Forward Neck Posture – Symptoms, Causes and Solutions

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Forward Neck Posture – Symptoms, Causes and Solutions

Poor neck posture leads to a Forward Head Position which is one of the most common causes of neck, head and shoulder tension and pain. This can be a result of injuries like sprains and strains of the neck leading to weak neck muscles, problems sleeping positions and the illustrated examples of driving stress, computer neck, couch neck and reader’s neck along with improper breathing habits.

For every inch that the head moves forward in posture, it increases the weight of the head on the neck by 10 pounds!

In the example to the left a forward neck posture of 3 inches increases the weight of the head on the neck by 30 pounds and the pressure put on the muscles increases 6 times.

Long term abnormal neck posture leads to straining of muscles, disc herniations, arthritis, pinched nerves and instability. Poor health can result from stretching of the spinal cord. A major part of head, neck, jaw and shoulder pain is due, at least in part, to the effects of poor posture including fibromyalgia syndrome, myofascial pain syndrome, temporomandibular joint dysfunctionand chronic fatigue syndromes.
The extra pressure on the neck from altered posture flattens the normal curve of the cervical spine resulting in abnormal strain of muscles, ligaments, bones and joints of the neck causing the joints to deteriorate faster than normal resulting in degenerative joint disease or spondylosis of the cervical spine.

Effects Of Poor Neck Posture

Posture is crucial part of normal balance and health. Many postural factors are involved in causing spasms of the neck, shoulders and back muscles, reducing healthy biomechanical function, and weakening soft tissues. These consist of forward head posture, largely due to popular use of computers, sitting at a computer or desk for extended periods, using chairs and desks that are not appropriate for the body type, a non-supportive mattress sustaining poor posture throughout sleep, deconditioning from lack of reasonable activity or exercise, increased emphasis on learning activities considered to be excessive as well as school bags that are too heavy.
Forward head posture is probably the most common posture deviations for individuals suffering neck pain. Individuals with neck and shoulder problems have greater forward head posture than those without these problems.
The effects of poor posture goes far beyond just looking awkward. In fact according to the January, 1994 issue of the American Journal of Pain Management, Posture and function are related in that poor posture is evident in patients with chronic pain related conditions including low back pain, headaches directly related to the neck, and stress-related illnesses. Posture affects and moderates every function from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the functions most easily influenced by poor posture.forward head causes

According to the Mayo Clinic Health Letter Vol. 18, #3, March 2000, the effects of long term forward neck posture leads to “long term muscle strain, disc herniation and pinched nerves.”

Can You Change The Posture Of Your Neck?

Correction of poor neck posture is key to stopping and reversing the decay and degeneration that neck structures undergo and problems that can result including neck pain symptoms, tension and migraine headaches and pain between the shoulders. When the spinal tissues are subject to significant pressure for long periods of time, they deform and undergo a remodeling in which these changes can become permanent. This is why it takes time and a concerted effort using multiple techniques to correct the poor neck posture condition.

A June, 2009 article in the Chinese Journal Zhongguo Yi Xue Ke Xue Yuan Xue Bao indicates that abnormal neck posture is associated with sympathetic symptom of degeneration which may include; headaches, abnormal functions of the eyes and the ears, and psychological and mental disorders.

I’m Not Sure If I Have A Poked Neck, Is There A Quick Way To Check If I Have It?

testYes. Stand up right now. Place your back towards a wall with your bottom, lower back and shoulder blades completely flat against the wall. Are you up against the wall? Good. If not, stop reading and get into position!
Whilst standing, does the back of your head naturally come in contact with the wall? (make sure that you’re not cheating by looking up or over arching your back).
If you are like the 85% of the patients I see, the chances are that you have tested positive for the forward head posture.

What Causes The Forward Head Posture?

