Spotlight on Posture – Forward Head Posture


Forward head posture (FHP), or ‘text neck’ is a common posture issue we see in the clinic that can have a number of painful follow on effects. Fortunately, with some simple exercises and awareness of posture this can be significantly improved.

What is forward head posture?

In ideal head and neck posture the mid-line of the ear is directly over the mid-point in the shoulder and torso. In (FHP) posture the head sits forward of the neutral position, so in front of the mid-line of the torso.

In this image we can see forward head posture on the right, with the ear sitting in front of the midline of the body, there is improved alignment in the image on the left, with the middle superimposed image highlighting the differences

Why is this a problem?

When structures are not sitting in a neutral alignment it changes the forces going through the joints and it also means there is an imbalance in the muscle activity in the area and increased compression in the neck structures. This can cause:

— Headaches

— Neck discomfort and pain

— Muscle tension in the neck and shoulders

— Tension and pain in the mid-back and chest

— When severe or long standing, it can cause cervical disc issues, pain, pins and needles and numbness in the arms and hands

What’s happening anatomically?

— Hyperextension upper cervical (neck) vertebrae

Muscles becoming short and tight:

— suboccipitals

— scalenes

— sternocleidomastoid

Muscles becoming weak and inhibited:

— deep neck flexors

— lower cervical extensors

Why does this happen?

Usually poor posture! Have a think about what positions you are sitting in. When working at a desk, do you have it setup for you, take regular breaks and sit tall in your chair? At home, do you sit on the couch texting? Or with your laptop?

The body and posture changes according to the forces and positions that it habitually rests and moves in. If you are consistently sitting with your head poking forwards, over time this changes the way the muscles are balanced in the neck, with some becoming tight and others long and weak, and leaving you with forward head posture.

Do I have FHP?

You can check by taking a photo of yourself side on or asking a friend to check for you. Another way to check is to stand with your back against a wall. Have your pelvis and shoulder blades touching the wall. Does the back of your head naturally touch the wall? If not, you likely have forward head posture.

What can I do about it?

One great exercise to do is the chin tuck. This exercise strengthens the deep neck flexors at the front of the neck whilst stretching through the suboccipitals at the base of the skull.

Check out Rhiannon’s demonstration of the chin tuck below

Working on improving general mobility of the neck and shoulders is also important if you have FHP, as the change in biomechanics can create general tension in this area. FHP is also closely related to some other postural imbalances, such as rounded shoulders or upper crossed syndrome, and many people will have more than one postural abnormality. Check out our previous post on rounded shoulders.

Check out Mary’s video below on stretching through the neck.

By incorporating the chin tuck exercise into your daily routine you will see an improvement in the position of your neck and shoulders. If you spend long hours at a desk, it is worth learning more about setting up your workstation ergonomically to really improve your posture and reduce any episodes of pain and restriction. You can check out our blogpost on desk ergonomics here and our blogpost on other tips to make your workspace more comfortable here.

For more specific advice about you posture or any other musculoskeletal complaint, give us a call or book online to see one of our Osteo’s or Remedial Massage therapists.

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