• Physioqinesis

Forward Head Posture

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.

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