It’s important to fix bad neck posture not only for aesthetics, but for the swathe of very common health issues that come with it—neck pain, upper back pain, arm pain, headaches, dizziness, arm numbness etc. (You could go on forever.) But with the right posture exercises, an awareness of the causes of forward head posture, and a little diligence, correct posture is quite attainable.
Every centimetre further forwards your head sits causes more strain, irritation, and muscle fatigue in your body. You can actually measure how much forward head posture you have by standing up against a wall so that your heels, pelvis and mid-back all touch the wall. Stand with your normal posture, then get someone to measure how far the back of your head is from the wall. You should be able to touch the back of your head against the wall naturally, without lifting your chin up, with no effort. If the back of your head is 2-3 cm from the wall, your neck posture is moderately bad. Over 5 cm is severe forward neck posture.
This is only a basic test, but a good way to measure how much work you have to do.
When the mid-back is rounded, our natural line of sight moves down. We compensate by lifting the chin, creating a kind of “Nerd Neck” posture, but this compensation compresses spinal joints at the base of the neck. The inflammation and corresponding nerve irritation can cause neck pain, upper back pain, and referred pain... This referred pain can cause the dreaded “Rhomboid Pain” that so many people suffer from—a nagging, burning, or even sharp knife-like in between the shoulder blades. In other people the nerve irritation can cause pain numbness or pins and needles down the arm and even into the hand.
When joints become seized in a forward head posture over a long time, this joint restriction can make it hard to straighten up again. Muscles adapt to the bad neck position and can become strained and painful. A forward angled neck has been shown by research to cause a sore neck and shoulders. And the effect on the body increases as we get older and is responsible for a lot of neck pain in the elderly.
Every minute the head sits forward of the body, the worse our neck posture gets. Spinal joints seize in this position. Muscles at the front shorten and adapt. Important postural muscles fatigue. This is becoming more common in society due to the amount of time we spend looking at screens. There are four very common causes of forward head posture that need to be avoided:
1. Looking at devices that are positioned on the stomach
Instead of placing mobile phones on your stomach, place your elbow on your stomach instead, and support the elbow with the other hand when you’re not texting or scrolling.
2. Looking down at laptop screens
Wherever possible, plug laptops into screens that are elevated. The top of your screen should be level with your eyes.
3. Craning the neck forward to peer at screens.
Make sure that font is big enough to read without needing to move the head forward into a position of poor posture. Bringing screens closer can help. Arms distance is the perfect distance for a screen.
4. Leaning back against sofa backrests and bedheads
When we lean back against something on an angle that is not very upright, the neck tends to be pushed forward. So, sit up straighter on the sofa. Place your feet on the ground. (Raising the feet onto an elevated foot rest encourages us to lean back more). And avoid sitting in bed.
People have a fat pad at the base of the neck that sits over the spine, the 'dorsocervical fat pad'. When the amount of fat here increases, this will create what some people call a Buffalo Hump, and will increase the appearance of bad head posture. But a larger fat pad does not increase the angle of the forward head position, so does not have the same health implications. Some people naturally deposit more fat that others in this location and this will increase if they put on weight. Hormone disorders, like Cushing Syndrome, can also cause the dorsocervical fat pad to increase, as will some medication. So, if you are concerned about the size of any fat deposits in this area always talk to your doctor about it.
In some people with significant osteoporosis, the weight bearing part of the vertebrae can collapse slightly. If this happens in the mid back, the front of the vertebral body often collapses more, resulting in an increase in the arch of the mid back (“thoracic hyperkyphosis”). The pushes the neck forward, causing a forward head position. This is possible in anyone with osteoporosis, but most commonly the elderly. An x-ray can confirm this.
Research has shown that (i)McKenzie Neck Exercises (neck retraction exercises), (ii)Deep Neck Flexor strengthening exercises, and (iii)releasing the Pec minor all help improve poor neck posture.
To fix bad neck posture we need to stretch any muscles that pull the head forward, strengthen muscles that help to hold us back into good posture, and mobilise the spinal and rib joints that seize in a rounded back posture.
Posture braces that strap around the shoulders and help keep our shoulders back can help, but only a bit. Posture correctors increase our awareness of our position, and help to stretch muscles at the front (like the pecs) that have adapted to poor position. But they do very little for our neck position. And we can become reliant on them. If you are using the posture corrector and not your own muscles to help maintain good posture, your postural muscles become weak. So, at most use these devices for an hour or two maximum a day.
There are some devices that are advertised as good for the posture that you can place underneath the neck while lying face up (a “neck cloud”)… but they do very little to help. They may be able to help increase the natural arch of the neck (and even this is questionable) but this does not help the posture much. A rolled-up towel under the mid back, as shown in the postural video on this page will help flatten out a rounded mid back much more.
One device that can be of help is a posture detection device placed at the base of the neck. These electronic devices detect the angle or inclination of the spine and vibrate to give you feedback if you slouch. This can help change our habits and encourage us to use our own muscles to straighten up. When used in combination with the best posture exercises, they can help provide great postural feedback.
If your desk setup is poor, it can encourage bad posture. Screens should be elevated so that the top of the screen is at eye level. Chairs need to be able to move under the desk so that we don’t end up craning our neck forward to see the screen. And you should be able to reach your keyboard and mouse with your elbows still by your side.
Here’s a 15 point ergonomic checklist for good desk posture in 3 minutes…
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