Forward Head Posture (FHP)

One of the most common postural problems is the forward head posture (FHP).

Since we live in a forward facing world, the repetitive use of computers, TV, video games, trauma and even backpacks have forced the body to adapt to a forward head posture. Repetitive movements in a certain direction will strengthen nerve and muscle pathways to move that way more readily.

An example would be the adaptation of the body to do gymnastics easily after repetitive practice. It is the repetition of forward head movements combined with poor ergonomic postures and/or trauma that causes the body to adapt to forward head posture.

Ideally, the head should sit directly on the neck and shoulders, like a golf ball sits on a tee. The weight of the head is more like a bowling ball than a golf ball, so holding it forward, out of alignment, puts a strain on your neck and upper back muscles. The result can be muscle fatigue and all too often an aching neck.(4) Because the neck and shoulders have to carry this weight all day is an isometric contraction, this causes neck muscles to lose blood , get damaged, fatigue, strain, cause pain, burning and fibromyalgia. When spinal tissues are subject to a significant load for a sustained period of time, they deform and undergo remodeling changes that could become permanent. This is why it takes time to correct FHP. In addition, FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis.(5) This abnormal position is also responsible for many tension headaches, often termed cervicoogenic headaches.

FHP also causes tension in the TMJ (temperomandibular joint) or jaw joint, leading to pain, headaches and bite problems. Some evidence exists that postural positions can affect the nerve tissue by altering blood flow to the spinal cord.(6) People with uncorrected FHP can potentially suffer chronic or unpleasant conditions such as, pinched nerves and blood vessels, like thoracic outlet syndrome, muscle and tissue pain, syndromes like fibromyalgia, chronic strains and early degeneration and arthritis.

FHP is relatively easy to detect. Have the person you are checking look up at the ceiling, down at the floor and then straight ahead. Find the center of the shoulder and draw an imaginary line up. It should land through the middle of the ear’s hole (external auditory meatus). Any forward head posture should be immediately checked by a chiropractor. The forward and backward curves of the spine are referred to as lordosis and kyphosis respectively. Lordosis is present in the cervical and lumbar regions of the spine, while kyphosis is present in the thoracic spine.

These curves are normal and are present to assist the spine in absorbing and dissipating the forces entering into the system from above and below.

In some cases, these curves can be lost, as is typically seen in the cervical spine following a whiplash injury where the cervical curve becomes straighter, while in other cases the curves can become more exaggerated as is sometimes seen in the thoracic spine.

Lordosis or Hyperlordosis

Lordosis is an exaggerated lumbar curve in the spine. To put it another way, the lower back curves inwards more than it would naturally do.

The spine needs a natural curve to function correctly. This is due to the shape of the individual bones of the spine (vertebrae). If the curve becomes too great then stress is placed on other parts of the spine causing pain.

Causes of Lordosis?

Some muscles around the hip and spine become tight and some become weak and stretched, causing an imbalance. This is often known as a lower crossed syndrome. This is due to the position of the tight and weak muscles. If you drew a line from the tight lower back to the tight hip flexors and then another line from the weak abdominals to the weak hamstrings and glutes, the two lines would form a cross shape.

The muscles that are often tight are:

  • Trunk extensors (erector spinae and quadratus lumborum).
  • Hip flexors, in particular the iliopsoas muscle.

These muscles require stretching.

The muscles that are often weak and stretched are:

  • Abdominal muscles (rectus abdominus, internal oblique and external oblique)
  • Hip extensors (hamstrings and gluteus maximus).

These muscles require stabilization. Your chiropractor will help you find the exercises and stretches best suited for your particular condition.

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