The Damaging Effects of Forward Head Posture

Forwarded Head Posture (F.H.P.)

The effects of posture on health is becoming more evident.  "Spinal pain, headache, mood , blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture.  The colorally of these observations is that many symptoms, including pain may be moderated."

[John Lennon, BM, MM, C, Norman Shealy, MD, Roger K. Cady, MD, William Matta, PhD, Richard Cox, PhD, and William F, Simpson, PhD.  Postural and respiratory Modulation of Autonomic Function m Pain and Health , AJPM Vol. 4 No. 1 January 1994]

One of the most common postural problems is the forward head posture (FHP). since we live in a forward facing world. the repetitive use of computers, TV, video games, trauma, and even backpacks have forced the body to adapt to the forward head posture.  Repetitive movement sin a certain direction will strengthen nerve and muscle pathways to move that way more readily.

[Restak, R.M. 1979  the Brain: The Last Frontier , NY, Warner Books; The Laws of Fasciculation, Portland's Medical Dictionary, Dorkonos.]

An example would be the adaptation of the body to do gymnastics easily after repetitive practice.  It is the repetition of forward head movement combined with poor ergonomic posture and/or trauma that caused the body to adapt to a forward head posture.

Ideally, the head should sit directly on the neck and shoulders like a golf ball sits on a tee.  The weight of the head is more like a bowling ball than a golf ball, so holding it forward, out of alignment, puts a strain on your neck and upper back muscles.  The result can be muscle fatigue and, all too often, an aching neck.

[Mayo Clinic Health Letter, March 2000, Vol. 18 #3]

Because the neck and shoulders have to carry this weight all day in an isometric contraction, this causes neck muscled to loose blood, get damages, fatigue, strain, cause pain, burning and fibromyalgia.  When spinal tissue are subject to a significant load for a sustained period of time, they deform and undergo remodeling changes that could become permanent.  this is why it takes time to correct FHP.  In addition, FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage, and early arthritis.

[Gore DR, Sepic SB, Gardner GM.  Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986; 591-694]

This abnormal position is also responsible for many tension headaches, often termed cervicogenic headaches.

According to Renee Calliet, M.D., "If the head weights 10 lbs and the center of the ear sits directly over the center of the shoulder, the load on the spine and its tissue is only 10 lbs.  However, if the head is translated forward, its weight will increases by 10 lbs. for every inch forward it is in. In effects, if the center of the ear is 3 inches forward from the center of the shoulders, the weight of the head on the spine and its discs, joints, and nerves is 30 lbs.!"

[Caillet R.  Soft Tissue Pain and Disability.  Philadelphia: FA Davis Co., 1977]

Back to Top 

FHP is relatively easy to detect.  Your chiropractor will have you look up at the ceiling, down at the floor, and then straight ahead.  He will then find the center of the shoulder and draw an imaginary line up.  It should land through the middle to the ear's hole (external auditory meatus).  Any forward head posture will be immediately checked by your chiropractor.  Medical doctors do not fix these types of problems.  "Despite considerable evidence that posture affects physiology and function, he significant influence of posture on health is not addressed by most physicians." Remember, long standing postural problems like FHP will cause spine and nerve damage, and symptoms are rarely present early on.  

[John Lennon, BM, MM, C, Norman Shealy, MD, Roger K. Cady, MD, William Matta, PhD, Richard Cox, PhD, and William F, Simpson, PhD.  Postural and respiratory Modulation of Autonomic Function m Pain and Health , AJPM Vol. 4 No. 1 January 1994]

Back to Top 

FHP also causes tension in the temperomandibular joint (TMJ) or jaw joint, leading to headaches, pain, and bite problems. Some evidence exists that postural position can effect the nerve tissue by altering blood flow to the spinal cord. 

[Adams CBT, Logue V.  Studies in cervical spondylotic myelopathy Part 1: Movements of the cervical roots, dura and cord and their relation to the course of the extrathecal roots. Brain 1971:  94:557-568]

People with uncorrected FHP can potentially suffer chronic or unpleasant conditions, such as pinched nerves and blood vessels, like thoracic outlet syndrome, muscle and tissue pain, syndromes like fibromyalgia, chronic strains, and early degeneration and arthritis.

[Donelli R. Wooden M. Orthopedic Physical Therapy, New York: Churchill Livingstone Inc., 1989; Caillet R. Low Back Pain Syndrome, Philadelphia: FA Davis Co., 1977; Reilly B. Practical Strategies in Outpatient Medicine. Philadelphia: WBV Saunders Co., 1984; Lee D. Principles and practices of muscle energy and functional techniques. In: Grieve GP (ed.) Modern Manual Therapy of the Vertebral Column. New York: Churchill Livingstone, 1986; Bourdillon JF, Day EA, Boohour MR. Spinal Manipulation. Oxford: Butterworth-Heinemann, 1991; Lewit K. Manipulative Therapy in Rehabilitation of the Locomotor System. Oxford: Butterworth-Heinemann, 1991.]