Overview of Forward Head Posture

Neck pain is often accompanied by misalignment in the area between your shoulders and head. If you sit at a computer for hours on end, or you drive for a living, you may be fostering a long-term problem known as forward head posture. Maintaining a forward head posture can strain neck muscles, leading to pain and worsening neck, shoulder, and back posture.

A Postural Deviation

Your head is in a good alignment with your neck when your ear lines up exactly with the gravity line. The gravity line (also called plumb line) is an imaginary straight line representing the downward pull of gravity. It is used in posture assessments as a reference for noting the positions of body parts and determining the presence of any postural misalignment or deviation.

A forward head posture occurs when the head is positioned forward of this gravity line when looking at the body from the side. Forward head posture is considered a postural deviation because the head varies from that reference line.

Medical Terminology

Here is a slightly more technical description of forward head posture. This is forward head posture from a clinician’s perspective: "Certain daily activities such as prolonged computer use may increase neck flexion (flexion means bending forward). Usually, the lower part of your neck (called the lower cervical spine, or lower c-spine for short) is the area that flexes most. The upper c-spine extends (bends backward) as you lift your head to be able to see."

Muscle Group Imbalance

Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. The muscles in the back of your neck will become shortened and overactive as they flex forward, while the ones in the front will be lengthened, weaker, and strained as they relax.

Kyphosis

Forward head posture often results from kyphosis, which is rounding forward of the shoulders and upper back. There are several types of kyphosis. You may know kyphosis by its less flattering nickname, hunchback.

When the shoulders round forward, as they tend to do after many consecutive hours sitting at a desk, computer, or at the wheel, the head is also brought forward. This occurs because the upper back area (called the thoracic spine) supports the neck and head. When the thoracic spine moves or changes its position, your head and neck will typically follow. Most of the head’s weight is in the front, and this contributes to the forward movement as well.

If you have kyphosis, your shoulders hunch forward, and you have to lift your head to be able to see. be able to see.

Correction and Treatment

Standing and sitting with good posture, along with exercises to strengthen your neck, may help get you back in alignment. Stretching may also help if the neck muscles are tight, which can prevent you from doing your exercises fully. Stretching your neck may also relieve pain.

If your neck gives you a lot of pain, consult with your healthcare provider. Your practitioner may include a postural assessment as part of your diagnosis.

You should only work with a qualified practitioner for managing your forward head posture. Examples are a physiatrist physician, a physical therapist, or an athletic trainer with experience and advanced education in posture and neck issues. Be sure any allied or holistic health provider you work with is in communication with your doctor.

Risk Factors

Almost all of us are at risk for forward head posture.

Common risk factors:

• Computer use strongly encourages rounded shoulders and upper back, and therefore forward head posture.
• Driving for a living (or for many hours at a stretch) causes prolonged back, neck, and shoulder positions.
• Habits such as reading in bed with a pillow propped under your head may also contribute to forward head posture.
• Doing work that requires manual dexterity and close-up positions, such as if you are a seamstress, or an electronic technician can cause you to position your neck forward

And if you regularly carry a significant amount of weight in front of your body, you may be developing kyphosis. An example of this is if you tend to carry your child or another load in front of your body. Very large breasts may also increase your risk for kyphosis and forward head posture.

A Word From Verywell

Forward head posture is a common problem. If you have developed it, or if you are at risk, it's important that you get medical attention so you can prevent complications, such as chronic neck pain or a pinched nerve. You can continue to do the work that you need to do, but you may need some postural adjustments so you won't continue to strain your neck while you work.