Forward head is one of the most common health problem in physiotherapy clinics. It is a postural imbalance of the head to the trunk that may develop muscle neck pain, fatigue, headaches, less neck mobility, and poor personality.
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| Ref: https://health.kapook.com/view142254.html |
Forward head posture is called more than one name, include; “Scholar’s Neck”, “Wearsie Neck”, “I Hunch”, and “Reading Neck” or “Texting Neck”. It is defined as a poor habitual neck posture that induces biomechanical changes in the head and spinal columns including protraction of craniocevical region. According to the forward head posture term, head away from the body centraline anteriorly. The structural change in the positioning of the cervical vertebrae in which the upper vertebrae is extended and the lower vertebrae is bent as result of which increase weight of the head over the neck.
This type of curvature changing is found often in upper cross syndrome that is strongly associated with impairmed muscles. First muscle impairment is shortness of suboccipital muscles that reduce neck mobility. Second is weakness of neck flexors. Third is sensorimotor dysfunction increases posture fluctuation when measured in an upright position without disturbance. All of them provide high stress on cervical extensors such as levator scapulae and semi spinalis capitis and fatigue in suboccipitals like rectus capitis posterior major.
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| Left: ideal posture, Right: upper cross syndrome (Ref: https://www.manchesterosteopathy.co.uk/neck-pain) |
Finally, high stress on neck muscles causes neck pain. Pain is an unpleasant sensation associated with actual or potential tissue damage. The sensory processing of affected body parts becomes abnormal and can detect changes in the central information processing system in the state of pain experience and chronic pain.
Common treatment approaches include client postural education, respiratory exercise, ergonomic office facilities, different exercise protocols, motor learning approaches and manual techniques. An important component of physiotherapy intervention provided to patients with neck pain using a combination of stretching, strengthening and sensory training.
Physiotherapists may start treatment with neck stretching to improve neck motion. You can study neck stretching in https://rehabcompanion.blogspot.com/2022/04/physiotherapy-with-9-stretching.html . Moreover, tennis ball massage which is self - massage with your body weight and tennis ball. This procedure plays the role to soften soft tissue and increase neck motion.
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| Tennis ball |
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| Spike massage ball |
One of the most common exercises for neck pain is “Chin tuck” which is a static exercise, but could not facilitate the function of cervical stabilizers while it increases the strength of cervical extensors and flexibility of cervical flexors. Additional, chin tuck exercises may improve neck pain, neck mobility, and sensorimotor. Sensorimotor or self - perception on posture should also be considered to correct posture that can enhance participants' posture awareness and potentially alter their habitual posture.
Basic physiotherapy intervention for improve forward head
Exercise #1: Tennis ball massage at sub - skull muscles: Duration of massage is not clear. When muscles decrease tension, you can start stretching or strengthening.
Exercise#2: Chin tuck: Direction of the chin tuck exercise is glide head backward. The goal standard recommends 10 - 15 reps/set for 3 sets a day. In my clinic experience, however, the recommendation is 10 reps per hour. It means chin tuck exercise happens between after waking up until going to bed.
Remark: In case of worse pain and/or any head discomfort, you should stop exercising and observe symptoms for a while. If you do not get better, you should consult doctor or physiotherapist.
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