Most of us appreciate that posture is important. Ideal posture means there is a ideal distribution of forces across different joints in the body and balanced muscle tone. Optimal posture will help you to not only feel great but also look great and exude confidence!
Today, I’m going to talk about a common postural phenomenon – forward head posture. I’m calling this an epidemic because Webster’s dictionary defines epidemic as “affecting or tending to affect a disproportionately large number of individuals within a population, community, or region.” When I meet people in my community, I see this everywhere!
What is Forward Head Posture?
Forward head posture is when the head translates forward relative to the torso. It is also commonly associated with straight neck syndrome (when there is loss of the normal curvature of the neck). Ideally, when looking at a person from the side, the ear should line up with the shoulder. Forward head posture is common especially in students and office workers who sit at a desk for hours on end.
Causes of Forward Head Posture:
Common causes of forward head posture are…
Carrying too heavy of a backpack or carrying it too low – the head often moves forward to counterbalance the weight of your bag.
Slouching or leaning forward for prolonged periods at one’s workstation
General lack of postural awareness
Symptoms Associated with Forward Head Posture:
Common symptoms associated with forward head posture are…
Neck pain
Tense and sore muscles in the back of the neck and shoulders
Joint irritation
Headaches
Back pain (yes, even back pain!)
What causes these symptoms? Basically, there is suboptimal loading of the muscles and joints. The head is akin to a bowling ball – roughly 10 pounds – that sits atop your neck and shoulders. When it moves forward, the posterior neck muscles must work more to counterbalance your head. Hence, tense and sore muscles. When the muscles tense up, this also increased pressure between the joints. This, combined with shearing forces from suboptimal position, results in joint irritation. Joint irritation and excessive muscle tension in the neck often causes headaches due to pain referral. Irritated nerve endings in the neck refer pain to the head causing or contributing to tension headaches.
Now what about back pain, you ask? Yes, forward head posture can even cause back pain! All the joints and muscles in your body are functionally connected. Think back to high school physics class when you learned about levers. When an object moves further from the fulcrum, the turning force (or moment) becomes greater. You can apply this concept for lifting a large object by using a long lever. The only problem in your low back is that the lever is short and can’t be changed. So, when your head moves forward relative to your centre of gravity, your low back muscles must fire like crazy to counterbalance your head – otherwise you’ll fall over.
How to Fix Forward Head Posture:
Chiropractic care can help you correct forward head posture. Your chiropractor will quickly and easily identify postural defects and will let you know if you have any. Specific exercises can be prescribed for stretching relatively short and tense muscles and for strengthening relatively weaker, lengthened muscles. A chiropractor will help you become more aware of your posture. Individualized treatments including chiropractic adjustments will help to release pressure in tight, restricted and irritated joints balancing spinal mechanics and relieving pain.
So, go see your chiropractor! Or, if you’re from Aurora or York Region, come see me!
Maintaining poor posture for a prolonged period can lead to common muscle imbalances known as upper crossed syndrome and lower crossed syndrome, described first by Dr. Vladimir Janda. In these syndromes, there is a pattern of muscles that become relatively tight/short versus muscles that become weak/long. Unfortunately, with ageing, posture tends to decline. That being said, much improvement can be gained from posture retraining and rehabilitation exercises of the involved muscles.
Predisposing Activities Leading to Muscle Imbalance:
It appears that we are living in a flexion-addicted society. What this means, is that people tend to frequently stoop forward. This is seen in office workers and students who tend to sit at a desk for prolonged periods, slouching forward to see the computer screen. Students carrying heavy backpacks also tend to lean forward – the shoulders curve inwards and the head juts forward to counterbalance the load. Reclining on the sofa and driving in one’s car, people are frequently in a forward flexed position.
In the above examples, the muscle imbalances are seen between the front and back of the body. It is also possible to see muscle imbalance between left and right sides. Handedness contributes to this phenomenon because the dominant side is used more and becomes stronger. One-sided rotational sports (such as tennis, golf, hockey, baseball…) can also predispose an individual to this type of muscle imbalance.
