What is Forward Head Posture?
Have you ever noticed a hump at the base of your neck? Or your head is always
protruding forwards when you work on your laptop or desktop for prolonged
periods?
That’s probably because of forward head posture, which may be acquired due to
faulty or prolonged bad postures.
Forward head posture occurs when the head shifts forward from your body‘s
center of gravity, to compensate the upper shoulders and thoracic spine.
There is hyperextension of the upper neck (cervical) vertebrae along with
forward translation of the cervical vertebrae which result in increase in keeping
the head more in the forward direction.
Thoracic Kyphosis, rounded shoulders and upper back are the further
complications of this syndrome {1} .
There may be painful shortening of the muscles of the back, the neck, as well as
compression of the cervical vertebrae.
What are the causes of this posture?
This type of posture is acquired due to faulty prolonged postures of the neck
more common in the people who have desk job, jobs which demands prolonged
working in front of desktop or laptop {2} .
As a result of prolonged faulty position of the neck the effect of gravity also
plays a major role in slouching, poor ergonomic alignment.
Improper sleeping postures with head elevated too high, or falling of the neck to
one side when sleeping in side lying position puts a tremendous load on the
neck and upper back region {3} .
This type of posture is more common in people who have compensated muscle
strength in upper back and lower back muscles.
Another cause of this type of posture is excessive use of the cellphone for
texting or for app usage.
What are the symptoms?
As there is an increase in comprehensive loading on tissues in the cervical
spine, particularly the facet joints and ligaments. Studies have reported that
symptoms including neck pain, headache, temporomandibular pain, and
musculoskeletal disorders are related to this posture.
FHP greatly influences respiratory function by weakening the respiratory
muscles. Forward head along with round-shoulders can result in shoulder pain
and dysfunction due to altered scapular kinematics and muscle activity which
may further increase the stress on the shoulder {4} .
Group of posterior cervical muscle goes into weakness. The corresponding
flexor or muscles in the front shorten and lengthen respectively.
How to avoid Forward head posture?
Minimize the screen time-avoid prolonged hours of sitting in front of desktop or
laptop, break your postures often make use of the standing desk which will
minimize the postural load.
Make use of proper pillow, make sure that your head is properly supported and
your neck doesn’t fall on one side when you sleep sideways use a towel roll to
support your neck.
Stand in an erect posture- Practicing good posture will naturally pull your
shoulders and neck back, instead of hunching toward the ground. This alleviates
a lot of the pressure coming to the neck and the lower back region.
Carry a backpack instead of shoulder bag. Try to keep backpack light in weight
otherwise make use of a trolley bag.
How to treat Forward Head Posture?
Ergonomics while using laptop or desktop. Workplace modification in sitting or
standing desk is very important along with the importance of breaking
prolonged postures which will decrease the load on the neck and entire spine
region.
A 2017 study comparing targeted exercise to workstation modification for
reducing office-related neck, shoulder, and back pain found exercise was the
more effective approach. The subjects in the study who exercised began to feel
better in just four months {5} .
Considering the compensations that happen in forward head postures exercises
should be planned accordingly. Focus should be on improving the mobility at
cervical and shoulder joints. Exercises including chin retractions.
Stretching Exercises targeted on the tight muscle groups such as
Upper trapezius
Scalenes
Sternocleidomastoid muscle.
Pectoralis Major
Pectoralis Minor
To reduce spasm and the tightness techniques like Deep Tissue Release, foam
ball rolling and icing can be used.
Strengthening and Endurance exercises including cervical isometric
strengthening exercises (initial phase) progressing to isotonic and dynamic
strengthening exercises.
To correct the forward head posture a detailed evaluation by a physiotherapist
mainly strength of neck muscles, shoulder blade muscles and tightness should
be done. Focusing on the concern areas like muscle strength insufficiency in
prolonged postures, along with that emphasis on do’s and don’t’s, correction of
work and home ergonomics should be in rehabilitation program.
.
References-
1] Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head
posture on thoracic shape and respiratory function. Journal of physical therapy
science. 2019;31(1):63-8.
https://www.ncbi.nlm.nih.gov/pubmed?cmd=link&linkname=pubmed_pubmed
_reviews&uid=30774207&log$=relatedreviews&logdbfrom=pmc.
2] Burt HA, Effects of faulty posture; President's Address. Proc R Soc Med.
1950; 43(3):187–194.
3] Cary D, Briffa K, McKenna L. Identifying relationships between sleep
posture and non-specific spinal symptoms in adults: A scoping review. BMJ
Open. 2019;9(6):e027633. Published 2019 Jun 28. doi:10.1136/bmjopen-2018-
027633.
4] Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH. Influence of
forward head posture on scapular upward rotators during isometric shoulder
flexion. Journal of Bodywork and movement therapies. 2010 Oct 1;14(4):367-
74.
5] Shariat A, Cleland JA, Danaee M, Kargarfard M, Sangelaji B, Tamrin SBM.
Effects of stretching exercise training and ergonomic modifications on
musculoskeletal discomforts of office workers: a randomized controlled trial.
Braz J Phys Ther. 2018;22(2):144-153.