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What home-retraining exercises do you give your forward-head posture clients?

Strengthening...stretching...what seems to work best for you?

Replies to This Discussion

Permalink Reply by Rick Johnson on January 18, 2010 at 11:47am

Allen, that's a great idea. I'll use it, Thanks.

Allen Rubin said:

When attempting to lengthen pec minor, I ask the client to reciprocally inhibit it by retracting and depressing the ipsilateral scapula ("put your shoulder blade in your back pocket") while I simultaneously strip through pec minor.

Permalink Reply by Michael McAleese on January 18, 2010 at 11:51am

Stretching neck, Rhomboids and pecks... just simple types of Stretching

Mike Outside Chicago
www.sohmar.com

Permalink Reply by Jacqueline M Curan on February 6, 2010 at 5:38pm

Eric what retraining exercises do you give to your forward head posture clients?

Permalink Reply by Erik Dalton, Ph.D. on February 10, 2010 at 10:34pm

Hey Jacqueline:

Most bodyworkers understand the down-side of head-forward postures. For every inch the head migrates forward of the shoulder girdle, the weight of the head on neck increases by 10 pounds. So, a forward neck posture of 3 inches increases the weight of the head on neck by 30 pounds forcing the neck's capital and cervical extensors to restrain around 40 pounds against the unrelenting forces of gravity.

An article in the Chinese Journal Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2009 Jun;31(3):381-2 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.

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".

As indicated in an article published in the Spine Journal, 1996;6:591-694, extra pressure on the neck from altered posture flattens the normal cervical spine's curve 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 neck arthritis.

Correction of forward head posture takes awareness, resolution of underlying causes, and repetition to make a lasting impact. I've found these simple home re-training tips helpful:

1. A great way for clients to re-program the neuromyoskeletal system is by performing 10 chin retractions every hour on the hour throughout the day.
2. In most cases, forward head postures are accompanied by rounded shoulders and a slouched upper back posture.
Therefore, client's must focus on lifting the chest, not just tucking the head and chin. Simply retracting the head will not correct the problem. In fact, this can cause a jamming of the lower cervical vertebrae.
3. A simple instruction to help them lift the chest is to imagine they have a helium balloon attached to each of their chest muscles and they are lifting them toward the ceiling. In most cases, just lifting the chest causes a natural retraction of the shoulder girdle.
4. Ensure clients use proper ergonomics when driving, at work and at home, i.e., check things like computer height. Another tip is to ask the client to try adjusting their car's rear view mirror an inch higher. This will remind them to sit straight while driving.
5. Improper abdominal training is a major culprit in forward head postures. Try to discourage clients from performing endless amounts of crunches. Think lift and spring when advising and treating clients.

The therapeutic goal is to restore natural spinal curvature and stimulate tone in the body's antigravity spring system.

Jacqueline M Curan said:

Eric what retraining exercises do you give to your forward head posture clients?

Permalink Reply by Hans Albert Quistorff, LMP on February 11, 2010 at 1:59am

Hi Barbara:
I will put my answer to Erik under your ? because this is what I give to my work at home clients.
First I suggest that you sit on an appropriately sized ball instead of an office chair. This will keep your spine in motion as you reach for and look for things on your desk.
Plan on regular breaks in your work schedule that only take a few minutes but reset your posture memory. Place the body ball against a clear space of wall. [the door may be the only clear space from what I have observed] Place the arch of the low back over the center of the ball. Turn the palms up and out to the side. tilt the head forward then push it back then up level. Keep a focal point so that the head stays level. as you slightly bend the knees. This will roll the ball up against T12/11/10 which are the reciprocals of the dowager's hump. as you increase the curve at this point it will signal a straightening at the dowagers hump. At that point you try to lift the first three ribs from the front of your neck as you breath in. This is a FUNctional exercise so only repeat it as many times as it is fun.
Hans Albert Quistorff, LMP
Antalgic Posture Pain Specialist

Permalink Reply by Erik Dalton, Ph.D. on February 11, 2010 at 9:24am

Keep em coming ...great suggestions..

