Do You Have Forward Head Posture? Its Implications for a Host of Painful Symptoms

Posted on September 25th, 2024

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

As a chiropractor for over 40 years I have witnessed a condition that is not commonly on most people's radar but can negatively impact yourdaily activities and make your life miserable.

This condition is termed Forward Head Posture (FHP).

It may not coined a disease but it can cause progressive pain in the neck and a host of collateral symptoms not commonly considered such as:

1. Headaches: Headaches are a common symptom of FHP.
2. Neck pain:The angle of the head puts extra pressure on the neck muscles, which can cause strain and stress.
3. Muscle tension: The neck and shoulders can experience muscle tension.
4. Mid back discomfort: FHP can cause discomfort in the mid back.
5. Pain in the arms and hands: FHP can cause pain, pins and needles, and numbness in the arms and hands.
6. Chest pain: FHP can cause chest pain.
7. Breathing issues: FHP can negatively affect breathing by causing the upper chest to expand while the lower chest contracts.
8. Swallowing difficulties: FHP can increase the distance between the tongue base and posterior wall, which can reduce tongue pressure and limit swallowing
9. Vertigo and balance problems: Forward head posture can reduce blood flow to the brain and ears, which can cause dizziness. The cerebellum, which is the brain'sbalance center, receives less information when blood flow is reduced, making it harder for the brain to control muscle movement
10. Tinnitus (Ringing in the Ears): FHP can create tension in the neck muscles, disrupting proper blood circulation and negatively affecting the function of your cranialnerves to cause a ringing in the ears.
11. Temporomandibular joint disorders: FHP creates tension in the muscles located above the hyoid bone.

What Exactly is FHP and What Does It Look Like

The National Academy of Sports Medicine (NASM) define FHP as holding the head out, in front of its natural position over the cervical spine.

Normally, looking at someone from the side, the ear should be directly over the shoulder. As you can see in the image below, for every inch of Forward Head Posture, itcan increase the weight of the head on the spine by additional 10 pounds.

Think about holding 12-15 lbs (the weight of a bowling ball and the weight of your head), out away from your body. It would be harder to hold there than close to thebody. This is comparable to the weight and stress we are placing on our spine and weight-bearing joints with FHP.

According to a U.S. National Library of Medicine clinical trial design, the muscles that FHP weakens and lengthens include:

Deep neck flexors, including the longus capitis and longus colli

Scapular stabilizers and retractors, such as the rhomboids, middle and lower trapezius, teres minor, and infraspinatus

The muscles that become shortened and overactive include:

Deep upper cervical extensors, such as the longissimus capitis, splenius capitis, cervical multifidus, and upper trapezius

Shoulder protractors and elevators, such as the pectoralis minor, pectoralis major, and levator scapula

What are the Common Causes of FHP

People may associate FHP with using electronic devices for a long time, such as cell phones or computers.

The following are additional causes of FHP:

• Slouching
• Sleeping with the head raised
• Carrying a heavy backpack or purse
• Driving with a hunched back
• Sewing
• Reading in bed

Basically, any activity that causes a person to lean their head forward for a prolonged period of time can lead to chronic FHP.

Treatment to Reverse FHP

With exercise and stretching, a person can reverse FHP and hold their head in a neutral position, in alignment with the spine.

There are several potential treatments that a person can try at home, along with medical interventions.

A person who works using a computer or other devices can practice sitting upright and keeping their neck in a neutral spine position. This means ensuring that the earsare in line with the shoulders.

A person can also incorporate exercises and stretching into their daily routine to help in the improvement of FHP

Chin tucks

The NASM suggest several techniques that strengthen and lengthen muscles, including chin tucks:

Stand with the upper back against the wall, with the feet shoulder-width apart.

Tuck the chin in and hold for a few seconds.

Return to the starting position and repeat a number of times.

This can help stretch the muscles in the upper neck.

Supine chin tucks

To do this, a person needs to lie down on the floor, facing up.

They then need to repeat the steps for the regular chin tucks.

Chest stretch

Stand upright with the feet shoulder-width apart.

Bring the shoulders back and down.

Interlace the fingers behind the back with the palms up.

Draw the shoulders back and down, ensuring that the elbows are straight and that there is no arch in the low back.

Dr. Grisanti's Comments:

I will be the first to tell you that I have been challenged with FHP and can tell you first hand how uncomfortable it is which has required diligent and focused application ofthe the exercises presented in the information and the video.

I found the following YouTube video of value in improving and reversing FHP

https://www.youtube.com/watch?v=_xg9z3bY90E