The forward head posture is part of a bigger problem – bad posture.
The human body was not designed for prolonged periods of sitting or sedentary lifestyles. Our bodies automatically adapt to our environment and when we continually place ourselves in sub-optimal positions such as hours of sitting, certain muscles that are responsible for good posture will weaken and tighten.
As the body follows where the head goes, if you have a forward head posture, your shoulders will also hunch forward with it.

According to the 31st Annual International Conference of the IEEE EMBS Minneapolis, Minnesota, USA, September 2-6, 2009; “Over time poor posture results in pain, muscle aches, tension and headache and can lead to long term complications such as osteoarthritis. Physiological and biomechanical stress due to sustained postures limit important musculoskeletal stimuli that are essential for normal musculoskeletal development”.

Neck Posture Solutions:

Awareness of the correct neck and shoulder posture is the beginning of correction. Do the wall test as described above. You can check someone you care about by standing straight and having them look up at the ceiling, down at the floor and then straight ahead. Picture an imaginary line through the center of the shoulder and up to the head. The line should land through the middle of the ear.

A crucial part of correcting poor neck posture is the retraction & nodding neck exercises which are designed to help gain control over postural neck muscles which have become weak and fatigued over time. These tend to be deep muscles that are responsible for maintaining good posture which are often overlooked in exercise/stretching programs. There are some great exercise equipment to help with neck exercises, which can help with training as well as motivation.
For office use and video game play, place your computer monitor height so that the top third of the screen is even with your eyes and the screen is 18-24 inches from your face. It is important to learn more about computer ergonomics.
Take frequent breaks. If you sit for long periods, take frequent breaks, even if only for 30 seconds to get up or do the neck exercises. Pull your head over your shoulders and squeeze the blades of your shoulders together in the back.

Maintaining correct posture is not just for the neck. Alignment of the back is important as well, and this can affect the neck and shoulders. A November, 2014 issue of the Journal of Physical Therapy Science featured a study where the authors found that sitting with the legs crossed for more than 3 hours a day can cause shoulder tilt and forward head posture.

Always use a back support pillow when sitting or driving if your seats are not designed properly to support the spine. By supporting the back, the head and neck will move back over the shoulders. If you have difficulty finding a back support that works for you, the Actively Designed Seat Cushion can help activate certain muscles to help support better posture for sitting and prevent muscle fatigue. In the journal Work. Volume 36, Number 1 / 2010, an article titled “Effect of different seat support characteristics on the neck and trunk muscles and forward head posture of visual display terminal workers”, indicates an unstable seat cushion relaxes neck muscles and improves posture better than a spongy soft-cushion seat support.

Many backpacks are improperly designed and cause the head to move forward to compensate for weight in the back. Make sure you and/or your kids use properly designed backpacks that distribute weight evenly and help to prevent strain that begins the process of poor neck posture.

According to a February, 2009 issue of the international journal Cephalalgia, “We found a concerning association between neck pain and high hours of computing for school students, and have confirmed the need to educate new computer users (school students) about appropriate ergonomics and postural health.”
Another February, 2009 article in Cephalalgia noted in regard to Respiratory Dysfunction In Chronic Neck Pain Patients; … “the study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients.”


All exercises are designed to be gentle and pain free. If you are unsure of anything, you may want to seek some advice from your health professional prior commencing these exercises.
You need to do the following exercises at least 2 times/day to see any significant benefit. It should take you roughly 15 minutes to complete properly.


There is a group of muscles which get very tight underneath the base of your skull (see above: X marks the spot).
These muscles are required to be loosened up before we can correct the position of your head. If you have pain in the neck, it is likely that you may experience a sense of heaviness or tenderness in this particular area.
These muscles are usually over active in people with a forward head posture and can be responsible for symptoms such as dizziness or headaches.

release2a) Tennis ball release – Tennis balls (or anything of the similar shape) make a great tool to release this area. Place the ball under your head as to press into the areas underneath the base of the skull.
Practice rotating your head from side to side to emphasise certain areas.
Generally speaking, if it hurts, you are on the right area. Aim to get a solid 5 minutes of this. Do both sides.
Note: If you start to feel dizzy or your pain gets significantly worse, apply less pressure on the neck as you may not be used to the exercise yet.

