Forward Head Posture

I didn’t know what “Forward Head Posture” was until a few weeks ago when I gave an introductory Alexander Technique lesson to a chiropractor.

I wanted him to stop compressing his neck but he complained that the orientation I wanted instead was “Forward Head Posture.”

When the head is balanced on top of the spine, movement and breathing are going to be much freer than when the head is not balanced on top of the spine. When the head tips forward or back, the pull on the spine is going to be up to four times the normal.

You can see this by holding up a book directly above you and then compare the effort it takes to do that versus holding the book out from you. Holding ten pounds straight up will take little effort for most of us, but holding ten pounds straight out from our body is going to cause strain for most people after a minute or so.

According to Wikipedia: “Forward head posture is the anterior positioning of the cervical spine. It is a posture problem that is caused by several factors including sleeping with the head elevated too high, extended use of computers, lack of developed back muscle strength and lack of nutrients such as calcium. [1] This posture is sometimes called “Scholar’s Neck” or “Reading Neck.”
Individuals who display this posture are often associated with geek culture due to the awkward appearance that is caused when moving.”

According to

In the poster on the left, the first sketch (top-left) represents “perfect” head posture. A line dropped from the center of the external auditory meatus (EAM) would land directly in the center of the shoulder (the tip of the acromion process). The graphic on the right demonstrates the progression of forward head posture (occasionally referred to as “anterior head translation”).

According to Kapandji (Physiology of the Joints, Volume III), for every inch your head moves forwards, it gains 10 pounds in weight, as far as the muscles in your upper back and neck are concerned, because they have to work that much harder to keep the head (chin) from dropping onto your chest. This also forces the suboccipital muscles (they raise the chin) to remain in constant contraction, putting pressure on the 3 Suboccipital nerves. This nerve compression may cause headaches at the base of the skull. Pressure on the suboccipital nerves can also mimic sinus (frontal) headaches.

Rene Cailliet M.D., famous medical author and former director of the department of physical medicine and rehabilitation at the University of Southern California states:
“Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. Forward head posture (FHP) may result in the loss of 30% of vital lung capacity. These breath-related effects are primarily due to the loss of the cervical lordosis, which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping lift the first rib during inhalation.”

Persistent forward head posture (a.k.a “hyperkyphotic posture”) puts compressive loads upon the upper thoracic vertebra, and is also associated with the development of Upper Thoracic Hump, which can devolve into Dowager Hump when the vertebra develop compression fractures (anterior wedging). A recent study found this hyperkyphotic posture was associated with a 1.44 greater rate of mortality.

Alexander teachers don’t use the phrase “Forward Head Posture” and they don’t seek perfect postural positions.

Children tend to have good posture but it’s rarely static. Instead, it is dynamic. As they jump up and run around, you’ll likely see the head leading the movement, balanced on top of a lengthened spine.

Instead of diagnosing “Forward Head Posture”, Alexander teachers would likely say that a person stuck in such a position is stuck in the fight-or-flight reflex.

My definition of the Alexander Technique is that it is a way of noticing how you respond to stimuli and learning to let go of those responses that don’t serve you. The fight-or-flight reflex may serve you in a fight or when stuff is falling on you, but most of the time in life it simply constricts your freedom of movement, breathing, and thinking.

When my students is stuck in some version of fight-or-flight, I first want him to notice how he’s tightening around his sub-occipital joint and then I want him to start letting go of this unnecessary tension. As he does so, his head will release forward in rotation and up in space, leading his whole body into length and width, freeing up his breath and his movement, his thinking and his emotions.

Here’s a chiropractor’s video (from on Forward Head Posture:

Notice how with every exercise, the chiropractor tightens and compresses. This increases the primary cause of bad posture — unnecessary body tension — and does nothing to educate a person about their responses to stimuli.

On the other hand, this chiropractor plainly has good posture and good use of herself, so there must be something to what she’s advocating. For people who must do exercises and don’t want the bother of looking at their own habits and reprogramming their own reactions to stimuli, this will likely work better for them than Alexander Technique.

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