Do you experience neck pain or stiffness?  Tension headaches?

Do your upper shoulders feel like bricks and have tight, sensitive knots as big as golf balls?

Any pain, strain or weakness in your upper back between your shoulder blades?

If so, you likely have Anterior Weight Bearing of the head, or Forward Head Posture.

Appearance is the least of your worries when it comes to poor posture.

Yes, people tend to look much better when standing up straight and confident as opposed to looking like Quasimodo in his advanced years.  But looks are not the main problem with a slouched posture.

You see, posture has a direct impact on your breathing quality.   If your rib cage and spine are hindering your diaphragm movement and lung expansion, then your breaths will be more shallow.  You’ll be getting less oxygen to your muscles and organs; you’ll expend more effort breathing, and you will likely feel fatigued more often than not.

On average, a person at rest takes about 16 breaths per minute. This means we breathe about 960 breaths an hour and 23,040 breaths a day!   That’s a lot of energy expenditure, which is hindered by poor posture.

Anterior weight bearing of the head, unfortunately, is very hard to avoid.  Because your eyes are in front of your body and not in the back of your head, you naturally flex your neck forward to focus your eyes on what you are doing.  This means bending your neck forward as you look at a computer monitor, when reading a book, or when doing just about every activity of daily living:  brushing your teeth in front of the mirror, working on a hobby, playing with your children and so on.  All these activities will cause you to bend your neck forward.


Bad posture can lead to advanced arthritis and spine decay.

Your spine, when viewed from the side, has curvatures that work like springs on a car’s suspension system.  They dampen shock to the spine.  Do you know that the simple act of walking puts significant forces into your spine, thanks to gravity?  If you are a runner, those forces are multiplied exponentially.

In a strong, healthy spine, these forces are adequately absorbed by the curves, discs and supporting soft tissues.  If you have lost some of your spinal curvatures, then the forces generated from walking, running, jumping, and yes, sitting are not going to be dispersed as well and your delicate joint surfaces will have to bear more of this burden.  Over time, this can make your spinal segments look like the one below (left spinal segment):


Spinal degeneration occurs mostly in the neck and lumbar spine.

Your neck and lumbar spine are where the nerves that go to your arms and legs branch out from, so adverse alterations to these areas can lead to symptoms in your extremities:  pain, numbness, tingling or weakness.

With forward head posture, your head, which weighs 10-12 pounds translates several inches in front of the spinal axis.  This creates a “moment force” that is placed mostly on the back neck muscles, upper shoulder muscles and cervical discs.

To get an appreciation of this, imagine balancing an eight pound shot put in your  hand, with your wrist bent and your elbow resting on a table; forearm pointing straight up supporting the shot put.  It takes little effort to keep that shot put steady.

Now, while still holding the shot put, straighten your wrist and flex it forward so that the shot put is no longer in line with your wrist and forearm (analogous to forward head posture).

All of a sudden, this shift in weight changes everything:  your forearm muscles tense up (analogous to your spinal muscles) and your wrist will soon experience strain (analogous to your neck muscles).

 This is what happens when the center of gravity of your head moves even just a few inches forward of your spine (reference point at the base of your neck).

Here I illustrate this using a therapy weight pad:


Normal neck curve = strong biomechanics and support, while…


Flattened or reversed neck curve = poor biomechanics and tissue strain

If you have persistently bad posture; especially forward head posture, you are setting the stage for problems.  Abnormal stresses to the spine weakens discs, ligaments and cartilaginous surfaces.  This is the recipe for spinal decay and increased chance of spinal cord or nerve root impingement.

So if you have forward head posture, start doing exercises that strengthen the back of your neck muscles; stretch shortened, anterior (front) neck muscles, and strengthen your lower back muscles and core.    It also helps to stretch shortened muscles in your legs and pelvis that might be restricting your lumbar spine of proper movement.  More on this later.

So what do you think?  Do you do any exercises and stretches to improve your posture?  Let me know!

Dr. P

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