For athletes and sports enthusiasts, a torn triceps can be a serious injury. Can knowing their symptoms, causes, risk factors, and potential complications help healthcare providers develop an effective treatment plan?
Torn Triceps Injury
The triceps is the muscle on the back of the upper arm that allows the elbow to straighten. Fortunately, triceps tears are uncommon, but they can be serious. The injury affects men more often than women and usually occurs from trauma, sports, and/or exercise activities. Depending on the extent and severity of the injury, a torn triceps injury can require splinting, physical therapy, and possibly surgery to regain movement and strength. Recovery after a triceps tear typically lasts around six months. (The Ohio State University Wexner Medical Center. 2021)
Anatomy
The triceps brachii muscle, or triceps, runs along the back of the upper arm. It is named tri- because it has three heads – the long, medial, and lateral head. (Sendic G. 2023) The triceps originates at the shoulder and attaches to the shoulder blade/scapula and upper arm bone/humerus. At the bottom, it attaches to the point of the elbow. This is the bone on the pinky side of the forearm, known as the ulna. The triceps cause movement at the shoulder and the elbow joint. At the shoulder, it performs extension or backward movement of the arm and adduction or moving the arm toward the body. The main function of this muscle is at the elbow, where it performs extension or straightening of the elbow. The triceps work the opposite of the biceps muscle on the front of the upper arm, which conducts flexion or bending of the elbow.
Triceps Tear
Tears can occur anywhere along the length of a muscle or tendon, which is the structure that attaches the muscle to the bones. Triceps tears commonly occur in the tendon connecting the triceps to the back of the elbow. Muscle and tendon tears are graded from 1 to 3 based on severity. (Alberto Grassi et al., 2016)
Grade 1 Mild
These small tears cause pain that worsens with movement.
There is some swelling, bruising, and minimal loss of function.
Grade 2 Moderate
These tears are larger and have moderate swelling and bruising.
The fibers are partially torn and stretched.
Up to 50% loss of function.
Grade 3 Severe
This is the worst type of tear, where the muscle or tendon is completely torn.
These injuries cause severe pain and disability.
Symptoms
Triceps tears cause immediate pain in the back of the elbow and upper arm that worsens when trying to move the elbow. Individuals might also feel and/or hear a popping or tearing sensation. There will be swelling, and the skin will likely be red and/or bruised. With a partial tear, the arm will feel weak. If there is a complete tear, there will be significant weakness when straightening the elbow. Individuals may also notice a lump on the back of their arm where the muscles have contracted and knotted together.
Causes
Triceps tears usually occur during trauma, when the muscle is contracted and an external force pushes the elbow into a bent position. (Kyle Casadei et al., 2020) One of the most common causes is by falling on an outstretched arm. Triceps tears also occur during sports activities like:
Throwing a baseball
Blocking in a football game
Gymnastics
Boxing
When a player falls and lands on their arm.
Tears can also happen when using heavy weights during triceps-targeted exercises, such as the bench press.
Tears can also occur from direct trauma to the muscle, like a motor vehicle accident, but are less common.
Long-Term
Triceps tears can develop over time as a result of tendonitis. This condition usually occurs from repetitive use of the triceps muscle during activities like manual labor or exercise. Triceps tendonitis is sometimes referred to as weightlifter’s elbow. (Orthopedic & Spine Center. N.D.) The strain on tendons causes tiny tears that the body typically heals. However, if more strain is placed on the tendon than it can keep up with, the tiny tears can begin to grow.
Risk Factors
Risk factors can increase the risk of a triceps tear. Underlying medical conditions can weaken tendons, increasing the risk of injury, and can include: (Tony Mangano et al., 2015)
Diabetes
Rheumatoid arthritis
Hyperparathyroidism
Lupus
Xanthoma – fatty deposits of cholesterol under the skin.
Hemangioendothelioma – cancerous or noncancerous tumors caused by abnormal growth of blood vessel cells.
Chronic kidney failure
Chronic tendonitis or bursitis in the elbow.
Individuals who have had cortisone shots in the tendon.
Individuals using anabolic steroids.
