or quad bike accident, a horse riding accident, a diving injury or a fall from a height or down several stairs, or if you have numbness, tingling or weakness in an arm or leg. If you hit your head and were knocked out, cannot remember what happened, have had a headache ever since, are being sick, or take medicine that thins your blood other than aspirin on its own, go to an emergency department, and do not drive yourself.

If you have a condition that stiffens the spine, such as ankylosing spondylitis, new neck pain after even a minor fall, knock or jolt is an emergency: keep still and call emergency services if it started straight after the injury, or go to an emergency department straight away, without driving yourself, if it started later. See a doctor the same day, before any exercise, if you are 65 or over, have low bone density (osteoporosis) or have taken steroid tablets for a long time, if your neck pain is severe, if you cannot turn your head halfway toward each shoulder, or if it hurts when you press on the bony middle of the back of your neck. Having none of these does not rule out an injury.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-26.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Seated neck extension strengthening