The cervical spine is the thinnest and most flexible part of the human spine. It is tasked with supporting the weight of the head in the upright position while allowing turning in multiple planes — looking left, right, up, down and behind. It also contains structures directly tied to life sustenance, which is why the neck is a logical target when it comes to martial arts/ self-defense and restraint (and unfortunately, murder).
Given all these vital functions, it is wise to take good care of your cervical spine in a proactive way.
The cervical spine is naturally designed to curve, where the apex is at about the level of the Adam’s apple.
This curve behaves much like a spring in a car’s suspension; or the slight upwards curve you see in any bridge design. Long ago, architects discovered that the load capacity of bridges could be dramatically increased simply by integrating curves or arcs into the design. Like a neck curve, a bridge curve or arc distributes weight over a greater area so that gravity cannot concentrate over one small area and cause structural failure.
If the neck curve helps distribute the weight of the head in the upright position, what do you suppose might happen if the curve straightened out or started to bend in the opposite direction like the one to the left?
If you lose your cervical curve over time, which could happen from years of poor posture or trauma like multiple rear-end car collisions, you will probably not notice it until several years pass. The change in biomechanics shifts a greater burden of support to your cervical discs and vertebral end plates. This promotes disc degeneration. The once thick and healthy discs lose fluid content, lose strength, allow the center material to bulge out (herniate, protrude or rupture) and cause bony protuberances called osteophytes to form all around the edges of the vertebrae and facet joints.
For some unfortunate people, the bony projections narrow the passageways where the nerve roots and spinal cord pass through (a condition called spinal stenosis) and neck surgery is necessary to prevent nerve tissue from permanent damage, paralysis and severe paresthesias (numbness, tingling) in both the arms and legs.
So the bottom line: be conscientious about the importance of the health of your cervical spine. Don’t get blind-sided by an MRI diagnosis of “multiple-level, severe degenerative disc disease with advanced neural encroachment.”
I’ve seen such cases where patients were oblivious to what was developing inside their necks. They dismissed their neck stiffness and aches to “getting older” or simple muscle strain. When massage and chiropractic provided only temporary relief, they had a cervicalMRI done which revealed the formidable origin behind these symptoms, and the next step was neck surgery. Neck surgery of this nature involves removing the damaged disc, shaving off the osteophytes and inserting a bone graft to promote fusion of adjacent vertebrae.
Prevention is the best approach. You don’t have to have neck problems to start preventive measures. In fact, the vast majority of patients who have early to moderate stage degenerative disc disease have no complaints. It’s like a cavity — you don’t feel anything as the pit erodes the tooth enamel, but as soon as it hits a nerve, you will definitely be aware of its presence. But by that time, you’ll need invasive procedures. In the case of a cavity, it means either a filling or tooth extraction; in the case of a cervical disc, it might mean cervical decompression surgery.
Below is a video that summarizes the importance of maintaining a healthy cervical curve (“lordosis”) and exercises to maintain or restore your neck curve so that it can better withstand the physical demands placed on it and hopefully preclude the need to visit an orthopedic surgeon years down the road.
Also, make sure to check out this site’s Self-Care for Neck Pain video, which demonstrates home care procedures for managing musculoskeletal neck pain and/or stiffness.
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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If the neck curve helps distribute the weight of the head in the upright position, what do you suppose might happen if the curve straightened out or started to bend in the opposite direction like the one to the left?
For some unfortunate people, the bony projections narrow the passageways where the nerve roots and spinal cord pass through (a condition called spinal stenosis) and neck surgery is necessary to prevent nerve tissue from permanent damage, paralysis and severe paresthesias (numbness, tingling) in both the arms and legs.
