I have been recently treating patients presenting with severe forward head posture. The situation is so bad that they have difficulty keeping their chins off their chest. They have been dealing with this situation for extended periods of time because the medical establishment has been unwilling or unable to identify the proper cause of this situation. As a result, some people have suffered from chronic neck pain while others had no pain but have had a major reduction in their ability to function. Not only do these people have difficulty holding their heads up to see, they also have a severe loss of neck motion from side to side. This can make important tasks like driving not only difficult but dangerous.
I have shown that this posture is actually fairly easy to resolve. The posture is a result of a muscle imbalance between the pecs, anterior deltoids and the biceps versus the interscapular muscles (mid traps and rhomboids), the posterior deltoids and the triceps. Due to the imbalance between these muscle groups, the pecs can shorten severely. This pulls the shoulders forward. With the shoulders being pulled forward, the shoulder blades move laterally away from the spine. Any muscle that attaches from the skull or the cervical spine to the shoulder blades become over stretched. This causes these muscles to lose their ability to create force because a muscle that is over stretched or shortened can no longer create as much force as when it is at its optimal length.
Since the upper traps and the levator scapula muscles attach from the skull and upper cervical spine to the shoulder blades, these muscles lose their ability to create force and perform their task of supporting the head. This makes it harder to hold the head up and that leads to the dysfunction associated with this posture.
The reason that neck rotation is affected by this posture is that once these muscles end up straining due to the improper length of the muscles and their inability to create their maximal force, the muscles have a tendency to increase their desire to shorten. This causes the muscles to pull the cervical vertebrae together creating a vacuum seal between them. The vertebrae can no longer move independently and therefore neck range of motion is diminished greatly.
To correct this situation, I incorporate three key actions. First, I massage the neck muscles and pec muscles. The neck muscles need to be loosened up so they can reduce the tension in them to allow greater motion of the cervical spine. The pec muscles need to be massaged and stretched to allow the shoulders to return to their correct position directly under the ear. This puts the shoulder blades in the correct position at the proper distance away from the spine which keeps the musles that attach from the shoulder blades to the spine and skull at their proper length.
Next I strengthen all the muscles at the upper back, shoulder and arm that can prevent the muscles at the front of the body to shorten creating the abnormal posture. These muscles include the mid traps, rhomboids, posterior deltoids and the triceps. The key is to make these muscles equally as strong as the pecs, anterior delts and biceps so that they cannot shorten.
Finally, I perform glides of the cervical vertebrae. This is a basic technique in which I apply mild force through the cervical spine to cause it to be realigned so that the ear is directly over the base of the cervical spine.
I have been able to achieve improvement in this extreme postural deficit in just 3 or 4 treatments. So it is clear that this issue is fairly easy to resolve with the proper treatment.
Don’t be swayed into being convinced that this postural deviation is the result of “aging” or a variation of the cervical spine. It is actually a muscular problem associated with an imbalance of the muscles that related to the shoulder and shoulder blade. You certainly don’t have to live with this situation and it is certainly not hopeless or something that should be tolerated as a part of life.