Back Clinic Posture Team. Posture is the position in which an individual holds their body upright against gravity while standing, sitting, or lying down. A proper posture visually reflects an individual’s health, ensuring the joints and muscles, as well as other structures of the body, are working properly. Throughout a collection of articles, Dr. Alex Jimenez identifies the most common effects of improper posture as he specifies the recommended actions an individual should take to improve their stance as well as enhance their overall health and wellness. Sitting or standing incorrectly can happen unconsciously, but recognizing the issue and correcting it can ultimately help many individuals develop healthier lifestyles. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 850-0900.
For individuals dealing with neck or arm pain and migraine headache symptoms it could be a splenius capitis muscle injury. Can knowing the causes and symptoms help healthcare providers develop an effective treatment plan?
Splenius Capitis Muscles
The splenius capitis is a deep muscle located on the upper back. Along with the splenius cervicis, it comprises the superficial layer – one of the three – of intrinsic back muscles. The splenius capitis works with the splenius cervicis, a smaller muscle located below it, to help rotate the neck and lower the chin to the chest, known as flexing. Maintaining a healthy posture is important because it helps keep the head in a neutral position.
Starting at the midline of the spine at C3 to T3, the splenius capitis spans the levels between the 7th cervical vertebra to the 3rd or 4th thoracic vertebrae, which varies for different individuals.
The muscle inserts at the nuchal ligament, which is a strong ligament of the neck.
The splenius capitis muscle angles up and out, attaching to the skull.
The splenius capitis and cervicis cover the vertical paraspinals, which are deeper and comprise the intermediate layer of the intrinsic back muscles.
The splenius muscles look like a bandage for the paraspinals and the vertical muscles that comprise the deepest layer.
The splenius muscles hold these deeper layers in the correct position.
These muscles start at the center of the spine and together form a V shape.
The sides of the V are thick, and the central indentation is shallow.
Pain
It’s common for individuals to experience pain associated with injury to the splenius capitis. This type of pain is known as splenius capitis syndrome. (Ernest E, Ernest M. 2011)
Symptoms
A headache stemming from injury often mimics a migraine headache. Symptoms of splenius capitis syndrome include: (Ernest E, Ernest M. 2011)
It’s recommended to contact a healthcare provider if experiencing symptoms that interfere with daily activities or quality of life. A healthcare provider will:
Postural orthostatic tachycardia syndrome is a medical condition that causes lightheadedness and palpitations after standing. Can lifestyle adjustments and multidisciplinary strategies help reduce and manage symptoms?
Postural Orthostatic Tachycardia Syndrome – POTS
Postural orthostatic tachycardia syndrome, or POTS, is a condition that varies in severity from relatively mild to incapacitating. With POTS:
The heart rate increases dramatically with body position.
This condition often affects young individuals.
Most individuals with postural orthostatic tachycardia syndrome are women between the ages of 13 and 50.
Some individuals have a family history of POTS; some individuals report POTS began after an illness or stressor, and others report it began gradually.
It usually resolves over time.
Treatment can be beneficial.
Diagnosis is based on assessing blood pressure and pulse/heart rate.
Symptoms
Postural orthostatic tachycardia syndrome can affect young individuals who are otherwise healthy and can begin suddenly. It usually happens between the ages of 15 and 50, and women are more likely to develop it than men. Individuals can experience various symptoms within a few minutes of standing up from a lying or seated position. The symptoms can occur regularly and daily. The most common symptoms include: (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)
Anxiety
Lightheadedness
A feeling like you’re about to pass out.
Palpitations – sensing rapid or irregular heart rate.
Dizziness
Headaches
Blurred vision
Legs turn to reddish-purple.
Weakness
Tremors
Fatigue
Sleep problems
Trouble concentrating/brain fog.
Individuals may also experience recurrent episodes of fainting, usually without any trigger/s other than standing up.
Individuals can experience any combination of these symptoms.
Sometimes, individuals cannot handle sports or exercise and may feel light-headed and dizzy in response to mild or moderate physical activity, which can be described as exercise intolerance.
Associated Effects
Postural orthostatic tachycardia syndrome can be associated with other dysautonomia or nervous system syndromes, like neurocardiogenic syncope.
