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Chronic Forward Cervical - Head Posture

Muscular imbalance associated with chronic forward head position and posture.


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








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