FORWARD HEAD POSTURE. Is this causing you trouble?

This problem is becoming prevalent in our communities due to poor posture when using your computer, mobile device and generally being unaware of posture or where our bodies are in space as we do less and less in our physical world. This is particularly important to parents as our children are now engaging in so many of the activities that lead to this condition.

As a child I remember we were always reminded to “walk tall” with head up, shoulders back and down. Our lifestyles have changed to the point where forward head posture or “poke chin” is becoming a real physical problem and making us old before out time. Just watch a line of graduates going up to collect their awards and you will see ample evidence of the prevalence of this condition.

I have been talking about this at exercise sessions where I remind you to keep your head in line with your body when doing planks and push ups (keeping eyes looking 40 to 50 cm ahead helps keep the right position) and also thinking about pulling shoulders back and down, drawing your scapulars together when in a standing position.

The reason for this is that for every inch the head moves forward of the shoulders, the effective weight of the head is amplified by 4.5 kg or 10 pounds! This means a 5.5 kg or 12 pound head held 3 inches past the shoulders places 19kg or 42 pounds of pressure on the neck and cervical extensors. Ouch!

When loads like this are added to the neck, a condition called forward head posture results and a myriad of problems for the body ensues.

Causes of FHP

A forward head posture can be the result of injuries like sprains and strains of the neck. It can also be created by:

  • Repetitive:

    • Computer and TV use

    • Video gaming

    • Texting

    • Heavy backpack carrying

    • Gardening

    • Movement during work. Certain professionals have a higher risk of developing FHP (hair stylists, massage therapists, painters, computer developers, writers, etc.)

  • Poor ergonomic posture during activity and rest that leads to:

    • Texting-neck

    • Driver’s-neck

    • Computer-neck

    • Sofa-neck

    • Reader’s-neck

  • Weak neck muscles
  • Rotational athletics where one side of the body is dominantly used (tennis, golf, hockey and baseball)

Symptoms of FHP

With this increased pressure on the neck and shoulders those muscles have to carry the added weight all day in an isometric contraction. This causes neck muscles to strain, lose blood, become fatigued and cause pain.

Some symptoms of forward head posture include:

  • Forward head position

  • Rounded shoulders

  • Chronic pain (neck, shoulders, upper, lower and middle back)

  • Temporomandibular joint (TMJ) dysfunction

  • Teeth clenching

  • Fatigue

  • Arthritis

  • Pinched nerves

  • Poor appetite

  • Decreased range of motion

  • Loss of overall height

  • Myofascial pain syndrome

  • Headaches and migraines

  • Numbness or tingling in arms and hands

  • Muscle spasms

  • Sore and tight chest and neck muscles

  • Asthma

  • Impaired athletic performance

  • Poor sleep or insomnia

  • Disc degeneration

  • Trigeminal neuralgia (facial pain)

  • Mouth breathing/sleep apnea


    Typical muscle imbalances associated with FHP

    Tight, facilitated muscles

    • Pectorals (pec minor and major)

    • Upper trapzius

    • Levator scapulae

    • Sternocleidomastoid

    • Suboccipitals

    • Subscapularis

    • Latissimus dorsi

    • Arm flexors

    • Weak, inhibited muscles

      • Longus capitis

      • Longus colli

      • Hyoids

      • Serratus anterior

      • Rhomboids

      • Lower trapezius

      • Posterior rotator cuff

      • Arm extensors

         Physiological effects of FHP

        Poor posture can negatively affect all of the body’s physiological systems including breathing and hormonal production altering mood, blood pressure, pulse and lung capacity. Some cases of FHP have even resulted in the loss of 30% of vital lung capacity!

        Physical consequences of FHP

        Extra pressure on the neck from altered posture flattens the normal curve of the cervical spine resulting in abnormal strain of muscles, ligaments, bones and joints of the neck. This causes the joints to deteriorate faster than normal, resulting in degenerative joint disease and/or neck arthritis.

        How to correct forward head posture

      • Implement strengthening and stretching exercises for the muscles in your upper body, from your hips all the way up to your chest, back, neck and head.

      • Strengthen your core muscles.

      • Practice deep breathing exercises.

      • Be mindful of your posture while driving a car, working at a desk, sitting on the sofa, reading, talking on the phone, texting and when sleeping.

      • Make sure your desk and office setups at home and work are ergonomically correct.



      Let’s face it, if you have rounded shoulders and forward head positon you look old and unconfident. If you have forward head posture, it is important that you address this issue sooner rather than later.  If you choose not to do anything about FHP, serious health consequences like degenerative joint disease and myofascial pain syndrome may develop.

      Avoiding the stress of added weight on your neck is important.  Practicing mindfulness and focusing on deep breathing and optimal posture will do wonders for the musculoskeletal system. Combine this with an appropriate corrective exercise and myofascial release program and you will help reverse forward head posture and the pain associated with it.

      Email me if you identify with any of these problems and we can set up a corrective program for you. I can also refer you to a good physiotherapist if your problems are severe.


      1.    Gore DR et al. Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986;6:591-694.

      2.    Kapandji, Physiology of Joints, Vol. 3