Triceps tears tend to occur more commonly in males between 30 and 50. (Ortho Bullets. 2022) This comes from participating in activities like football, weightlifting, bodybuilding, and manual labor, which also increases the risk of injury.
Treatment
Treatment depends on which part of the triceps is affected and the extent of the damage. It may only need resting for a few weeks, physical therapy, or require surgery.
Nonsurgical
Partial tears in the triceps that involve less than 50% of the tendon can often be treated without surgery. (Mehmet Demirhan, Ali Ersen 2016) Initial treatment includes:
Splinting the elbow with a slight bend for four to six weeks allows the injured tissue to heal. (Ortho Bullets. 2022)
During this time, ice can be applied to the area for 15 to 20 minutes several times daily to help decrease pain and swelling.
Non-steroidal anti-inflammatory medications/NSAIDs – Aleve, Advil, and Bayer can help reduce inflammation.
Other over-the-counter medications like Tylenol can help decrease the pain.
Once the splint is removed, physical therapy will help restore movement and strength in the elbow.
Full movement is expected to return within 12 weeks, but full strength will not return until six to nine months after the injury. (Mehmet Demirhan, Ali Ersen 2016)
Surgery
Triceps tendon tears that involve more than 50% of the tendon require surgery. In some cases, however, surgery may still be recommended for tears smaller than 50% if the individual has a physically demanding job or plans to resume playing sports at a high level. Tears in the muscle belly or area where the muscle and tendon join are typically sewn back together. If the tendon is no longer attached to the bone, it is screwed back on. Recovery and physical therapy after surgery depend on the specific surgeon’s protocols. In general, individuals will spend a couple of weeks in a brace. Around four weeks after surgery, individuals will be able to start moving the elbow again. However, they won’t be able to start doing heavy lifting for four to six months. (Ortho Bullets. 2022) (Mehmet Demirhan, Ali Ersen 2016)
Complications
Complications can occur after triceps repair, whether there was surgery or not. For example, individuals may have problems regaining full elbow extension or straightening. They are also at a higher risk of re-rupture if they try to use the arm before it’s fully healed. (Mehmet Demirhan, Ali Ersen 2016)
Grassi, A., Quaglia, A., Canata, G. L., & Zaffagnini, S. (2016). An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints, 4(1), 39–46. doi.org/10.11138/jts/2016.4.1.039
Casadei, K., Kiel, J., & Freidl, M. (2020). Triceps Tendon Injuries. Current sports medicine reports, 19(9), 367–372. doi.org/10.1249/JSR.0000000000000749
Mangano, T., Cerruti, P., Repetto, I., Trentini, R., Giovale, M., & Franchin, F. (2015). Chronic Tendonopathy as a Unique Cause of Non Traumatic Triceps Tendon Rupture in a (Risk Factors Free) Bodybuilder: A Case Report. Journal of orthopaedic case reports, 5(1), 58–61. doi.org/10.13107/jocr.2250-0685.257
For individuals starting to lift weights, motor units are important for muscle movement. Can building more motor units help build strength and maintain muscle mass?
Motor Units
Motor units control the skeletal muscles and are the force behind every body movement. (C J. Heckman, Roger M. Enoka 2012)
This includes voluntary movements like lifting weights and involuntary movements like breathing. When lifting objects and weights, the body adapts to motor unit needs, meaning that individuals must consistently increase the weight to progress.
Lifting weights regularly trains the body to generate more motor units and force.
General guidelines recommend lifting weights for all muscle groups two to three non-consecutive days a week.
Consistency helps maintain muscle mass.
Regular progression increases the risk of plateauing.
What They Are
Exercise increases the body’s muscle strength, while sedentariness and inactivity weaken them. A motor unit is a single nerve cell/neuron that supplies the nerves to innervate a group of skeletal muscles. The neuron receives signals from the brain that stimulate all the muscle fibers in that particular motor unit to generate movement.
Muscles comprise different fiber types.
They are attached to the bones with connective tissue, which is stronger than the muscle.
Multiple motor units are dispersed throughout the muscle.
The motor units help ensure muscle contraction force is evenly spread throughout the muscle.
Motor units are different sizes and operate differently depending on where and what they do.
