Forward Head Syndrome

Why is it that we continue to move through life with forward heads? This includes everyone!

Forward head is the “chronic contraction of the suboccipital muscles”, which pull the back of the head toward the upper neck and back. Forward head pulls the spine out of alignment, compresses joints and nerves, compromises respiration, causes headaches, leads to poor concentration and restricts nerves and blood vessels that supply the hands, leading to numbness and tingling. This posture decreases the curve of the cervical spine, rounds the shoulders, displaces the first rib and jaw, contributes to core weakness and inhibits the gluteal muscles.

Is this just an inevitable by-product of our device-dominated lives? Will we all eventually evolve into creatures with eyes on our foreheads?

Obvious causes of forward head are use of computers, slouching, prolonged sitting and carrying heavy bags or backpacks. Other causes include habitual sleeping positions, poor respiration, poor vision or hearing, faulty exercise habits (treadmill head, overemphasis on anterior muscles), tight fascia, emotional issues, motherhood and trauma.

All of these need to be identified and addressed. We also need to look for compensatory patterns in the body. Forward head may or may not be accompanied by thoracic kyphosis. Other compensations may include shoulders pulled posteriorly, with the back muscles held in constant tension—most common in men—or the ribcage thrust forward, causing tightness in the low back extensors—most common in women.

Obviously, a strong powerhouse is the foundation of good posture and supports the spine as it bears the weight of the upper body. We hear “scoop the abs, navel to the spine, etc…” but do we really make sure we are working the Transverse Abdominis properly? Common errors such as a posterior tilt of the pelvis into the mat or bulging abdominals compromise building strength in the Transverse Abdominis, which is the deepest abdominal layer.

The neck is one of the four hypermobile hinges of the body. Care must be taken to not move from the hinge of the neck but rather from a supported cervical spine. The deep back and neck muscles help us to safely flex our necks and time must be taken to strengthen these. Sometimes cues such as “chin to your chest” or “eyes on the belly”—while useful cues—can provoke a hinge rather than a lengthened curve.

When working in forward flexion, keep the upper end of the sternum up and out. This releases the shoulder girdle and allows the head to find its place on the spine. Remember to support the neck, as well.   “Fill the space” with a rolled towel or cushion. When in supine position, it isn’t enough to “lower the chin.”  Instead use the fundamental Head Nod, patterning a lengthening that will, over time, release the suboccipitals.

In ideal posture, the head should have a sense of “floating” above the spine, able to move with ease and little effort. Pay attention to the eyes, especially when looking at a screen (like right now!) Don’t let them “grip” the screen. When you grasp the world with your eyes or when tension in the jaw interferes with the delicate balancing of your head by your suboccipital muscles, you misuse your head to stabilize yourself.

Our goal should be to work to unravel the causes and habits that bring us in to forward head.  We will then be closer to finding our optimum posture and function.