Individuals are often co-diagnosed with other conditions like:
Chronic fatigue syndrome
Ehlers-Danlos syndrome
Fibromyalgia
Migraines
Other autoimmune conditions.
Bowel conditions.
Causes
Usually, standing up causes blood to rush from the torso to the legs. The sudden change means less blood is available for the heart to pump. To compensate, the autonomic nervous system sends signals to the blood vessels to constrict to push more blood to the heart and maintain blood pressure and a normal heart rate. Most individuals do not experience significant changes in blood pressure or pulse when standing up. Sometimes, the body is unable to perform this function correctly.
If blood pressure drops from standing and causes symptoms like lightheadness, it is known as orthostatic hypotension.
If the blood pressure remains normal, but the heart rate gets faster, it is POTS.
The exact factors that cause postural orthostatic tachycardia syndrome are different in individuals but are related to changes in:
The autonomic nervous system, adrenal hormone levels, total blood volume, and poor exercise tolerance. (Robert S. Sheldon et al., 2015)
Autonomic Nervous System
The autonomic nervous system controls blood pressure and heart rate, which are the areas of the nervous system that manage internal bodily functions like digestion, respiration, and heart rate. It is normal for blood pressure to drop slightly and the heart rate to speed up a little when standing. With POTS, these changes are more pronounced.
POTS is considered a type of dysautonomia, which is diminished regulation of the autonomic nervous system.
Several other syndromes are also thought to be related to dysautonomia, like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome.
It isn’t clear why the syndrome or any of the other types of dysautonomia develop, but there seems to be a familial predisposition.
Sometimes the first episode of POTS manifests after a health event like:
Pregnancy
Acute infectious illness, for example, a severe case of influenza.
An episode of trauma or concussion.
Major surgery
Diagnosis
A diagnostic evaluation will include a medical history, a physical examination, and diagnostic tests.
The healthcare provider will take blood pressure and pulse at least twice. Once while lying down and once while standing.
Blood pressure measurements and pulse rate lying down, sitting, and standing are orthostatic vitals.
Typically, standing up increases the heart rate by 10 beats per minute or less.
With POTS, heart rate increases by 30 beats per minute while blood pressure remains unchanged. (Dysautonomia International. 2019)
The heart rate stays elevated for over a few seconds upon standing/usually 10 minutes or more.
Symptoms happen frequently.
Lasts more than a few days.
Positional pulse changes are not the only diagnostic consideration for postural orthostatic tachycardia syndrome, as individuals can experience this change with other conditions.
During this test, blood pressure and pulse are measured several times when lying on a table and when the table is moved to an upright position.
Differential Diagnosis
There are various causes of dysautonomia, syncope, and orthostatic hypotension.
Throughout the evaluation, the healthcare provider may look at other conditions, like dehydration, deconditioning from prolonged bed rest, and diabetic neuropathy.
Medications like diuretics or blood pressure medication can cause similar effects.
Treatment
Several approaches are used in managing POTS, and individuals may require a multidisciplinary approach. The healthcare provider will advise regularly checking blood pressure and pulse at home to discuss the results when going in for medical checkups.
Fluids and Diet
Drinking non-caffeinated fluids can keep the body hydrated.
A healthcare provider can calculate the right amount of fluids that are needed each day.
Overnight dehydration is common, so it is especially important to drink fluids first thing in the morning, preferably before getting out of bed and standing.
Exercise and physical therapy can help the body learn to adjust to an upright position.
Because it can be challenging to exercise when dealing with POTS, a targeted exercise program under supervision may be required.
An exercise program may begin with swimming or using rowing machines, which do not require upright posture. (Dysautonomia International. 2019)
After a month or two, walking, running, or cycling may be added.
Studies have shown that individuals with POTS, on average, have smaller cardiac chambers than individuals who don’t have the condition.
Regular aerobic exercise has been shown to increase cardiac chamber size, slow heart rate, and improve symptoms. (Qi Fu, Benjamin D. Levine. 2018)
Individuals must continue an exercise program for the long term to keep symptoms from returning.