Small motor units might only innervate five or ten fibers. For example, to blink or sniff.
Large motor units can comprise hundreds of muscle fibers for swinging or jumping movements.
How They Work
The number of units activated depends on the task. Stronger muscle contractions require more. However, fewer units are needed to accomplish the movement for individuals expending less effort.
Contraction
Once a unit receives a signal from the brain, the muscle fibers contract simultaneously.
The force generated depends on how many units are required to accomplish the task. (Purves D. et al., 2001)
For example, picking up small objects like a pen and paper requires only a few units to generate the force needed.
If picking up a heavy barbell, the body needs more units because more force is needed to lift the heavier load.
The body can generate more force with stronger muscles.
This happens when lifting weights on a regular basis and overloading the muscles with more weight than they can handle.
This process is known as adaptation.
Adaptation
The purpose of lifting weights is to challenge the muscles so they adapt to the new challenge and grow in strength and mass. Motor units are a major part of the adaptation process. (Dr. Erin Nitschke. American Council on Exercise. 2017)
As individuals continue working out, their ability to generate more force increases and units activate more rapidly.
This makes movements more efficient.
Individuals can increase motor unit recruitment by consistently increasing the weight challenge to their muscles.
The development creates movement memory.
A relationship between the brain, muscles, and motor units is established even if the individual stops working out. The pathways are still there no matter how long the individual takes off.
When returning to training, the body will remember how to ride a bike, do a bicep curl, or squat.
However, the muscles will not have the same strength as the strength needs to be built back along with endurance that may have been lost.
It is the movement memory that remains.
Military Training and Chiropractic Care: Maximizing Performance
References
Heckman, C. J., & Enoka, R. M. (2012). Motor unit. Comprehensive Physiology, 2(4), 2629–2682. doi.org/10.1002/cphy.c100087
Purves D, Augustine GJ, Fitzpatrick D, et al., editors. (2001). Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. The Motor Unit. Available from: www.ncbi.nlm.nih.gov/books/NBK10874/
For individuals dealing with lower back pain, it could be quadricep muscle tightness causing the symptoms and posture problems. Can knowing the signs of quadricep tightness help prevent pain and avoid injury?
Quadriceps Tightness
Quadriceps muscles are in the front of the thigh. Forces that could be creating chronic pain and posture problems could be happening at the same time are:
Quadricep tightness causes lower back pain as the pelvis gets pulled down.
Tight quadriceps lead to weakened hamstring muscles.
These are the opposing muscles behind the thigh.
Stress and pressure on the hamstrings can cause back pain and problems.
The rectus femoris attaches to the pelvis at the anterior superior iliac spine, which is the front part of the hip bone.
The rectus femoris is the only muscle in the group that crosses over the hip joint, which also affects movement.
When the quadriceps, especially the rectus femoris, become tight, they pull down on the hips.
The pelvis tilts downward or forward, technically referred to as the anterior tilt of the pelvis. (Anita Król et al., 2017)
The spine is between the pelvis, and if the pelvis tilts forward, the lumbar spine compensates by arching.
A larger arch in the lower back is referred to as excessive lordosis and often causes tightness and pain in the back muscles. (Sean G. Sadler et al., 2017)
Hamstring Compensation
When the quadriceps tighten and the pelvis gets pulled down, the back has an abnormal lift. This puts the hamstring on a consistent stretch that can cause pain symptoms.
Healthy posture and hamstring muscle tone help maintain correct pelvic positioning in the back.
This is correct because it helps maintain a comfortable position.
Quadricep tightness can set off a reaction as the pelvis tilts down in front and up in the back while overly stretching the hamstrings.
Pain and soreness are the usual result
Lack of hamstring strength and quadriceps stretching can cause the hamstrings to lose their ability to support correct pelvic and spinal positions. (American Council on Exercise. 2015)
Knowing When Quads Are Tightening
Individuals often don’t realize their quadriceps are tight, especially those who spend most of the day sitting.
The more time spent in a chair can cause the quadriceps and lower back muscles to tighten steadily.
Individuals can try a few tests at home:
Standing Up
Push the hips forward.