Hans Albert Quistorff, LMP said:

Hi Barbara:
I will put my answer to Erik under your ? because this is what I give to my work at home clients.
First I suggest that you sit on an appropriately sized ball instead of an office chair. This will keep your spine in motion as you reach for and look for things on your desk.
Plan on regular breaks in your work schedule that only take a few minutes but reset your posture memory. Place the body ball against a clear space of wall. [the door may be the only clear space from what I have observed] Place the arch of the low back over the center of the ball. Turn the palms up and out to the side. tilt the head forward then push it back then up level. Keep a focal point so that the head stays level. as you slightly bend the knees. This will roll the ball up against T12/11/10 which are the reciprocals of the dowager's hump. as you increase the curve at this point it will signal a straightening at the dowagers hump. At that point you try to lift the first three ribs from the front of your neck as you breath in. This is a FUNctional exercise so only repeat it as many times as it is fun.
Hans Albert Quistorff, LMP
Antalgic Posture Pain Specialist

Permalink Reply by Erik Dalton, Ph.D. on February 13, 2010 at 9:00am

Off the subject but just had an interesting case in the office Thursday.

Are any of you familiar with a non-FDA approved treatment for tennis elbows, rotator cuffs, knees, etc. called Platelet Rich Plasma Therapy?

Treated this guy for a severe Achilles teninitis running injury but couldn't get it to heal. After four injections (6 weeks), he was back to marathon running. See a demo here: http://www.orthohealing.com/news/kabc-plateletrichplasmatherapy-video/

Have invited Rick to attend our Myoskeletal Alignment class next week in Santa Fe and show his home video....good stuff.

Permalink Reply by Ray Mingo on February 17, 2010 at 10:27am

Along with some safe light weight strengthen exercises of the rhomboids, med traps, splenius and stretching of the pec region I would emphasize the importance of proper posture especially while sitting. Apart from some type of injury poor posture is the main culprit of forward-head posture. It is important to teach clients to become conscious of poor posture in everyday life style while at work and home this is a conscious effort exercise that will help counter act this head posture. We unconsciously trained your muscles into this condition we can consciously retrain our muscles through good posture and therapeutic exercises. I would also look further down the kinetic chain and look for some muscular dysfunction in the pelvic region that may misaligns the pelvic and introduce some stretching and strengthen exercises for those muscles associate with this region.

Permalink Reply by SC on March 4, 2010 at 5:08pm

JIm- by far the most effective exercise for strengthening the spine and opening the chest. I alter it by keeping my arms in anatomical position along my torso. So I do not rest on my wrists. The trick is to keep the glutes relaxed to prevent jamming the SI joints.
I first thought of doing this after being diagnosed with disk herniation both in my cervical and lumbar spine as well as moderate degeneratiive facet and costovertebral joints. I tried to remember how children start developing strength in their back muscles. If you put a baby on the stomach, he starts by lifting his head little by little. Then for longer period of time. They don't use their arms for a while. The neck muscles seem to develop first, then the thoracic then the lumbar. By the time a baby can sit, their seated posture is perfect! I don't think, I'll ever seat like that effortlessly again but it is working. It's like relearning it all from scratch.

Jim Moon said:

I have found prone cobra on a stability ball w/ext. rot. (no cervical ext. eyes fixed forward head neutral) scaps squeezing shldr. down and back this can be a timed event or pulse reps,

Permalink Reply by Allan J Jones on April 22, 2010 at 4:17pm

All the ideas of stretch the hypertonics, release the contracted is valid to a point. The upright human usually has dysfunctional anatomy at lower levels than the thoracic/cervical region that are major contributors. Over correction at any given point will cause further maladaption.

Kunnee Chew said:

Seated row to strengthen the rhomboids, place a tennis ball or a racquetball behind the head against a wall or on the floor to get stability and press against the ball just to strengthen the extensors in the neck. Also, place a long bar below the hips level and stretch out the traps.

Permalink Reply by Allan J Jones on April 22, 2010 at 7:28pm

And after all that waffle..... I'm trying to say that posture is conditional and plastic, and sometimes forward head, rounded shoulders can be partially self corrected by simple getting the client/patient to be conscious to shift their weight more to the toes.
My statements would have been better directed to the main thread , rather than Kunnee's reply.......

Allan J Jones said:

All the ideas of stretch the hypertonics, release the contracted is valid to a point. The upright human usually has dysfunctional anatomy at lower levels than the thoracic/cervical region that are major contributors. Over correction at any given point will cause further maladaption.

Kunnee Chew said:
Seated row to strengthen the rhomboids, place a tennis ball or a racquetball behind the head against a wall or on the floor to get stability and press against the ball just to strengthen the extensors in the neck. Also, place a long bar below the hips level and stretch out the traps.