Medication
Prescription medications to manage POTS include midodrine, beta-blockers, pyridostigmine – Mestinon, and fludrocortisone. (Dysautonomia International. 2019)
Ivabradine, used for the heart condition of sinus tachycardia, has also been used effectively in some individuals.
Conservative Interventions
Other ways to help prevent symptoms include:
Sleeping in the head-up position by elevating the head of the bed off the ground 4 to 6 inches utilizing an adjustable bed, blocks of wood, or risers.
This increases the blood volume in circulation.
Performing countermeasure maneuvers like squatting, squeezing a ball, or crossing the legs. (Qi Fu, Benjamin D. Levine. 2018)
Wearing compression stockings to prevent too much blood from flowing into the legs when standing can help avoid orthostatic hypotension. (Dysautonomia International. 2019)
Conquering Congestive Heart Failure
References
National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center (GARD). (2023). Postural orthostatic tachycardia syndrome.
Sheldon, R. S., Grubb, B. P., 2nd, Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., Sutton, R., Sandroni, P., Friday, K. J., Hachul, D. T., Cohen, M. I., Lau, D. H., Mayuga, K. A., Moak, J. P., Sandhu, R. K., & Kanjwal, K. (2015). 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart rhythm, 12(6), e41–e63. doi.org/10.1016/j.hrthm.2015.03.029
For individuals working at a desk or work station where the majority of the work is done in a sitting position and increases the risk for a variety of health problems, can using a standing desk help prevent musculoskeletal problems and improve short and long-term wellness?
Stand Desks
More than 80% of jobs are done in a seated position. Stand desks have proven to help. (Allene L. Gremaud et al., 2018) An adjustable stand desk is intended to be the standing height of an individual. Some desks can be lowered to use while sitting. These desks can improve:
Blood circulation
Back pain
Energy
Focus
Individuals who are less sedentary may experience decreased depression, anxiety, and risk of chronic disease.
Improve Posture and Decrease Back Pain
Sitting for prolonged periods can cause fatigue and physical discomfort. Back pain symptoms and sensations are common, especially when practicing unhealthy postures, already dealing with existing back problems, or using a non-ergonomic desk set-up. Instead of only sitting or standing for the whole workday, alternating between sitting and standing is far healthier. Practicing sitting and standing regularly reduces body fatigue and lower back discomfort. (Alicia A. Thorp et al., 2014) (Grant T. Ognibene et al., 2016)
Increases Energy Levels
Prolonged sitting correlates with fatigue, reduced energy, and productivity. A sit-stand desk can provide benefits like increased productivity levels. Researchers discovered that sit-stand desks could improve the general health and productivity of office workers. Individuals in the study reported:
According to the CDC, six in 10 individuals in the U.S. have at least one chronic disease, like diabetes, heart disease, stroke, or cancer. Chronic disease is the leading cause of death and disability, as well as a leading force of healthcare costs. (Centers for Disease Control and Prevention. 2023) While further research is needed to see if standing desks can reduce the risk of chronic disease, one study looked to quantify the association between sedentary time and the risk of chronic disease or death. Researchers reported that sedentariness for prolonged periods was independently associated with negative health outcomes regardless of physical activity. (Aviroop Biswas et al., 2015)
Improved Mental Focus
Sitting for extended periods slows down blood circulation. This decreased blood flow to the brain lowers cognitive function and increases the risk of neurodegenerative conditions. One study confirmed that healthy individuals who worked in a prolonged sitting position had reduced brain blood flow. The study found that frequent, short walks could help prevent this. (Sophie E. Carter et al., 2018) Standing increases blood and oxygen circulation. This improves cognitive function, which also helps improve focus and concentration.
Depression and Anxiety Reduction
Modern lifestyles typically contain large amounts of sedentary behavior.
However, there is a small amount about the mental health risks of prolonged sedentary behavior. There have been a few studies aimed at improving public understanding. One study focused on a group of older adults, having them self-report sedentary habits that included television, internet, and reading time. This information was compared to their individual scoring on the Centre of Epidemiological Studies Depression scale. (Mark Hamer, Emmanuel Stamatakis. 2014)
The researchers found that certain sedentary behaviors are more harmful to mental health than others.
