Journal of Novel Physiotherapies
Open Access

It is a very common postural deviation which is identified by examining the position of your head with respect to the cervical spine (CS). It is characterized by hyperextension of the head together with the upper cervical vertebrae accompanied by a forward translation of the lower cervical vertebrae.

It often co-exists with Upper Crossed Syndrome and is also associated with rounded shoulders, called kyphosis.

Head and neck of a person with FHP are noticed to be in front of their shoulders instead of resting directly above the shoulders and the person looks like if their head is hanging off the front of his shoulders.

As per study in 2014, when our head is hunched forward at an angle of 45°, the effective weight of our head on our spine increases from 10-12 pounds in the neutral position to 49 pounds. So, Forward head posture loads extra pressure to the muscles attached to the cervical spine which may increase risk of spinal degeneration. Also, a 2012 study says that FHP reduces balancing ability in people working on computers for more than six hours a day. This muscle imbalance may have further disastrous repercussions on various functions, health and life.

As our body tries to adjust in an efficient way to hold the head upright for straight-ahead vision so due to FHP, the length and strength of muscles of our upper back, neck and shoulder that support our head also gets changed. The muscles at the back of your neck gets elongated and weakened, while muscles at the front of your neck shorter and tightened. This posture is associated with weakness in deep cervical short flexor muscles (also called longus capitus and longus colli), cervical erector spinae (lower cervical and upper thoracic), lower trapezius, and rhomboids. Inactiveness of these muscles contributes to the inability cervical extensor, pectoralis minor muscles, suboccipital muscles, Levator scapulae, the upper trapezius scalenes, sternocleidomastoid. Overactivity of these muscles enables forward head migration, and rounding of the shoulders in some cases.

How it arises?

Day by day as we are speeding towards development, we are acquiring sedentary lifestyle and physical activity has reduced to very greater extent. Spending most of the time with the incorrect posture in front of Media devices such as Mobiles, laptops, computers are responsible for causing FHP.

As it arises due to prolonged bending towards a computer screen, or hunching over a laptop or cell phone, it is also called as “text neck” or “nerd neck”.

Person may feel pain across the side or back of the neck, as well as into the upper back, shoulder, and/or head. Due to being overworked or injury, etc., Muscles can become inflamed and tight.

This poor neck posture affects mainly neck muscles and cervical spine and causes neck pain, increase risk of strain and sprain in neck muscles and may also lead to extensive degenerative effects or incomplete or partial dislocation in the neck area further resulting in accelerated arthritis, upper back pain, decreased range of neck motion. It sometimes greatly impacts the respiratory function by weakening the respiratory muscles.

Other causes includes some occupations which require you to lean forward like carrying heavy backpack, sewing. It may be caused due to injury such as whiplash, sleeping by keeping head up too high, reading in bed, congenital malformation, etc.

How it can be fixed?

As this posture is formed in a long time, it may take some time to restore again but using the correct stretching and strengthening exercises would help in relieving pain and restoring proper posture.

To correct forward head posture, chin tuck exercise and chest stretches can be practised. This will improve ROM, restore elasticity to soft tissue in the cervical spine and reduce the strain caused by FHP.

Other than this, one needs to pay attention to head position and good posture while sitting and standing which will evoke better posture and would reduce the stress on the cervical spine. You can set a reminder so that it alerts you several times to check your posture and you remember to keep your head in correct posture.

Also, make sure to focus on something at eye level and not tilting your head up or down to focus while sitting or standing. So, arrange your workstation in a way which encourages you to keep your head aligned over your shoulders. Make use of headrest chair.

Avoid tiling or angling your head for long duration. Try to keep your ears aligned with your shoulders while standing. Try to keep your neck neutral rather than flexed forward while sleeping to better support the natural curves of the head and cervical spine.