Whether it’s looking down at our phone, at the screen in front of us, or just the effects of prolonged forward head posture, it is evident that we are altering the positioning of our spines, thus creating a neuromuscular dysfunction all along our Kinetic Chain of movement. This altered posture is creating an ever growing epidemic of joint discomfort and muscular injuries that consists of all ages, young and old.
The vertebral column, which is part of the axail skeleton, consists of the cranium, verterbral column, ribs and sternum, consists of reciprocal curvatures along the sagital plane that provide the “ideal” posture to support the frame of the body in it’s vertical line against gravity. Throughout ones life, a multitude of disorders of the spine can affect the posture and lordosis of the cervical and lumbar region of the spine. Disease, trauma, overuse and normal aging can create neuromuscular and musculoskeletal components of the spine (Neumann, 2010). Due to the close proximity of the spinal cord and nerve roots, many neurological complications can occur along the vertebral column along with habitual malaligned postures can create impingement on the neural tissues (Neumann,… Click To Tweet
The prolonged cervical protraction as displayed by the client in the image, extends the upper craniocervical region when the head flexes the lower to mid cervical spine which diminishes the space between spinous process of C1 and C2, and increass the strain on the craniocervical extensor muscles (Neumann, 2010).
. Clark and Lucett define this posture as an Upper Extremity Impairment Syndrome that is characterized by the forward head posture with rounded shoulders Click To Tweet. This malalignment would lead to improper scapulothoracic or glenohumeral disfunctions in joint movement. The tight overactive muscles would be the pectoralis major and minor, anterior deltoid, subscapularis, latissimus dorsi, levator scapulae, upper trapezius, teres major, sternocleidomastoid, scalens and the rectus capitis. The lengthened muscles would be rhomboids, lower trapezius, posterior deltoid, teres minor, infraspinatus, serratus anterior, and the longus coli and capitis. Potential joint dysfunctions would be at the sternoclavicular joint, acromioclavicular joint, and the thoracic and cervical facet joints. Injuries that could create would be rotator cuff impinginment, shoulder instability, biceps tendinitis, thoracic outlet sysndrome and headeaches (Clark and Lucett, 2011).
Proper corrective exercise activation and integration would be static stretching of the over active shortened muscles and strengthening of the lengthened, potentially weakened muscles. Exercises to help strengthen the isolated muscles would be as follows: 3-5 days per week for 1-2 sets each exercise for 10-15 repetitions with a 2-4 second isometric hold at end range and 4 second eccentric action. ParQ and health questionnaire for possible precautions and contraindications must first be completed.
Correct Forward Head Posture
Holding onto a resistance band or weight system with arms extended forward, pull by squeezing your scapula together towards the spine. Complete 10-12 reps for 1-2 sets in a slow controlled manner.
Holding a light dumbbell or can, with your thumb in the upright position, raise to the side and hold for 2 seconds at the top. Return to the side. Complete 10-12 repetitions for 1-2 sets in a slow controlled motion.
Using a light resistance band or pulley system, pull towards the upper chest with the elbows out wide and hold for 2 seconds. This exercise will target the posterior deltoid to help keep your shoulders back. Complete for 10-12 repetitions for 1-2 sets.
Lying on your side with a light dumbbell or can, keep your elbow tight towards the body and rotate outward. This exercise strengthens the infraspinatus and teres minor (rotator cuff muscles) to help stabilize the shoulder joint. Complete 8-10 repetitions for 1-2 sets in a slow motion.
Laying supine and holding a pair of dumbbells with fully extended arms, attempt to rotate the shoulders upward while keeping the arms completely straight. You should feel your shoulder blades (scapula) move away from the spine. Complete 10-12 repetitions for 1-2 sets.