FHP – The Damaging Effects of Forward Head Posture

It is becoming more and more evident how posture is affecting overall health. "Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the functions most easily influenced by posture. The corollary of these observations is that many symptoms, including pain, may be moderated or eliminated by improved posture." 1

Forward head posture (FHP) is one of the most common postural problems. Many cultural and environmental influences have forced our heads forward: frequent use of computers, Television, traumas, video games, and even back packs. When the body repeats a movement, the nerve and muscle pathways strengthen, therefore making it easier to repeat that movement.2-3 Poor ergonomics combined with repetitive forward head movements often is the cause of the body adapting a forward head posture.

Balance: A Golf Ball Resting on a Tee

In an ideal body, the head sits directly on the neck and shoulders, just as a golf ball balances on a tee. If it is held out of alignment in a forward position, the weight of the head (more like that of a bowling ball) puts strain on neck and upper back muscles. An ache in the neck and muscle fatigue is the result.4 Those with FHP commonly suffer from tension headaches.

If your head weighs 10 lbs and your head sits directly over the center of the shoulder, the weight on the spine and tissues is only 10 lbs. But, a forward head posture causes the weight to increase. Every inch the head is forward, the weight load on your spine increases 10 lbs! That means, if your head is 3 inches forward of it’s balanced alignment center on the shoulders, the weight of your head on your spine, shoulders and neck is 30 lbs. 10

Carrying the weight of your head out of alignment all day causes neck muscles to lose blood, creating damage, fatigue, strain, pain, burning and fibromyagia. "F.H.P leads to long term muscle strain, disc herniations, arthritis, and pinched nerves," according to the Mayo Clinic Health Letter.4 Extra load on your spinal tissues for a length of time causes deformation and permanent remodeling. Also, FHP can cause the normal neck curvature to flatten which compresses the discs and damages structure leading to early arthritis.5 There is some evidence that postural positions can adversely effect nerve tissue by altering blood flow to the spinal cord.6 Therefore, reversal of FHP takes time. Those who suffer from uncorrected FHP often have chronic or unpleasant conditions like pinched nerves and blood vessels, thoracic outlet syndrome, muscle pain, fibromyalgia symptoms, strains, early spinal degeneration and arthritis. 7-14 If you have tension in your temperomandibular joint (TMJ) or jaw, leading to headaches, pain and bite problems, it could be caused by FHP.

Common Causes

Backpacks

It’s alarming to think that children now carry backpacks weighting up to 30-40 lbs! The effects of wearing a backpack forces the head forward as counterbalance for the weight. This results in abnormal stress to the discs, joints, nerves and muscles in the neck, shoulders and lower back.

Ergonomics and Computers

The primary contributors to FHP are a computer screen set too low and repetitive motions of the head forward to read the screen.

TV and Video Games

Children using poor posture to watch TV and play video games can cause early FHP. Sitting in one position continuously and repetitively for long periods of time causes the body to adapt to bad posture.

Trauma

Whiplash from a fall, accident or trauma results in muscle imbalance. Muscles pull the spine out of alignment and force the head forward.

Detecting and Correcting FHP

Detecting FHP is quite easy. When checking out a person, have them look up at the ceiling then down at the floor, and then straight ahead. From the center of the shoulder draw an imaginary line straight upward. This line should land through the middle of the ear’s hole. If you detect FHP, by noticing the misalignment of the head in a forward position, it should immediately be checked out by a chiropractor. Medical doctors are not trained to fix and do not fix these type of problems. "Despite considerable evidence that posture affects physiology and function, the significant influence of posture on health has not been addressed by most physicians." 1 Long term postural problems, like FHP will cause spine and nerve damage. Remember that symptoms are rarely present early on.

Steps to Correcting FHP

1. The first step toward correction is identifying and examining the exact measurement of FHP. During an exam and X-Ray by a chiropractor, the examines will establish the extent of the FHP and what is the specific corrective care program for your symptoms. Along with adjustments and special exercises, the chiropractor will point out poor ergonomics and other contributing factors for FHP and help with solutions.
2. Correcting your video and computer monitor will be important. Place the monitor so the top third of the screen is even with your eyes and the screen is 18" – 24" away from your face. Add lower back support. Children who sit on the floor looking up will need a floor pillow armchair and instructions on sitting up straight.
3. Every 20 – 30 minutes, sit up straight and pull the neck and head back over the shoulders. Do 15-20 reps, holding each for a count of 3. Or you can try standing against a wall with a small pillow under the midback. Bring your head back to touch the wall, hold for 3 sec, and do 20 – 25 reps.
4. When driving or sitting, always use a lower back support pillow. When the lower back is supported, the head and neck will move back over the shoulders.
5. An at home exercise to try: lay face down on the floor and bring your head and shoulders up, then pinch your shoulder blades together. Hold for a 3 count and do 15-20 reps.
6. When wearing a backpack, it should be a maximum of 15% of your weight. Never wear it over one shoulder. Use the waist belt whenever possible and a chest belt if available to spread the load over more than just the shoulders. Without the belts, your head will move forward to compensate for the load. A new type of backpack, with an airbladder, has been shown to significantly reduce weight without a strap.

Choose Good Posture

Checking and maintaining posture requires a lifetime commitment to wellness. With a little effort and a chiropractor on your healthcare team, you can look forward to a future doing the things you love to do instead of suffering from damage and degeneration that poor posture can bring.

Bad Back Linked to Driving Posture

From the October 10, 2003 BBC News comes a report that urges people to be aware of their posture while driving.  Whether in Britain or in the United States, people spend much of their lives driving.  The article notes that poor posture while driving contributes to spinal problems.  According to the British Chiropractic Association, (BCA),  32,000 people each month visit one of the BCA members with a back problem related to poor driving posture.

Dr. Tim Hutchful, from the BCA, says that people who sit incorrectly in car seats are asking for trouble. He said: "There is almost twice as much pressure on your back when you are sitting incorrectly than there is if you stand up." He goes on to state, "Those most at risk are the people who not only spend long periods of time in the car, but also those who make infrequent short journeys in the car, because it can be compared to an unaccustomed form of exercise."

The BBC article concludes with a list of tips for proper driving posture from the British Chiropractic Association.  These are:

• Relaxing at the wheel: A relaxed driving position reduces stress on the spine
• Always adjusting the seat when you enter the car
• Taking regular breaks from driving - once every two hours or so
• Clench your buttocks if stuck in traffic - add some side bends and shoulder shrugs if possible
• Unload items off the back seat from the back doors of the car, rather than the front
• Don't wear tight clothes while driving