Forward head posture is a condition that occurs when the head and neck protrude too far in front of the body. This condition occurs as a result of tight and/or weak muscles, and poor postural habits. In addition to its aesthetic drawbacks, forward head posture can lead to painful muscles, headaches, and even pinched nerves. However, it is possible to improve this posture over time by being mindful of the position of your head, as well as utilizing several simple exercises to strengthen your muscles to keep you in proper alignment.
Forward head posture (FHP) occurs when the head (cranium), which rests on the cervical (neck) vertebrae, becomes positioned too far in front of the rest of the body. The resulting stooped posture leads to tightness and pain in the neck muscles. If left uncorrected, the head will move further and further forward, making the back take a hunched shape. However, if identified early, the condition is correctable with several postural adjustments.
To determine if you have FHP, stand in your normal stance, and have a friend take a picture of you from the side. If you have FHP, your ears will be forward (anterior) of the shoulder seam of your shirt, and your chin will be pointed forward instead of down.
A person suffering from FHP may experience tightness in the neck, and soreness and tenderness in the upper back muscles. This tight feeling can cause anything from mild discomfort to unbearable pain. Some sufferers notice radiating pain to the head and down the arms. If you experience tingling or numbness in the face or arms, contact your medical professional, as this can be a sign of a pinched nerve.
In FHP, as the chin and head slowly shift forward, the muscles shift to adjust to and support this new head position. The vertebrae of the neck thereby stiffen, making neck movement painful and increasing the difficulty of adjusting the head back to an aligned position.
In FHP, as the head slowly tilts forward, gravity pushes the head down into the chest, instead of down into the vertebrae upon which it should rest. This causes the head to bow down toward the chest, which in turn pushes the eyes and face down. Regardless of the position of the head, the brain automatically centers the eyes ahead of the body, forcing the head to crane upward. Consequently, the neck muscles support the head all day against the force of gravity, instead of the head resting on the bony vertebrae supports that nature intended. As a result, the neck muscles become exhausted from holding the head up all day.
This postural change can be the result of spending excessive time looking at a computer screen while seated at a desk, driving for prolonged periods of time, looking through a microscope, or just sleeping with too many pillows. It is often referred to as a “modern” condition because it has become more prominent with the increased use of computers and cell phones.
- Look up! Most people spend a disproportionate amount of time looking down at the floor or at their computer screen. When walking down the street to go to lunch, or even down the hall to make copies, challenge yourself to set your gaze just above the horizon. This simple change will remove excess tension on the neck and start to train your muscles back into better alignment.
- Take breaks. If you spend most of your workday staring at a computer screen, take short breaks. Don’t worry; you don’t even have to stand up for this. Simply take your eyes off the screen and look at the space above your computer. Keep your gaze up while simultaneously making triple chins—lower the chin slightly and draw it back toward the neck. Hold this position for 3 to 5 breaths before getting back to work. Start by doing this 3 times each day. You can gradually increase the number of times you take breaks any time you start to feel neck or shoulder pain.
- Lower your pillows. You can fix your forward head posture while you sleep! If you typically sleep with 3 or more pillows, see what it would feel like to eliminate just one. Once you feel used to sleeping with one less pillow, try eliminating another one. Ideally, you’ll get to the point where you only need one. If eliminating a pillow is too much, try a softer pillow on top. Considering that the average person sleeps for 7 to 9 hours each night, that’s a huge chunk of time you can be fixing forward head posture without doing any work!
1. Soften the Base of Skull. The base of the skull is the back of the head where the head and neck meet. This is where the spinal cord connects to the brain. When the muscles at the base of the skull are overworked, the chin may protrude forward. Aligning the head atop the spine and softening the muscles at the base of the skull will ensure your head and neck are in proper alignment, thus reducing the risk of developing forward head posture. To Soften the Base of Skull, place finger pads at the base of the skull, set your gaze slightly above the horizon, and pull the chin back as if making double, triple, even quadruple chins! Imagine the base of the skull opening east and west. Use your hands to notice how the neck muscles feel during this exercise. Moving the head back into alignment over the spine relaxes the neck muscles and clears the passage for the spinal cord, decreasing tightness in and around the area, alleviating pain, and ultimately preventing future pain. Set an alarm to practice this exercise 3 times each day. In everyday life, you can Soften the Base of Skull while waiting in line at the grocery store. Set your gaze high toward the cashier. Keep your gaze high, but then pull the chin back in line with the neck. Take a few deep breaths.
2. Align the Shoulders. Just as forward head posture can lead to shoulder misalignment, shoulder misalignment can be a precursor to forward head posture. When the shoulders round forward and the spine slumps, the chin naturally juts forward. To Align the Shoulders, first pull the collarbones wide—create width between the outer tips of the shoulders without compromising the space between the shoulder blades, then push the shoulder blades down toward the feet, creating space between the shoulders and the ears. In everyday life, you can Align the Shoulders while carrying a heavy bag. Instead of letting your shoulders slump under the weight of the bag, stand tall and pull your collarbones wide. Then let the pressure of the bag’s strap remind you to push your shoulder blades down your back toward your feet.
3. Anchor the Hips. In order to support proper neck and shoulder alignment, it’s important to have core stability. The hips are such a heavy bone structure that if they are out of alignment, it can throw off the alignment throughout your entire body. To Anchor the Hips, make “L” Mudra with your hands. Place your thumbs on your ribs and your index fingers on your hips. The space between the thumbs and the index finger is called the side body. This area shortens when you slump or slouch. Increase the space between the index fingers and thumbs to lengthen the side body. Now, draw the lower belly—the space between the belly button and the pubic bone—back toward the spine and up toward the ribcage to engage the deepest layer of abdominal muscle (transverse abdominis). Finally, release the glutes (butt muscles). To learn to release your glutes, it may help to understand what it feels like to do the opposite—grip the glutes. To grip the glutes squeeze them together. Now release. In everyday life, you can Anchor the Hips when standing up from a chair. Before rising, lengthen the side body. On an exhale, Ground the Feet, and simultaneously pull the belly in toward the back and up toward the ribcage and release the glutes to stand.
Stretch it out. Forward head posture leads to excessive tightness in many of the muscles in the neck, shoulders, and chest. Stretching tight muscles helps to make space for the bones to find proper alignment. Always start a stretching sequence with a warm up. Focus on warming up the shoulder and neck joints with simple mobilizing exercises, like shoulder rolls and head circles. Then implement a stretching routine focused on the trapezius, suboccipital muscles and pectorals. Ideally, stretching takes place after movement. This is why it’s best to precede stretching sequences with a warm up. Movement increases blood flow to the muscles for a safer stretch. This is often referred to as stretching “warm” muscles. The increased blood flow from movement raises the temperature in the muscle so it is literally warmer. Plus, the blood flow boosts the oxygen supply to the body and causes the muscle fibers to have greater flexibility. So, contrary to what many of us were taught, there is no need to stretch before exercise. When you stretch a “cold” muscle, the muscle fibers are less flexible. So, not only is the stretch limited, the muscle is more susceptible to injury.