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Forward Head Posture (FHP)

Presented by Chiropractor Andrew Green


Forward Head Posture (FHP)


Forward head posture can cause pain arthritis and pinched nerves

Forward head posture

Think of someone standing tall with perfect posture, and you probably imagine a spine appearing “straight as an arrow.” However, Andrew Green teaches patients that a normal, healthy spine has three unique curves, which are essential for balance and posture.

While side-to-side spinal curves, such as scoliosis, are abnormal, front-to-back curves are not. These curves help the body carry its weight and distribute it down through the pelvis. The three curvatures are: a bend of the neck with the apex toward the front of the body (cervical curve), a bend in the mid back (thoracic curve) with the apex toward the back of the body, and a bend in the low-back (lumbar curve) with the apex toward the front of the body.

When one of the three curvatures decreases, the body’s alignment is thrown off balance. For example, if the cervical (neck) spine’s curve is lost, the neck will begin to straighten, causing a condition called “cervical kyphosis.”

Cervical kyphosis, often termed “military neck,” can progress to the point where the curve in the neck actually reverses, going in the opposite direction from its normal, healthy state. This reversal is also known as forward head posture (FHP).

FHP can cause vast degenerative effects in the spine of the neck, such as speeding arthritis, chronic pain, limited range of motion and increasing risk of strain. The good news is that FHP may be reduced, or even corrected in many cases.

Because of the amount of time most people spend hunched over desks and computers, FHP is one of the most common findings in patients cared for by Andrew Green.  In the Reading area there is a very high proportion of the workforce in desk-based jobs and FHP and headache are common presentations at our Reading chiropractic clinic.



When the neck has a normal curve, the weight of the head is balanced and muscles endure only minimal strain. However, if the neck is straight or in a FHP position, constant strain is placed on joints.  Joints that are strained continuously are predisposed to arthritis which can even begin at early ages.


Muscle Strain

By upsetting the balance of the spine and the muscles that are attached, FHP also dramatically increased the risk of neck muscle strain. With FHP, neck and shoulder muscles are constantly working to prevent the head from falling completely over. Muscles that were designed to stabilise the neck and head now must support the weight of the neck and head throughout the day. And you thought that you were overworked – imagine how overworked the neck and shoulders must feel!


Chiropractic Care

For decades, chiropractic care has helped countless FHP sufferers. At chiropractic school, doctors of chiropractic spend five years studying the spine and techniques to maintain its natural curves.

In one study, 30 patients with reduced cervical curves received chiropractic care, which included chiropractic adjustments and a special type of cervical traction for FHP. Each patient was matched with a “control” subject who received no care.

After 38 visits over 14.6 weeks, the chiropractic group had “statistically significant improvements” in pain ratings and head angle. Control subjects reported consistent pain and no change in cervical curve or alignment.

Twenty-one (70 percent) of the chiropractic subjects were followed for an additional 14 months. All subjects maintained the correct neck curvature and pain reduction (J Manipulative Physiol Ther 2003;26:139-51).


Seat Solutions

In addition to chiropractic care, doctors of chiropractic often recommend ergonomic changes, For example, when you sit down to read or work, do you tend to adopt a “gooseneck” position with you head jutting forward? Over time, this position can increase chances of FHP.

The solution? Try to keep your head aligned with your shoulders, with the middle of you back fairly straight. As you sit, it may help to visualise the three natural curves in your spine from neck to lower back.

Also, invest in a properly designed seat to support the spine’s natural curves. One researcher reviewed studies that assessed head, spine, pelvis and lower extremities while subjects were seated.

The researchers found that ideal seats have lumbar support, armrests, adjustable heights and seat bottoms with an inclination of five degrees. They recommended that “to reduce forward translated head postures, a seat-back inclination of 110 degrees is preferable over higher inclinations. Work objects, such as video monitors, are optimum at eye level.” (J Manipulative Physiol Ther 1999;22:594-609.)


Backpack Basics

correctly fit your child's backpack

backpack fitting

Millions of children worldwide use backpacks every day, but just how safe are backpack loads on neck and head posture? Carrying heavy loads places additional stress on a child’s rapidly growing spine, making it prone to neck and spine changes.

In one recent study, researchers assessed approximately 1,000 students – aged 12 to 18 years from 10 different high schools in Adelaide, South Australia – with and without their school backpacks.

When the students carried heavy backpacks, “significant changes” were visible in their head and neck angle. The youngest students in the study displayed the greatest posture changes (Spine 1999;24:2262).

Of course, eliminating backpacks isn’t practical, but limiting their weight reduces FHP risks. Biomechanical data suggests a maximum backpack load of 10 percent to 15 percent of body weight that means simply that if your child weighs 100 pounds, his or her pack should weigh a maximum of 10 to 15 pounds.

However, a recent review of back-pack-load studies questioned this limit.

“Based on the current literature, the value of 10% weight to 15% body weight Is a justified weight limit; however, further research is required to determine the association between backpack use and injury and how the factors of load, backpack design , and personal characteristics, such as physical fitness, interact and influence the adaptations required when carrying a backpack.” (Spine 2004;29:2184-90.)


Assessing Posture

Right now, whether you’re sitting or standing, assess your neck posture. Is your head leaning forward with your neck and shoulders tense? Or is your neck straight without its proper curve? How does your family’s neck posture rate? Even small postural misalignments can eventually lead to pain and health problems. Schedule an appointment today for a complete postural assessment.  Reflex Chiropractic Caversham is your partner in spinal health and overall wellness.

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