Forward head posture (FHP) is a complication of the combination of slouched-forward shoulders and kyphosis (rounded upper back) that has become a common result of modern-day living and working.
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Causes of Forward Head Posture
This "humpback" position can lead to a painful shortening of the muscles of the back of the neck, as well as compression of the cervical vertebrae—the uppermost portion of the spine that supports the head and protects the spinal cord.
Here's why: When your shoulders and upper back round forward and down, your head naturally follows, pulling your gaze downward as well. In order to see what's in front of you—say, your computer screen or the view out of the front windshield—you need to lift your head.
Doing so causes your jaw to jut forward and creates a sharp crease in the back of your neck where there should instead be a straight line extending from the back of your head to the middle of your upper back.
Other situations that can contribute to forward head posture resulting from kyphosis include constantly looking down at a cell phone, tablet, or another device; doing close work, such as sewing; and frequently carrying a significant amount of weight, such as a child, in front of your body.
Side Effects
The consequences of chronic forward head posture can be significant. In this condition, the weight of the head places increased pressure on the neck and cervical spine, forcing the body out of balance.
Over time, this misalignment can lead to a number of issues:
- Hyperextension of the cervical spine
- Contraction at the front of the chest
- Nerve issues in the arms and hands (pins and needles, numbness)
- Headache
- Tension neck syndrome (neck, shoulder, and joint pain, stiffness, and decreased range of motion
- Temporomandibular joint pain
- Balance issues
- Reduced respiratory function and efficiency
How to Fix Forward Head Posture
Any ergonomic changes you can make to your workspace, environment, or lifestyle habits that make sitting or standing upright more comfortable will help reduce the risk of forward head posture. However, this may not be enough.
A 2017 study comparing targeted exercise to workstation modification for reducing office-related neck, shoulder, and back pain found exercise was the more effective approach.
Exercises
That's why exercise—in the form of stretching and strengthening—can be so helpful. The following three exercises are designed to address the individual problems that contribute to forward head posture, including kyphosis. Try to do these exercises for at least 15 minutes each day. It's best to perform them in one quick session (although you can do cervical retraction throughout the day as well).
Cervical Retraction
Cervical means "neck" and retraction means "to bring back." In this key posture exercise, the goal is to bring your head back in line with your cervical spine.
To do the exercise:
- Start by sitting up straight on a chair.
- Tuck your chin slightly toward your chest.
- Holding the tuck, press the back of your head toward the wall behind you. It will feel as if you're moving your head a bit diagonally toward the ceiling.
- Hold the stretch for a few seconds, relax, and repeat.
Do 20 to 30 reps at once. Or, break it up into 5 to 8 reps four to five times a day.
Rhomboid Strengthener
The rhomboids are the muscles that support the upper back and hold it in proper alignment. They are responsible for pulling the shoulder blades toward each other and pressing the shoulders down, away from the ears.
You can activate them by squeezing your shoulder blades toward each other—a move that will immediately and naturally pull your shoulders down and back, reversing the forward slump. Strengthening the rhomboid muscles so they're more resistant to the forward pull of gravity can help reverse kyphosis and the forward head posture it causes.
To perform the exercise:
- Sit on a firm chair.
- Wrap your arms around your ribs as if to hug yourself.
- Try to touch your shoulder blades with your fingers, keeping in mind you'll only be able to reach the outside border.
- "Walk" your fingers downward to try to find to bottom tips of each blade and then release the hug.
- Bring both hands behind your head, lifting your elbows to bring your upper arms parallel to the floors.
- Holding this position, squeeze your shoulder blades toward each other to activate the rhomboid muscles. Hold for a count of 5 and slowly release.
- Repeat, this time imagining there's a quarter between your shoulder blades that you need to hold in place. This will help you increase the degree to which you squeeze the muscles.
- Hold for a count of 5 and slowly release.
Pectoral Stretch
The third exercise is a simple stretch of the muscles that span across the width of your chest—the pectoralis muscles, or pecs. When the shoulders slump forward, these muscles squeeze together and tighten up, so it's important to try to loosen them from that position.
A corner pec stretch is much like a push-up at the wall, except that the emphasis is placed on staying in the position that causes your chest muscles to lengthen.
Here are the basic moves:
- Stand facing the corner of a wall.
- With your elbows bent 90 degrees and your upper arms parallel to the floor, place your palms and forearms against each adjacent wall.
- Inhale and then, as you exhale, pull your abdominal muscles toward your spine to stabilize your lower back.
- Without moving your feet, lean your torso toward the wall until you feel a gentle stretch across the entire front of your chest.
- Hold for between 20 and 30 seconds, then return to starting position and repeat three to five times.
How to Check Your Posture
A small mirror placed at your desk (so you see your profile from the corner of your eye) can help remind you to keep an upright posture while sitting. You can also set an alarm on your phone or computer to ping every 15 minutes or so to remind yourself not to slouch (devices are also available especially for this purpose).
Over time—especially if you’re combining strengthening and stretching into your routine—you eventually won’t have to think about it. Maintaining your posture will feel better and more natural than slouching or leaning forward.
Remember that the human body was simply not built to maintain one position all day—taking a quick break to stretch and move every half-hour or so should be an essential part of your daily routine if you work at a desk or perform repetitive motion of any kind.
When to See a Healthcare Provider
If you’re experiencing headaches, TMJ pain, or other symptoms of forward head posture, or if your neck and shoulder pain is persistent (lasts for more than a few days) or interferes with your quality of life, it’s time to see your healthcare provider. They can help diagnose the source of your problems and refer you to a physical therapist, who can design a program of strengthening and stretching tailored to your individual circumstances and physiology.
Frequently Asked Questions
How long does it take to fix forward head posture?
With a stretching and strengthening routine, it doesn’t take long to start to feel better. In one study, just four weeks of strengthening and shoulder stabilization exercises improved pain, discomfort, and quality of life in participants who trained for 30 minutes a day, three times a week.
A Word From Verywell
If you're prone to neck pain, if you've injured your neck, shoulders, or back, or if you have a condition such as arthritis, check with your healthcare provider or a physical therapist before doing these (or any) exercises for the first time. These moves can be beneficial, but you'll need to know how to avoid exacerbating an existing problem.