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This May Be the Reason for your Neck and Shoulder Pain

alignment Dec 06, 2023

Tight neck and shoulders? Neck pain? Super tight upper back? Headaches? Impaired digestion? Temporomandibular Joint (TMJ)?

All of these discomforts could be the results of Head Forward Posture – a postural misalignment where the head is forward of where it actually should be – stacked on top of your shoulders. Ideally, your ears should stack on top of your shoulders.

The average head weighs 10 to 12 pounds. Various research shows that for every 1-inch deviation in head forward of its alignment, 10+ pounds of extra weight is supported by the cervical spine (the spine in the neck area). Depending on how far the forward the head is, a 10-pound head can turn into a 20, 30, or 40+-pound head. That is A LOT of extra weight for the poor neck and upper back muscles to support.


Image from research paper ‘Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head’ by Kenneth K. Hansraj, MD, Chief of Spine Surgery New York Spine Surgery & Rehabilitation Medicine.

The result – some muscles shorten, others lengthen, and all muscles are out of their expected position. Sustain the mid-alignment for a long enough time, problems will start creeping up. Thanks to the misalignment, the Head Forward posture goes hand in hand with a slouchy posture, rounded upper back, and tightened chest. These in themselves lead not only to an unsightly posture but an entire slew of other problems, some of which you will likely not relate to posture. The organs – such as the lungs, the heart, and the digestive system – are all negatively impacted by the compression caused by slouchy posture. To translate - reduced lung capacity with inefficient inhales and exhales, the strain on the heart, bloating, constipation, and acid reflux are just a few examples to throw at you.

As you can imagine, technology has not done us good when it gets to posture. The constant gaze down on your phone, the tilt down to the computer screen – looking down has become the new and not so healthy normal. Combined with slouchy sitting, the Head Forward Posture is gaining an epidemic proportion. You don’t have to trust me, look around.

Here is another fascinating development. Your constant head-down posture may be responsible for your growing horns on the lower back of your skull, just above the neck. Research by David Shahar, a health scientist at the University of The Sunshine Coast, Australia confirmed the wide spread of this spike-like feature. While in the past, such spikes have been observed, they have been rare and insignificant of size. Shahar’s study confirmed the spikes to be way more prevalent than expected and the largest horns measured in the study were 30 mm or over 1 inch long. Also interestingly, these horns were found to be more common in young people, starting at age 18 with 1 in 4 young adults having them.

Hypothesis for the development of these horns or protrusions on your skull are adaptations to absorb the extra pressure from the head down on your neck muscles as phone usage has significantly increased over time. The natural adaptation is so that there is a wider surface area to distribute the constant unexpected weight. While the protrusions themselves are probably harmless, misalignments and other compensations likely to happen could lead to problems.

How aligned is your head? Is your head stacked on top of your shoulders?

In the video, we see an example of a Head Forward posture along with the associated rounding of the shoulders forward. You can clearly observe the tension in the neck and shoulders as well as how correct posture is a full-body experience – when the entire body stacks where it should and is aligned, the body releases and let go of the tension. The next step would be to train the body to balance and strengthen the muscles so the posture is maintained over time.

The demonstrated postural adjustment is a huge release for someone experiencing tension headaches, neck pain, constant tightness, and such. The long-term implications to health are that much more significant.

Now, let’s review a couple of exercises you can do in the comfort of your own home to offset the effects of a head forward posture.

  1. Lie down on the floor with knees bent and feet on the floor. Pull your sternum inward towards your spine and down, away from your ears – this may cause your shoulders to come off the floor – that’s ok. 
  2. Soften your ribs and let these come toward each other and down. These actions will assist your upper back form contact with the floor.
  3. Pull your pubic bone in and up – you will feel your lower back press firmer against the floor. 

All these actions will engage your abdominal and corresponding back muscles so that your spine is comfortably pressing against the floor. Throughout the movement, do your best to maintain a stable pelvis and spine pressing against the floor.

Do your best to not grip with the front of your thighs.

  1. Inhale and take your arms as far as possible overhead with palms up towards the ceiling without your spine lifting off the floor. Exhale and return the arms down. Keep the arms engaged and pretend you are resisting the air each way. With time, your range of motion will increase.Exercise-for-correcting-head-forward-posture
  2. This time, as you take the arms overhead, move your shoulder blades up towards your ears without the shoulders shrugging up. Return the shoulder blades down prior to returning the arms to starting position.
  3. Now, take your arms overhead and while keeping palms up towards the ceiling, draw a snow angel bringing your wings (arms) out to the side and then back to starting position. As the arms go out to the side, reach each arm in an opposing direction for a nice stretch.Exercise-for-correcting-head-forward-posture-1
  4. Reverse exercise #3 by taking the arms out to the side all the way up to overhead and then return back to starting position.
  5. Add the shoulder blade move (up and then down) to exercises 3 and 4 while the arms are overhead.
  6. Alternate moving one arm overhead while the other arm stays down.Exercise-for-correcting-head-forward-posture
  7. Now, sit up as tall as possible with abs engaged in a crisscross apple sauce position. Roll your shoulders back to open your chest and pull the armpits downward to create more space for your neck. You can repeat the sternum in and down the action to create greater neck space. Inhale and take your arms overhead as you open the chest and lift the sternum towards the ceiling. Note – do not arch your low back or crunch your neck; move from your upper back and maintain a long neck. Exhale and return arms to starting position.Exercise for correcting head forward posture

For all the exercises, move with your breath – maintain a constant inhale and exhale. The breath will help you flow with the movement and will calm your nervous system.
Get in the habit of doing 2 reps of the exercises daily.

Do you feel a difference after performing these exercises? 


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