Consequences of Poor Posture:
Most people don’t think about the impact that posture plays on overall health. Many people also don’t put two and two together and recognize that posture can be responsible for pain – yet they wonder why they have frequent headaches, neck pain, back pain and fatigue. Suboptimal posture inevitably leads to suboptimal loading of the spinal joints and stress and strain on muscles and ligaments which can contribute to pain and even arthritis over time. Below is a list of common negative consequences of poor posture.
pain in the neck, mid-back or low back
muscle spasm/tightness
decreased range of motion
fatigue
arthritis, due to uneven joint wear over time
increased risk for disc herniation (especially when poor posture is combined with exertion or repetitive flexion)
headaches (including migraines, tension headaches and cervicogenic headaches)
suboccipital pain
teeth clenching & TMJ problems
rib dysfunction
pinched nerves
reduced lung capacity
loss of overall height
poor appearance
reduced balance
reduced performance
poor digestion (due to compression of internal organs)
less energy, poor mood
As seen above, poor posture can impact one’s whole body and overall health. How do we correct this? The first step is awareness.
Optimal Posture:
Optimal posture is the posture that minimizes joint compression and shearing forces and minimizes muscle contraction necessary to stand upright. The body can carry the weight of gravity comfortably and efficiently. In general, there are two gentle backward curves in the spine (the cervical lordosis and lumbar lordosis) and a gentle forward curve in the mid-back (thoracic kyphosis). Having these gentle curves aids in shock absorption between joint surfaces as you ambulate. Deviations from normal (either excessive curvature or reduced curvature) can lead to problems. When visualizing the body in the side view, ideally the following structures should line up: the ear, the shoulder, the hip, the knee and the front of the ankle.
Upper Crossed Syndrome:
Upper crossed syndrome is characterized by the following muscle pattern.
Tightness: upper trapezius, levator scapulae, sternocleidomastoid and pectoralis muscles
Weakness: deep neck flexors, serratus anterior, middle trapezius and lower trapezius muscles
Lower Crossed Syndrome:
Lower crossed syndrome is characterized by the following muscle pattern.
Tightness: erector spinae (thoraco-lumbar), rectus femoris and iliopsoas muscles
Weakness: abdominals and gluteal muscles
Correcting Upper and Lower Crossed Syndromes:
Correcting upper and lower crossed syndromes can be challenging especially if they’ve existed for a long time. Patience and dedication are required to ultimately correct posture. In some people, posture can’t be fully corrected but with the following tips, improvements can be made and further declines can be prevented.
**Note: Poor posture, especially when accompanied with pain can sometimes be a sign of a deeper underlying condition (such as osteoporosis or rheumatological conditions). The following is for information purposes only and does not apply to everyone. Consult with a health professional before beginning any exercise program.
Posture Education: You must understand the importance of good posture and be conscious of your posture as you carry about daily activities. Actively correct yourself.
Avoid Prolonged Postures: If your work requires prolonged sitting, remember to get up frequently and walk around. In other words, take posture breaks at regular intervals. Sit up tall and do the Brugger’s stretch.
Stay Physically Active: Overall fitness and endurance helps improve posture and prevent declines. It is also good for overall health.
Corrective Exercises: Specific exercises to target the involved muscles are important. In general, tight/short muscles must be stretched and weak/long muscles must be strengthened. Endurance is just as important as strength.
CORRECTIVE STRETCHES A) Brugger’s stretch: Sitting tall with chin tucked back, lift chest and externally rotate arms back. B) Chin tuck: Tuck chin straight back and hold for several seconds. C) Forward lunge: With hands on hips and torso tall, lean forward to feel a stretch in the psoas. D) Pectoralis stretch: Staying tall, rotate shoulders and extend arms back. E) Quadriceps stretch: Pull heel to buttocks.CORRECTIVE STRENGTHENING A) Deep neck flexor exercise: Tuck your chin straight back and lift head 1 inch off floor. B) Bridge: Squeeze gluteal muscles then lift pelvis of floor to make a straight line. C) Plank: Resting on elbows, lift body off floor in straight line to strengthen abdominals. D) Scap T: Lying prone with pillow under forehead, lift arms up in ‘T’ position with thumbs pointed to ceiling to strengthen middle traps. E) Reverse fly: This is an alternative to D. Keep spine neutral, only bending at hips and knees. Holding light weights, bring arms back in ‘T’ position.
