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Rehab for Forward Head Posture

February 2 2012

 Rehab for forward head posture

by Elizabeth Welch, DC


orward Head Posture (FHP) is a condition where the head extends out in front of the shoulders creating an insidious breakdown of the musculoskeletal system throughout the entire spine. In a "normal" posture, the middle of the shoulder should align with the external auditory meatus. While detecting FHP in a patient is a simple process, correcting it is another thing altogether.

R32;FHP affects much of the population - men and women, adults and children, alike. Whether due to computer ergonomics, carrying a heavy backpack, a weak core, or trauma causing muscle imbalance, the fact is that the public is more affected by FHP today than ever before.R32;When a child carries a heavy, book-laden backpack, the head is forced forward to counter balance the weight, resulting in abnormal stress to the discs, joints, nerves of the neck, shoulders, and lower back. Positioning computer screens too low, coupled with the repetitive motion of moving the head forward to read the screen, is another primary cause of FHP.

R32;When kids play video games or watch TV in poor posture, the repetition of sitting in one position for long periods of time causes the body to adapt to this bad posture. In fact, the bent-over posture of a 60-year-old woman with a dowager's hump, has its seeds in the posture of a 16-year-old girl slumping in front of a TV or computer for hours on end.

R32;Despite ample evidence that posture affects physiology, function and balance, the medical community does not give FHP proper attention. We in the chiropractic community, on the other hand, see this potentially devastating condition for what it is - a true malady. ("Forward Head Posture leads to long-term muscle strain, disc herniations, arthritis and pinched nerves." Mayo Clinic Health vol 18 #3 Mar2000.)

R32;The average patient walks into our office overweight and carrying a 10-15 pound head an inch or more in front of his or her shoulders (the effects of gravity on this now-unbalanced object results in an effective weight of 45+ pounds). With this condition, all of the compensating mechanisms go into effect - rounded fibrotic shoulders, and a core that’s proportionately weak to the cervical lordotic curve (or lack of it) - resulting in undue stress on the nervous system as well as reduced health and well-being.

R32;We can treat this condition with an "active care program." This is great not only for the patient’s health and well-being, but it can also significantly contribute to your income streams. Part of your active care program should include a self-help component, so you empower your patients for a lifetime of good health.R32;Although it's great to have systems in place that utilize a variety of different therapeutic exercises when billing for active care services, if your emphasis is on using exercise machines - or even bands, Bosus’, balls, etc. - the patient can only benefit while in your office, as it relates to changing muscle memory and reducing FHP. That is, if you’re even focusing on reducing FHP and core strengthening. If not, your patients are missing out on this huge benefit of care, postural improvement.R32;In addition to providing active care in the office, teach your patients how to properly exercise key posture muscles when at home, in the gym, or at work. This will result in changing muscle memory to achieve and sustain a neutral neck, as well as shoulders that are loose and upright, and at the same time develop a stronger core. We all want this result!

R32;The exercise program should address the following five aspects of fitness that all work together for good health:


  strength (supports calcium uptake)



  posture (or balance).

This is also the kind of active care that insurance carriers want to see. It isn’t cookie cutter, but addresses flexibility, balance, resistance, strength, and cardio and all while improving your calcium uptake for a healthier BMI and BMR. This type of program creates stronger muscles and stronger bones, as patients learn to exercise in good posture.

R32;The end result is rehab for a lifetime, simply because it’s necessary to exercise for a lifetime to maximize your health potential.


Written by Dr. Elizabeth Welch, DC.

Reference: http://www.thechiropracticjournal.com/news4.php?M=january&Y=2012

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