Television watching, for example, resulted in increased depressive symptoms and decreased cognitive function. (Mark Hamer, Emmanuel Stamatakis. 2014)
Internet use had the opposite effect, decreasing depressive symptoms and increasing cognitive function.
Researchers theorize that the results come from the contrasting environmental and social contexts in which they are happening. (Mark Hamer, Emmanuel Stamatakis. 2014)
Another study looked at the possible correlation between sedentary behavior and anxiety.
Incorporating a standing desk into the workspace can help to reduce the negative effects of sedentary behaviors, leading to improved productivity, improved mental and physical health, and a healthy work environment for individuals who work long hours at a desk or workstation.
Understanding Academic Low Back Pain: Impact and Chiropractic Solutions
References
Gremaud, A. L., Carr, L. J., Simmering, J. E., Evans, N. J., Cremer, J. F., Segre, A. M., Polgreen, L. A., & Polgreen, P. M. (2018). Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers. Journal of the American Heart Association, 7(13), e007735. doi.org/10.1161/JAHA.117.007735
Thorp, A. A., Kingwell, B. A., Owen, N., & Dunstan, D. W. (2014). Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occupational and environmental medicine, 71(11), 765–771. doi.org/10.1136/oemed-2014-102348
Ognibene, G. T., Torres, W., von Eyben, R., & Horst, K. C. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of occupational and environmental medicine, 58(3), 287–293. doi.org/10.1097/JOM.0000000000000615
Ma, J., Ma, D., Li, Z., & Kim, H. (2021). Effects of a Workplace Sit-Stand Desk Intervention on Health and Productivity. International journal of environmental research and public health, 18(21), 11604. doi.org/10.3390/ijerph182111604
Centers for Disease Control and Prevention. Chronic disease.
Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 162(2), 123–132. doi.org/10.7326/M14-1651
Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. Journal of applied physiology (Bethesda, Md. : 1985), 125(3), 790–798. doi.org/10.1152/japplphysiol.00310.2018
Hamer, M., & Stamatakis, E. (2014). Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Medicine and science in sports and exercise, 46(4), 718–723. doi.org/10.1249/MSS.0000000000000156
Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15, 513. doi.org/10.1186/s12889-015-1843-x
Many individuals attribute to some degree, their neck or back pain to unhealthy posture. Can knowing the causes and underlying factors help guide lifestyle adjustments and seeking medical rehabilitative treatment?
Unhealthy Posture Causes
Numerous factors can cause individuals to practice unhealthy postures regularly.
Unhealthy posture can also be brought on by an injury, illness, or genetics.
A combination of these factors is also common.
Practicing healthy posture is a form of exercise where the muscles support the skeleton in stable and efficient alignment that is present in stillness and movement.
Injury and Muscle Guarding
After an injury, muscles can spasm to protect the body and help stabilize injuries and protect against further injury.
However, movements become limited and can lead to pain symptoms.
Prolonged muscle spasms lead to weakened muscles over time.
The imbalance between muscles guarding the injury and those still operating normally can lead to posture problems.
Musculoskeletal treatment with massage, chiropractic, and physical therapy can help restore optimal functioning.
Muscle Tension and Weakness
If certain muscle groups become weak or tense, posture can be affected, and pain symptoms can develop.
Muscle weakness or tension can develop when individuals hold a prolonged position day after day or when performing routine tasks and chores in a way that places tension on the muscles or uses them in an unbalanced way.
Postural retraining and physical therapy adjustments can help strengthen the muscles and relieve pain symptoms.
Daily Habits
As individuals find ways to accommodate muscle spasms, weakness, tension, and/or imbalances, the mind and body can forget and abandon healthy posture.
The body then begins compensating using alternate, awkward, and counterproductive muscle contractions and stretching that compromise body and spinal alignment.
Use of Technology
Technology – whether sitting at a desk/workstation, using a tablet or cell phone, or working with several devices can gradually shift the body out of alignment. (Parisa Nejati, et al., 2015)
Individuals constantly looking down at their phone may develop a text neck, a condition in which the neck is held in flexion or forward tilting too long, which can lead to pain.
Mental Attitude and Stress
Individuals under stress or are experiencing stressful situations can begin to have posture problems. (Shwetha Nair et al., 2015)
Stress can contribute to over-contracting muscles, which can cause muscle tension, shallow breathing, posture problems, and pain symptoms.