How Chiropractic Helps with Posture Syndromes:
Chiropractic care plays an important role in diagnosing and correcting postural problems. Chiropractic care helps relieve pain, improve flexibility, improve joint function and improve muscle balance. Chronic poor posture can lead to pain and arthritis. Muscle imbalance can lead to joint dysfunction and poor spinal alignment. Chiropractic care involves manual therapies to help put the body into better balance both mechanically and neurologically. Chiropractors can also prescribe exercises to balance the muscles and facilitate recovery and provide other holistic advice. Postural problems and related joint dysfunction do not appear overnight and will not disappear overnight. These issues require a program of care and dedication on the patient’s part too. Combining passive chiropractic treatment with home exercises leads to the best results.
Preventing Spinal Injuries:
Having good posture as you carry about your daily activities plays a critical role in prevention of spinal injuries. Having a strong core is also important.
It always amazes me how many people have postural imbalances and don’t even realize it! Many of them wonder why they have neck pain, back pain, headaches or general soreness without having any form of injury or trauma. A lot of the time, these problems are a direct result of irritation to muscles, joints or nerves from chronic, uncorrected imbalances in the body. Allow me to explain…
Some of the most common postural imbalances that I see are forward head carriage, excessive spinal curves, uneven shoulders or pelvis and scoliosis. These imbalances can arise from many different things such as daily activities, slips/falls, inactivity, daily stress, one-sided activities (such as golf or tennis) or poor posture habits (such as slouching). Posture imbalances can also sometimes originate at the feet which serve as one’s base of support. For example, if one or both arches collapse, it sets up an imbalance that will affect the alignment of related joints (like the knees, hips and pelvis). Everything is connected! In any event, body asymmetry over time can lead to uneven wear and tear to the body which can contribute to arthritis, muscle tension and tightness/restriction in spinal joints.
It simply makes sense that a body in balance will feel better, heal better and function better!
A Healthy Spine = A Healthy Body.
Standing posture, sitting posture and dynamic postures are all important. Inappropriate body posture/position while lifting, for example, can result in injuries.
Posture is a like a window to the spine. If your posture is off, so too is your spinal alignment.
Regardless of pain or symptoms it is important to have your posture imbalances and alignment corrected as a form of spinal health maintenance and overall wellness. You don’t have to have pain to have a problem and a lot of the time these asymmetries can be corrected before chronic uneven wear and tear results in pain. You only have one spine! So take care of the one you have! Regular chiropractic checkups can prevent problems before they start just like how regular dental cleanings can prevent cavities.
The great news is that many posture problems can be corrected or drastically improved with chiropractic care. Chiropractors use hands-on adjustments to correct the alignment and mobility of the spine, pelvis and related joints such that your body regains its mechanical and neurological balance. Soft tissue therapies and home exercises may also be incorporated into your care plan depending on individual needs.
Achieving mechanical balance is only half of the chiropractic story. Chiropractic care also helps to balance nervous system function. Spinal health is so important because it protects the nervous system which controls and co-ordinates every system and process in the body. For optimal health, we need optimal communication in the nervous system. This can be achieved by optimizing alignment of the spine.
Regardless of pain or symptoms, everyone should have their spine checked. Chiropractic works.
“The doctor of the future will give no medicine but will interest his patients int he care of the human frame, in diet, and in the cause and prevention of disease.” ~ Thomas Edison
Health is a lifestyle choice. Choose it. Make Chiropractic care a part of your healthy lifestyle.
Most of us appreciate that posture is important. Ideal posture means there is a ideal distribution of forces across different joints in the body and balanced muscle tone. Optimal posture will help you to not only feel great but also look great and exude confidence!
