Forward Head Posture

Introduction

Forward head posture is one of the most common postural dysfunctions that is seen and treated by physiotherapists on a daily basis. As a result of the forward head position, a range of painful conditions may develop including

head

headaches, facial pain, pain in the jaw, neck, shoulders, upper back, midback and even the low back.

 

In standing, observed from side on, a vertical line drawn from the ear to the ground should run through the shoulder, hips, knee and the ankle. In sitting the same line should pass through the ear, shoulder and hip. If the head falls in front of these other points, you are in a forward head posture.

Cause and Effect

One of the most common causes of forward head posture is poor sitting posture. For every 2.5cm forward that the head sits in relation to the shoulders, the weight of the head on the neck is increased by 5kg!(1) With forward head posture, your upper back and neck muscles have to work harder to keep your chin from dropping forwards onto your chest.

This forces the muscles that raise the chin to remain in constant contraction, Studies (2) have shown that forward head posture is associated with chronic tension-type headaches and the greater the degree the head is thrust forward the longer headaches last and the more frequently they are experienced. The extra pressure on the neck from altered posture flattens the normal curve of the spine resulting in abnormal strain to the structures of the neck and causing early degeneration of the joints (3)

 

Quite often as a compensation for the extra weight caused by the forward head position, the upper back will round and push backwards, resulting in stiffness and restriction through this part of the back and weakness of the muscles that should be holding it upright. In this position the muscles and tissues in the front of the shoulder become tight and we become “spring loaded” into this dysfunctional position.

This is often compounded by the typically male trait of wanting to focus training on the chest and front of the arms, further increasing this spring loading effect and the difficulty in maintaining correct upright posture. Due to the close relationship of the muscles attaching onto the neck and the shoulder, a problem in one area often results in a change to or problem with mechanics in the other.

Treatment

 

The first step in treating problems that result from forward head posture is identifying the factors that have caused you to adopt the posture in the first place and trying to eliminate them. This may be as simple as postural advice, changing your work setup and altering training programs for a more balanced workout.

 

The second step in treatment of these problems is in stretching the stiff “spring loaded” parts of the body, which are pulling you in the wrong position and strengthening up the weak muscles which should be doing a better job of holding you upright. This is done in conjunction with joint mobilisations, stretching, soft tissue release and acupuncture as directed by your physiotherapist, to settle the symptoms that you have been experiencing.

 

1. Bonney, R.A. and Corlett, E.N. (2002) Head posture and loading of the cervical spine. Applied Ergonomics 33 (5); 417-417.

2. Fernández-de-las-Peñas, C.; Alonso-Blanco, C.; Luz Cuadrado, M.; Gerwin, R.D. & Pareja, J.A. (2006). Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension-Type Headache. Headache: The Journal of Head and Face Pain, 46 (3): 454—460.

3. Abstract. Spine Journal (1986) 6; 591-594.

This article is in no way intended as a reference for self diagnosis or treatment. Diagnosis and intervention should always be guided by a qualified health professional.