Chronic Forward Cervical -
Muscular imbalance associated with chronic forward head position and
Habitual forward head posture can occur for two different reasons.
First, a hyperextension or whiplash to the neck can injure anterior
muscles such as the sternocleidomastoid, longus colli, and scalenes
anterior. As a result of this whiplash, chronic spasm in the
strained muscles translates the head forward, resulting in excessive
flexion, especially at the cervical thoracic junction. A clinical
sign often associated with forward head posture is the realignment
of the sternocleidomastoid within the sagittal plane.
A second cause of chronic forward head posture can be related to
progressive shortening of the anterior neck muscles. One such
scenario involves purposely protracting the craniocervical region to
improve visual contact with objects manipulated in front of the
body. This activity is typical when viewing computer screen. This
position if held for an extended period, may alter the functional
resting length of the muscles eventually transforming the forward
posture into “natural” posture.
A chronic forward head posture also stresses the extensor muscles
such as the levator scapula and the semispinalis capitis muscles.
Additionally, the suboccipital muscle such as the rectus posterior
major maybe fatigued as a result of prolonged extension activity
required to level the head or eyes. Prolonged muscular stress can
lead to localized and painful muscle spasms or trigger points, which
are found commonly in the levator scapula and suboccipital muscles.
This condition is often associated with headaches with radiating
pain into the scalp.
Taras V. Kochno, M.D.
Board Certified in Physical Medicine & Rehabilitation
Copyright July 2, 2012