August 29, 2016
Another Look At Forward Head Posture
By Michael D. Shaw
We touched on the topic of forward head posture back in 2014, as part of a discussion on various occupationally-induced maladies. This article will focus more on specific strategies to combat the condition, which affects virtually everyone using tech devices. It is most disheartening to see people in their 20s already exhibiting symptoms.
Forward Head Posture (FHP) is simply the anterior positioning of the cervical spine. That is, the neck slants forward, placing the head in front of the shoulders. Some authorities identify this as one manifestation of Upper Crossed Syndrome, first described by pioneering physician Vladimir Janda. Janda devoted the better part of his career to the study of chronic pain produced by muscular imbalance. Crossed syndromes are characterized by alternating sides of inhibition (weakness) and facilitation (tendency to tightness and shortness) in the upper quarter and lower quarter.
Upper crossed syndrome is manifested by facilitation of the upper trapezius, levator, sternocleidomastoid, and pectoralis muscles; as well as inhibition of the deep cervical flexors, lower trapezius, and serratus anterior.
As described in the earlier piece: An individual with “perfect posture” would have his ear, shoulder, hip, knee, and ankle in vertical alignment. As such, if you were to drop a plumb line from your ear, it should pass through all those points. I submit that you will encounter very few people who could pass this “vertical axis” test, without first re-aligning their stance.
A particularly insidious aspect of FHP is that no one seems to know about it until they already have it. Curiously, even some professionals tend to miss it, unless it is mentioned to them by the patient/client. In fact, after the first article appeared, I received a few e-mails relating stories along this line:
“I went to my orthopedic surgeon (or chiropractor) complaining of neck and/or shoulder pain. While the doctor did offer therapy for the pain, he said nothing about my FHP—which was pointed out to me months later by a friend. After that, I noticed it everywhere!” For those who enjoy pop culture, this is known as the Frequency Illusion or the Baader-Meinhof phenomenon.
Baader-Meinhof or not, FHP really is ubiquitous. Listen to Blake Bowman, owner and lead trainer of GuerrillaZen Fitness, located in Chesterfield, MI…
“Forward head posture is a little-known EPIDEMIC plaguing every modern society around the globe. Someone with FHP walks around with their head pushed forward in front of their center of gravity like a chicken. Not only does this put a lot of stress and mechanical load on the cervical spine (neck), but leads to tension and pain between the shoulder blades.”
“A further complication can be thoracic kyphosis—an excessive rounding of the upper back. If unchecked, thoracic kyphosis can progress to so-called Dowager’s Hump, a soft tissue protrusion from the upper back.”
Bowman offers a video, aptly entitled “How to Fix Forward Head Posture.” Besides the oft-stated causes—such as prolonged sitting at a computer desk and looking down at smart phones—Bowman blames overstuffed pillows, which can force your head forward all night.
Another good and simple exercise routine comes to us from Dr. Otto Janke, of Cortland, NY. You’ll always remember “Airplane, Superman, Goal.”
Next, we journey north of the border to Aurora, Ontario, Canada and Dr. Greg MacLuckie. MacLuckie presents two posture exercises—the Pec corner stretch; and one from the Brugger series, which strengthens the back.
A more aggressive and advanced exercise is the Dynamic Prone Floor Cobra, as presented by San Francisco personal trainer Michael Behnken. You’ll work up to this one.
Dr. Alan Mandell of Miami, FL offers an interesting approach to FHP. In this video, he is aiming to retrain the proprioception organelles (located in the ligaments). He also posts a gentle isometric exercise to help correct the condition.
As Blake Bowman says, Forward Head Posture is an epidemic. But, we can fight back by promoting awareness and promulgating therapies such as those cited above.