Push from the sitting bones so you’re at the correct level.
How far forward do the hips go?
What is felt?
Pain could indicate tight quadriceps.
In A Lunge Position
With one leg forward and bent in front of the other.
The back leg is straight.
How far forward does the leg go?
What is felt?
How does the front of the hip on the back leg feel?
Standing Bent Leg
Stand with the front leg bent and the back leg straight.
Discomfort in the back leg could mean tight quadriceps.
In A Kneeling Position
Arch the back
Grab the ankles
Modify the position to adjust for any pain or joint issues.
If you have to prop yourself up or modify the pose to reduce pain, it could be tight quadriceps.
Helping to understand the condition can help in communication with a healthcare provider.
A healthcare provider and/or physical therapist can conduct a posture evaluation examination to test the quadriceps.
Understanding Academic Low Back Pain: Impact and Chiropractic Solutions
References
Kripa, S., Kaur, H. (2021). Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy, 26(34). doi.org/doi: 10.1186/s43161-021-00052-w
Król, A., Polak, M., Szczygieł, E., Wójcik, P., & Gleb, K. (2017). Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. Journal of back and musculoskeletal rehabilitation, 30(4), 699–705. doi.org/10.3233/BMR-140177
Sadler, S. G., Spink, M. J., Ho, A., De Jonge, X. J., & Chuter, V. H. (2017). Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies. BMC musculoskeletal disorders, 18(1), 179. doi.org/10.1186/s12891-017-1534-0
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 experiencing pelvis pain symptoms and associated problems, can integrating pelvic floor physical therapy exercises help with treatment and prevention?
Pelvic Floor Physical Therapy
The pelvic floor muscles are located at the base of the pelvis and protect the pelvic organs like the vagina, cervix, uterus, bladder, urethra, and rectum. (U.S. Food and Drug Administration. 2019)
When the muscles fail to function correctly, individuals can experience symptoms like:
Painful intercourse
Prolapse – when an organ or tissue drops or shifts out of place.
Urinary incontinence
Constipation problems
These conditions are common in pregnant individuals or older women.
These symptoms can be treated with pelvic floor physical therapy to alleviate discomfort. Pelvic floor physical therapy can help women and individuals with vaginas:
Alleviate issues like painful sex, urinary leakage, and prolapse.
In physical therapy, individuals work on breathing, relaxation, and lengthening and strengthening techniques to train their muscles to function optimally.
Causes of Pelvic Floor Issues
Pelvic floor dysfunction tends to happen with age, during pregnancy, or in combination with events like the postpartum period and menopause, which can lower hormone levels.
Individuals who are pregnant are especially prone to pelvic floor issues but might not know they have a problem.
The pregnancy weight of a uterus can pressure and strain the muscles.
If left untreated, these symptoms can worsen over time.
Pelvic Floor Physical Therapy
An individual will meet with a specialist to discuss symptoms and undergo a physical examination that includes:
Pelvic floor exam.
Evaluation of posture, mobility, and core strength.
Once the initial exams and evaluation are complete, the practitioner will go over pelvic floor exercises and provide a treatment plan.
Recommended exercises vary based on symptoms but focus on relaxing, stretching, and/or strengthening muscles.
Muscle Relaxation
To relax the muscles, a therapist may recommend breathing exercises.
For pregnant individuals, this means timing breaths with contractions.
For individuals experiencing constipation, breathing exercises can help the body relax and reduce strain.
Stretching Muscles
Stretching can help relieve muscle tightness and stiffness.
A therapist may help stretch the pelvic floor through various therapy modalities.
This type of physical therapy can help loosen tight muscles or help gently reset dislocated organs back into place.
Strengthening Muscles
After the pelvic floor is loose and relaxed, the focus typically switches to strengthening the muscles.
Strength work may target abdominal muscles or the pelvic floor muscles themselves.
With time, commitment, and targeted treatment, individuals can use pelvic floor physical therapy to loosen tissues, strengthen muscles, and restore function.
Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and clinical urology, 62(1), 79–84. doi.org/10.4111/icu.20190248
Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493–vii. doi.org/10.1016/j.gtc.2008.06.003
Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives of gynecology and obstetrics, 299(3), 609–623. doi.org/10.1007/s00404-018-5036-6
Individuals dealing with chronic knee discomfort, hip tightness, and lower back pain could be experiencing dormant gluteal-butt syndrome. Can recognizing the symptoms and signs and incorporating lower body and core fitness help prevent and treat the condition?
Dormant Gluteal Butt Syndrome
Knee, hip, and lower back problems could be traced back to weakened buttocks. Some scientists call the condition “dormant butt syndrome” (Ohio State University, .2023). However, researchers are learning about the important role the gluteal muscles provide in maintaining the lower body strong and healthy. (Hal David Martin, Manoj Reddy, Juan Gómez-Hoyos. 2015)
What Is It?
The syndrome is defined as weak buttock muscles and tight hip flexors. Experts from the Ohio State Wexner Medical Center have worked with individuals dealing with knee, hip, or back injuries and believe many of these issues are linked to weakened gluteal muscles. (Ohio State University.2023) The glutes are the muscles of the hips and buttocks. Weakened muscles fail to absorb the shock they’re supposed to during activities, which results in overloading the surrounding muscles and joints and increases the risk of injury. (Ohio State University, .2023)
Dormant gluteal-butt syndrome can result from a sedentary lifestyle and prolonged inactivity, like sitting for long periods.
The condition also occurs in runners and other physically active individuals who forget about these muscles with targeted exercises.
Exercises
Exercises to target the gluteals and prevent dormant gluteal-butt syndrome include activities/exercises that work the hips and core.
When walking properly, the gluteals should execute hip extension naturally.
Unhealthy postures, excessive sitting, and continued dysfunctional biomechanics mean walking without achieving optimal hip extension. (Hadi Daneshmandi. 2017)
When this happens, the gluteal muscles never get to fully function work, ending up with a series of aches and pains.
Pilates exercises can be adjusted to address order, repetition, and variation to strengthen the gluteals. (Laís Campos de Oliveira, 2015)
Hamstring Curls
Lie face down on an exercise mat.
Use your hands to create a cushion for the forehead.
Bend both knees so the feet point up towards the ceiling.
Let the knees be slightly apart, but keep the heels together.
Squeeze the heels together and tighten the gluteal muscles.
Hold for 3 seconds, then release the buttocks.
Repeat 10 times and then rest.
Hamstring curls can also be done using a weight machine.
Place the hands just behind the backside with the fingers pointing forward if possible.
Raise the body up.
Keep your head up and look straight ahead.
Raise one leg as high as possible.
Hold for as long as possible.
Lower and raise the other leg.
Repeat for a total of 3 reps.
Lining Up With A Wall Posture Helper
Standing posture is important to proper buttock function. Lining the body up with a wall can help train the body to maintain proper posture.
Find a wall and stand against it from the heels to the back of the head.
Work the backs of the legs and spine as firmly as possible into the wall.
Work to get the back of the skull into the wall as well.
Add some abdominal work by working the waistline inward and upward.
Hold for up to one minute.
The alignment is how you want to hold your body.
As you move off the wall, learn to maintain that posture throughout the day and night.
Repeat the wall exercise several times for reinforcement.
If aching of the hip, back, or knee is part of daily struggles, working out the gluteal muscles may be the solution. Contact the Injury Medical Chiropractic and Functional Medicine Clinic for a full consultation.
Martin, H. D., Reddy, M., & Gómez-Hoyos, J. (2015). Deep gluteal syndrome. Journal of hip preservation surgery, 2(2), 99–107. doi.org/10.1093/jhps/hnv029
Daneshmandi, H., Choobineh, A., Ghaem, H., & Karimi, M. (2017). Adverse Effects of Prolonged Sitting Behavior on the General Health of Office Workers. Journal of lifestyle medicine, 7(2), 69–75. doi.org/10.15280/jlm.2017.7.2.69
Campos de Oliveira, L., Gonçalves de Oliveira, R., & Pires-Oliveira, D. A. (2015). Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial. Journal of physical therapy science, 27(3), 871–876. doi.org/10.1589/jpts.27.871
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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