If you can’t get your hands on any tennis balls, you can apply pressure to the same areas by pressing with your thumbs, however, please do not injure those thumbs of yours!

b)stretch Stretch: With your hands at the back of your head, feel the stretch at the back of your neck as you gently pull your head forward. Hold for a minimum for 30 seconds and repeat 3 times. Check out this post: The 5 best stretches for neck pain for more information on neck stretches.



tucksNow that those tight muscles are released, we can start to strengthen the muscles that are responsible for maintaining the correct position of the head.

a) Chin tuck: Whilst sitting upright, gently tuck your chin in as to make a double chin. (Yes , I know it feels weird and looks odd, but I guarantee you that the more you do this, the easier it will become). You should feel a gentle lengthening sensation at the back of your neck as you are performing this exercise.

A common mistake I often see is the person starts to move their head up/down. Make sure your eyes and jaw stay level, and move the head horizontally backwards. Hold for 5 seconds and repeat 30 times.
As this exercise becomes easier, challenge yourself with the following exercise progressions…


holdb) Chin tuck (against gravity): Whilst lying on your stomach and your head off the edge of a bed (as above), continue to gently tuck your chin in as described before. Since you are moving your head against gravity, there is a greater challenge on your muscles. Aim to hold for 5 seconds with 30 repetitions.




wbandc) Chin tuck with theraband: This progression is similar to the chin tuck as mentioned above, however, against a theraband resistance. Aim to hold for 5 seconds with 30 repetitions. If you can do these exercises with proper technique, you are well on your way on developing strong muscles of the neck.



nodsWe also need to strengthen the muscles at the front of your neck (called the deep neck flexors) which work in conjunction with the muscles at the back. Whilst lying down with a fairly thin pillow to support your neck, gently perform a chin tuck (as above) and add a chin nod (as if to say ‘yes’).
As you perform these exercises, you may feel a slight stretch at the back of the neck, but also a small sensation of the muscles at front moving.
The trick with this exercise is to make sure you to remain as relaxed as possible. You should not feel the muscles at the front of your neck strain as you nod. Be gentle. Hold for 5 seconds. Repeat 30 times.



The thoracic spine is essentially your upper back. If this area is very stiff (which it is in most people who have a desk job), it can indirectly cause the forward head posture.


Without boring you with too much detail: If you have a forward head posture, then you most likely have tightness at the front of your chest/shoulder due to shoulder hunching.

door-stretcha) Chest stretch: Whilst lunging forward, spread out both of your arms and lean on the door frame. Try this exercise at different angles to get different areas of tightness. Hold for a minimum for 30 seconds and repeat 3 times.

peck-stretchb) Front shoulder stretch: Whilst keeping your hands on a chair behind you, slowly squat down until you feel a stretch at the front of your shoulder. Make sure you maintain an upright posture. Do not flare your elbows out. Hold for a minimum for 30 seconds and repeat 3 times.

c) Scapula strengthening: To prevent the front of your shoulders rounding forward and becoming tight again, you will scapulaneed to strengthen the scapula blade muscles. Practice pulling your shoulder blades back and down. Hold for a minimum for 30 seconds and repeat 3 times.



– When sleeping, make sure you do not use a overly thick pillow to support the neck. Your ideal neck alignment should be maintained whilst lying down.
– When walking, pretend that there is a steel bar connected to the back of your head and the back of your spine. This will help you not to lead with your chin and keep it tucked in.
– Maintain good posture throughout the day.

Although many experience immediate pain relief, do not be discouraged if you do not see immediate results. It surely hasn’t taken a short time for your forward head posture to develop, so it is going to take some time for it to be corrected.
See how you go with that. And keep that chin tucked in!