Physio: Forward Head Posture puts strain on neck and upper back

FHP is essentially when your head starts creeping forward ahead of your shoulders, or a forward poking of the chin.

  • Nov. 11, 2013 5:00 p.m.

Have you noticed a little hump slowly developing on the base of your neck?

Are you noticing increased pain with activities like knitting, reading, driving long distances, and sitting at the computer?

These signs and symptoms may be manifested by an increasingly common problem called  Forward Head Posture (FHP).

FHP is essentially

when your head starts creeping forward ahead of your shoulders, or a forward poking of the chin. Some people can blame genetics and degeneration on this problem but a lot of us are guilty right from an early age through our bad habits.

The problem with FHP is that it places increasing shearing stresses on the joints and discs in the neck and upper back, and the forward shearing of the vertebrae closes down the foramen (holes) where the nerves come out. This of course leads to joint and disc pain, and possibly nerve impingement.

Habits are tough to change but can be reversed. Degeneration is irreversible but can be controlled through proper management.

First, try to maintain a relatively chin tucked posture during activities, that is keeping your chin towards your Adam’s apple.

This is a staple stretch we teach at physiotherapy. Gently tuck your chin a few times to your Adam’s Apple, holding for 10 seconds each time.

Imagine a string is pulling straight up on the back top part of your head as you tuck in.

This will help take your neck regularly out of the bad zone to reduce the potential for swelling build up in and around the nerves, joints or discs.

Here are some lifestyle changes you can make.

Take sitting at the computer for instance. Often the ergonomics of your workstation is a large reason for FHP.

Make sure the top of your screen is eye level, and straight in front. Your seat height should keep your hips, knees, and ankles at 90 degrees.

Keep the distance from the screen appropriate for your eyesight.

You may even need to get your eyes checked as you may be inherently poking forward to see the screen properly.

As for driving, make sure your seat height allows easy forward vision. It is common to get lazy on long drives and feel your head slumping forward.

Use your rear view mirror as a guide. If you are seeing the ceiling of the car an hour into a drive, you know you’re bobbing.

Try your best efforts with rest, ice, and maybe even anti-inflammatories (with your doctor’s recommendation). If the problem is still at large, there are some very beneficial things your physiotherapist can do to help.

Through a combination of manual joint and soft tissue manipulation, some of the secondary joint and muscle stiffness can be relieved.  Often traction, either manual or mechanical, is an asset in readily improving the problem.

Traction is a technique that every so slightly pulls the vertebrae apart with a goal of taking pressure off the nerve, disc, and joint space.

More importantly, the process of the foramen being slightly stretched open and relaxed creates a circulatory effect to help move swelling out of the region.

And lastly, if the pain and stiffness has been going on longer than eight weeks, IMS can be a very effective form of treatment in releasing neck compression caused by neuropathically tightened muscles.

Kevin Bos is a fellow of the Canadian Academy of Manipulative Therapists and co-owner of Sun City Physiotherapy.


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