Back & Neck Pain Exercise Overview of Forward Head Posture By Anne Asher, CPT facebook linkedin Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial process Anne Asher, CPT Medically reviewed by Medically reviewed by Laura Campedelli, PT, DPT on September 19, 2020 linkedin Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Review Board Laura Campedelli, PT, DPT Updated on September 29, 2020 Print Table of Contents View All A Postural Deviation Medical Terminology Muscle Group Imbalance Kyphosis Correction and Treatment Risk Factors 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 well be fostering a long-term problem known as forward head posture. Maintaining forward head posture can strain muscles of the neck, leading to pain and even worse neck posture. Blend Images / Hill Street Studios / Collection:Brand X Pictures / Getty Images A Postural Deviation Theoretically, 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, looking at the body from the side. Forward head posture is considered a deviation because the head varies from that reference line. 5 Effective Exercises to Correct Your Posture 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 cervical spine, or 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." Injuries of the Cervical Spine 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 front of your neck will become shortened, while the ones in the back will be lengthened, weaker, and strained. Kyphosis Forward head posture often results from yet another posture issue called kyphosis. Kyphosis is a clinical term for a posture in which your shoulders and upper back round forward. (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 thoracic spine) supports the neck and head. When the thoracic spine moves or changes its position, under most circumstances, your head and neck will follow. Most of the head’s weight is in the front, and this contributes to the forward movement as well. To be able to see, you then lift your head. How Dorsal Kyphosis in Your Back Is Measured 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 as neck muscles, in general, can get extremely tight and prevent you from doing your exercises fully. Stretching your neck may also relieve pain. If your neck gives you a lot of pain, or if you are not sure how to get started with a neck exercise program, consult with your doctor. Your doctor will include a postural assessment as part of your diagnosis because it will likely inform your treatment plan. You should only work with a qualified practitioner when addressing your forward head posture. Examples are an MD such as a physiatrist, a physical therapist or an athletic trainer or body worker 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 MD. Causes of Back and Neck Pain Risk Factors Almost all of us are at risk for forward head posture. Computer use strongly encourages rounded shoulders and upper back, and therefore forward head posture; it is a significant risk factor. Driving for a living (or for many hours at a stretch) is another risk factor. Habits such as reading in bed with a pillow propped under your head may also contribute to forward head posture. Doing close work requiring manual dexterity and eyesight acuity can raise your risk, too. If you are a seamstress, an electronic technician, or you have an occupation in which you are positioned similarly, this means you. And if you regularly carry a significant amount of weight in front of your body you may be developing kyphosis which, as we've seen often leads to forward head posture. An example of this is if you tend to carry your child or another load in front of your body. Possessing very large breasts may also increase your risk for kyphosis and forward head posture. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012;36(1):98–104. doi:10.5535/arm.2012.36.1.98 Kim DH, Kim CJ, Son SM. Neck pain in adults with forward head posture: Effects of craniovertebral angle and cervical range of motion. Osong Public Health Res Perspect. 2018;9(6):309–313. doi:10.24171/j.phrp.2018.9.6.04 Szczygieł E, Sieradzki B, Masłoń A, et al. Assessing the impact of certain exercises on the spatial head posture. Int J Occup Med Environ Health. 2019;32(1):43-51. doi:10.13075/ijomeh.1896.01293