Being aware of body position and correcting and adjusting posture can help to counteract stress. (Shwetha Nair et al., 2015)
Wearing down the outside or inside of the shoes faster from things like weight-bearing habits will imbalance kinetic forces that translate up the ankle, knee, hip, and lower back leading to pain symptoms in any or all of these joints.
Heredity and Genetics
Sometimes the cause is hereditary.
For example, Scheuermann’s disease is a condition in which adolescent males develop a pronounced kyphosis curve in the thoracic spine. (Nemours. KidsHealth. 2022)
Consult Injury Medical Chiropractic and Functional Medicine Clinic for an evaluation, and let us help you by developing a personalized treatment and rehabilitation program.
The Path To Healing
References
Czaprowski, D., Stoliński, Ł., Tyrakowski, M., Kozinoga, M., & Kotwicki, T. (2018). Non-structural misalignments of body posture in the sagittal plane. Scoliosis and spinal disorders, 13, 6. doi.org/10.1186/s13013-018-0151-5
Nejati, P., Lotfian, S., Moezy, A., & Nejati, M. (2015). The study of correlation between forward head posture and neck pain in Iranian office workers. International journal of occupational medicine and environmental health, 28(2), 295–303. doi.org/10.13075/ijomeh.1896.00352
Nair, S., Sagar, M., Sollers, J., 3rd, Consedine, N., & Broadbent, E. (2015). Do slumped and upright postures affect stress responses? A randomized trial. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 34(6), 632–641. doi.org/10.1037/hea0000146
Silva, A. M., de Siqueira, G. R., & da Silva, G. A. (2013). Implications of high-heeled shoes on body posture of adolescents. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo, 31(2), 265–271. doi.org/10.1590/s0103-05822013000200020
For older individuals experiencing posture problems, slumping, slouching, and upper back pain, could adding rib cage exercises help bring relief and prevent the condition from worsening?
Improved Posture
It’s common to associate a collapsed upper back posture with age, but other factors can also contribute to the problems. (Justyna Drzał-Grabiec, et al., 2013) The rib cage and the pelvis are important to body structure and comprise much of the core. If these bone structures become misaligned due to unhealthy posture, the muscles that attach to them become tight, weak, or both, and the surrounding muscles have to compensate, causing a worsening of the condition and further injury.
Unhealthy postures can be caused by a rib cage that compresses down onto the pelvic bone.
As the upper back slumps or compresses, height can begin to decrease.
Posture awareness exercises can help lift the rib cage off the pelvic bone.
Rib Cage Exercises
This exercise can be done sitting or standing. A daily routine can help improve posture and relieve back problems and pain.
The sitting version helps keep the focus on doing the exercise right.
The standing version challenges body awareness, allowing the individual to feel how the rib cage and upper back movements affect pelvic and lower back posture.
To begin, it is recommended to start in a sitting position.
Once the basics are learned, then certainly progress to standing.
Exercise
Position the pelvis so it is in a slight forward tilt.
This forward tilt will exaggerate the low back curve slightly while tightening the lower back muscles in a good way.
Establishing and maintaining this curve in the sitting position should feel natural.
Inhale and exaggerate the upward lift of the rib cage.
Inhaling causes the spine and ribs to extend slightly.
Exhale and allow the rib cage and upper back to return to their natural position.
Repeat up to 10 times once or twice a day.
For this exercise, use breathing to develop the rib cage’s lift and carriage incrementally.
Don’t max out on the spinal extension.
Instead, focus on how breathing/inhaling supports the movement of the ribs and upper back and develops the muscles from there.
Try to lift the rib cage equally on both sides as the body allows.
With practice, individuals will realize the healthy posture changes and increased distance between the ribs and pelvis.
Guidance and Variation
Perform the exercise with the back against a wall for upper back guidance.
Another variation of the pelvis and rib cage posture training exercise is to raise the arms.
This will create a different posture awareness training perspective.
Focus on rib cage movement when the arms are raised.
Does lifting the arms make the exercise easier, harder, or different?
To enhance posture improvement, stretch the pectoral muscles.
