By Patricia Staszak, PT, Owner
 

"Stop slouching!" How many times did your mom tell you that? Of course, just like that advice about eating your vegetables and wearing a hat, mom was right.

And it all starts with your head. Or, more specifically, how you carry your head.

Forward head posture (FHP), in which the mid back is rounded, shoulders slump forward and the head is carried in front of the shoulders, is something we see a lot at APT, especially among those who spend time on a computer.

The reason it's a problem is that while our necks generally do OK supporting an eight- to 12-pound head, shifting that head forward a mere inch ads about 10 pounds of pressure to your cervical spine. And someone with FHP might hold his head as much as three inches out of alignment. If you do the math, then you can see why head-on-neck and neck-on-thorax disorders rank high among the most common pain generators! (1)

Indeed, well-documented research tells us that the effects of FHP go beyond looking awkward – it can also result in pain, muscle aches, tension, and even long-term complications such as osteoarthritis. FHP also impacts bodily functions ranging from breathing to hormonal production as well as mood, blood pressure, and lung capacity. FHP in particular can pull your entire spine out of alignment while promoting accelerated aging of intervertebral joints. This in turn leads to degenerative joint disease. (1)

Ready to straighten up?

Here's the first key: The body follows the head.

As physical therapists, we often cue patients from below – i.e., we teach you to keep your pelvis and spine neutral and your ribs centered above your pelvis. But changing FHP requires diligent postural awareness about head position. That means that we're continually working to align our bodies under our heads (which I know may sound obvious!), keeping the chin tucked and head pulled back. Imagine a string pulling the top of your head towards the sky so your entire body and neck stay nice and lengthened.

To practice this (and it really does take practice!), it's helpful to get feedback by doing the following exercises in front of a mirror. At APT, we also use tactile feedback, such as standing against a wall or sitting in a chair with a high back. We also place a small pillow or slightly deflated ball behind the base of the neck and head. By gently pressing against the ball or pillow, you receive additional feedback about your head position.

Exercises:
Standing:

Start Position:  Stand with your back towards the wall. Your pelvis and shoulder blades should touch the wall and your feet a few inches from the wall. Place a soft ball or small pillow or towel at the base of your head. Keep the chest open and the muscles in your jaw, face and front of your neck relaxed.  
Action:  Gently tuck your chin and pull head backwards so your ears are above your shoulders.  Look straight ahead and don't squint. Hold for five to 10 seconds. Repeat 10 times.
Sitting:
Start Position:  Sit in a high-backed chair so your weight is equally distributed through your sits bones and your feet. Center ribs over pelvis and head over shoulders. Place a soft ball or small pillow or towel at the base of your head. Push your shoulder blades gently against the back of the chair.
Action:  Gently tuck your chin and pull head backwards so your ears are above your shoulders.  Look straight ahead and don't squint. Hold for five to 10 seconds. Repeat 10 times.

Another way you can practice good head position is what I call the "Henry Maneuver." OK, I made that up, but I base it on the way my greyhound, Henry, takes in his surroundings. Because he's a sight hound, he has a very wide range of vision – he never moves when he's scoping out the room. So in addition to looking extremely cute (not that I'm biased), he looks really relaxed – and he provides a great example https://origin.ih.constantcontact.com/fs156/1102009606326/img/233.jpgof how to adjust your gaze without moving your entire head forward, especially when looking down. So when you're sitting in your chair, keep your head back and your shoulder blades pressed against your chair and let your eyes wander. While you're at it, make a mental note to make sure you're not tightening the muscles in your jaw or face too. Holding tension in any of these muscles of the head and neck can also pull you out of alignment.

So remember:

  • Stay aware of your head position
  • Focus on whole-body alignment
  • Reach head up to the sky, keep those ribs open
  • Check for muscle gripping and start moving your eyes more

Good luck with your new posture!

Works Cited

 

  1. Dalton, Erik, PhD. "Forward Head Posture." Freedom From Pain Institute: Erik Dalton's Myoskeletal Alignment Therapy. Freedom From Pain Institute, n.d. Web. 04 Dec. 2012. <http://erikdalton.com/media/published-articles/forward-head-posture/>.
  2. Forward Head Posture. Digital image. Kamego Chiropractic Wellness Center Official Website. N.p., n.d. Web. 04 Dec. 2012. <http://www.kamegochiro.com/SiteImages/fig142lbhead_w.jpg>.