Forward-head Position

About ten years ago I was at a fantasy, anime, comics and science fiction event (called FACTS) with a friend. After several hours of wading through the crowd and visiting booths, we took a short brake at the sideline. As we were watching the crowd I pointed out how common it is to see people with their head in front of their body, how it looks kinda goofy and how the head should sit on top of the body. It was just an observation then. Nothing more came of it.

For years I walked slumped over. Years before this event, and a long time after, I had terrible positioning of my body. I’m not perfect now, but I am a lot better. This is in a large part due to better awareness, awareness of my body and of its position. I got better with some simple alignment exercises and strength training. The impact on proper body positioning of stronger muscles and learning proper positioning to lift heavy weights can not be understated.

Now I know not only how to better a bad position but also some names for these grievances. What we observed at the event, the head in front of the body, is simply called forward-head position or forward head posture. It becomes chronic forward head posture if one does this all the time, when it has become your ‘natural’ position. There is, of course, nothing natural about this position. After a prolonged time of adopting this forward-head position, the tissues of your neck adopt this shape to form a new stable position. This new position might be stable, in a sense, but it can still cause pain in the neck and the shoulders. Before we move on, let’s visualize what we are talking about. Observe how the neck is slanted and the ears are not aligned above the shoulders.

Forward-head position. (Wikimedia Commons)

Stacked or deviated

When your body is in good alignment then your ankles, knees, hips, shoulders and head a stacked on a straight line. This line can be an imaginary line representing the pull of gravity. It is a tool to determine postural misalignment. One can easily visualize this by using a plummet or plumb bob. One simply attaches one end a rope high up, like the ceiling, and attaches a weight on the other end. The weight is then dangled down, pulling the rope perfectly vertical. Once you look at the body from the side, the head is in a forward-head position when it is in front of the plumb line. The front being the frontal plane of the body under examination. From the patients view, everything he can see. One doesn’t name from the examiners point of view.

A sketch of deviation versus stacked.

Common causes

Several habits, day-to-day tasks and/or hobbies can lead to forward-head position. Call it modern day living, if you will. The use of a computer is strongly conducive toward rounded shoulders and upper back with a head that is pushed forward. A slumped down position while driving is another factor. Streamlining cars might be good for fuel economy but can you maintain a good position and still have a clear view of traffic and signs? How about reading a book? Are you in a chair or in bed? Either way, I bet you are rounding your back and pushing your head forward. Another example is manual work like sewing or soldering. Even in broad daylight and/or with a magnifying glass one still tends to bend forward to have as close a look as possible. Carrying a backpack full of books, for instance when going to school, is another one. One has to balance the body or you just fall over. So, pushing the shoulder and head forward is a common way to achieve this. And lastly, the major one that is ever so present everywhere, smartphone usage. If a car doesn’t hit you while staring at these tiny screens then at least you’ll have a sore neck.

Correcting

Correcting a forward-head position starts with awareness. You might not realize you have it. Once you become aware, you can check in with yourself multiple times during the day and correct where necessary. To become aware we must observe and feel within our body how deviated we are. Go stand against a straight surface, like a wall or a door. Notice how you are standing. Where are your feet? Where’s your head? Is it comfortable? Proceed and place your ankles against the surface. See if your butt is against the surface. It should be because your feet are. Then check in with your shoulders. Have them against the surface. How is your head doing? Did you correct along the way? Is it still forward? If your head is still forward, now is the time to put it against the surface. Notice your body and how you are standing. Is it comfortable? If when you first place yourself against the surface and you have to correct your head, you have forward-head position. Go stand against a flat surface every day until you are aware enough to correct yourself throughout the day. You started your journey towards correct positioning. Congrats and best wishes.

Further reading

Kendall, Florence Peterson; et al.: Muscles, testing and function. Baltimore: Lippincott Williams & Wilkins, 20055.

Neumann, Donald A.: Kinesiology of the musculoskeletal system: foundations for rehabilitation. St. Louis, Missouri: Mosby Elsevier, 20102.