Yoga
Individuals looking for more ways to strengthen healthy posture should consider yoga.
A study published in the International Journal of Yoga suggests that a great way to activate the core may be to include a variety of yoga postures into the routine. (Mrithunjay Rathore et al., 2017) The ab muscles attach to various places on the rib cage and play a role in posture, alignment, and balance. The researchers identified two muscles, the external obliques, and the transverse abdominal, as key to a healthily aligned posture.
Core Strength
References
Drzał-Grabiec, J., Snela, S., Rykała, J., Podgórska, J., & Banaś, A. (2013). Changes in the body posture of women occurring with age. BMC geriatrics, 13, 108. doi.org/10.1186/1471-2318-13-108
Rathore, M., Trivedi, S., Abraham, J., & Sinha, M. B. (2017). Anatomical Correlation of Core Muscle Activation in Different Yogic Postures. International journal of yoga, 10(2), 59–66. doi.org/10.4103/0973-6131.205515
Papegaaij, S., Taube, W., Baudry, S., Otten, E., & Hortobágyi, T. (2014). Aging causes a reorganization of cortical and spinal control of posture. Frontiers in aging neuroscience, 6, 28. doi.org/10.3389/fnagi.2014.00028
For individuals trying to achieve healthy posture, could using posture awareness training be effective in treatment and prevention?
Posture Awareness
Spinal curves help support the body’s weight, movement, and balance. Five areas include the neck, upper back, lower back, sacrum, and coccyx. The bottom of the spine or sacrum rests between the two hip bones that comprise the pelvis. Because of this location, the movements made with the pelvis significantly affect the spine. (Ibrahim Alkatout, et al., 2021) When the pelvis moves, the spine moves.
Posture-related back pain and associated symptoms are often caused by a weakened strength and flexibility ratio between the opposing muscle groups that hold the body upright.
Achieving healthy posture requires technique and consistent practice for maintaining a healthy pelvis and low back curve. (DeokJu Kim, et al., 2015)
Finding the low back curve and exploring how it responds when moving the pelvis is important to effective posture awareness training.
Kim, D., Cho, M., Park, Y., & Yang, Y. (2015). Effect of an exercise program for posture correction on musculoskeletal pain. Journal of physical therapy science, 27(6), 1791–1794. doi.org/10.1589/jpts.27.1791
Alkatout, I., Wedel, T., Pape, J., Possover, M., & Dhanawat, J. (2021). Review: Pelvic nerves - from anatomy and physiology to clinical applications. Translational neuroscience, 12(1), 362–378. doi.org/10.1515/tnsci-2020-0184
Żurawski, A. Ł., Kiebzak, W. P., Kowalski, I. M., Śliwiński, G., & Śliwiński, Z. (2020). Evaluation of the association between postural control and sagittal curvature of the spine. PloS one, 15(10), e0241228. doi.org/10.1371/journal.pone.0241228
Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International journal of environmental research and public health, 18(10), 5400. doi.org/10.3390/ijerph18105400
Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?
Forward Head Posture
Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it’s important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.
Postural Deviation
The head is in a healthy alignment with the neck when the ears line up with the gravity line.
The gravity line is an imaginary straight line that represents gravity’s downward pull.
It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)
Muscle Imbalances
Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.
Kyphosis
Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.
This occurs because the upper back area supports the neck and head.
When the upper back moves or changes position, the head and neck follow.
The majority of the head’s weight is in the front, and this contributes to the forward movement.
An individual with kyphosis has to lift their head to see.
Treatment
A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.
Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
Targeted stretching can help if the neck muscles are tight.
At-home stretches may also relieve pain
Risk Factors
Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:
Constantly looking down at a phone and staying in this position for a long time aka text neck.
Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
Driving for a living causes prolonged back, neck, and shoulder positioning.
Sleeping or reading with a large pillow under the head can contribute to forward head posture.
Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
An example is carrying a child or another load in front of the body.
Large breasts can also increase the risk of kyphosis and forward head posture.
Neck Injuries
References
Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. doi.org/10.5535/arm.2012.36.1.98
Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. doi.org/10.24171/j.phrp.2018.9.6.04
Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. doi.org/10.13075/ijomeh.1896.01293
Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.
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