The correlation between forward head posture and neck pain
Joseph E . Muscolino | DC
The purpose of this article is multifold . We will explore the biomechanics of forward head posture ( FHP ). We will then explore how it , and indeed other postural distortion patterns are being viewed with relationship to pain and dysfunction . And finally , we will take a step back , and using the context of FHP , look at how we know what we know .
Forward Head Posture
Forward head posture ( FHP ) is the name given to a sagittal-plane postural distortion pattern in which , as its name implies , the head is held forward . This usually involves excessive flexion of the neck at the cervical spinal joints as well as excessive forward translation and extension of the head at the atlantooccipital joint . The net result is that the center of weight of the head is anterior to the trunk .
Whenever a body part is not centered on the body part below , there is an imbalance such that the body part should fall with gravity . In the case of FHP , the head and neck should fall into flexion due to the force of gravity ( until the chin hits the chest ). To prevent this , an equal force of extension must be occurring to counterbalance gravity ’ s flexion force . This extension force is usually created by contraction of the cervicocranial extensor musculature in the back of the neck ( Figure 1 ). Muscles such as the upper trapezius , splenius capitis and cervicis , semispinalis capitis , and others will have to isometrically contract to oppose gravity ( Figure 2 ).
Figure 1 . Forward head posture and the counterbalancing contraction of neck musculature . ( Image courtesy of Dr Joe Muscolino )
8 | vol28 | no1 | JATMS