Crisis Plan Series
Forward head posture, Neck pain
Forward head posture is the most common observable sign of all different kinds of neck pain. Such incorrect postural change of the spine could be the original cause of neck pain. Or it could be an avoidance posture adopted to temporarily relieve neck pain caused by other mechanical injuries. This is similar to the kyphotic (slouching) posture adopted by patients with lumbar (low back) disc condition as described in other newsletters. Such poor head and neck posture will frequently aggravate the condition. Immediate attempts to correct such forward head posture is therefore very important to ensure prompt and best recovery of neck pain.
A simple test of such poor posture is to hold the index finger vertically upright and align the fingertip to the front of the chin, the base of the index finger should be resting on the sternum (chest bone). The farther away it is from the sternum, the poorer the posture. Almost 10 out of 10 patients will fail this test as one may argue that no one sits or stands like this! This is rather true, as holding such correct spinal alignment requires lots of work, mentally and physically. Postural awareness is the key. A one-minute postural correction can be taught to patients easily:
The patient may practice such posture standing back against the wall. With the buttock and mid thoracic (upper back) spine touching the wall, the back of the head should be leaning against the wall as well. If standing front on, only the lower ribs of the chest should be touching the wall, the nose should be free from the wall.
It is certainly not easy to learn and maintain such good posture especially when the patient is in pain. Therefore, plenty of encouragement and reassurance must be given and the patient should understand the long-term benefit of such posture. Of course, there are many specific hands-on techniques available to loosen up the neck and back so the patient may achieve and maintain such posture more easily. Again, you may like to leave such hard work to the musculoskeletal physiotherapists.
A simple test of such poor posture is to hold the index finger vertically upright and align the fingertip to the front of the chin, the base of the index finger should be resting on the sternum (chest bone). The farther away it is from the sternum, the poorer the posture. Almost 10 out of 10 patients will fail this test as one may argue that no one sits or stands like this! This is rather true, as holding such correct spinal alignment requires lots of work, mentally and physically. Postural awareness is the key. A one-minute postural correction can be taught to patients easily:
- Buttock out --- to obtain a normal lumbar lordosis (low back S-curve)
- Lower stomach in --- to maintain trunk stability
- Chest up, shoulder blades together (squeeze a thousand dollar note) --- to reduce thoracic kyphosis
- Chin in (Double chin with chin vertically aligned with the sternum) --- to reduce forward head posture
The patient may practice such posture standing back against the wall. With the buttock and mid thoracic (upper back) spine touching the wall, the back of the head should be leaning against the wall as well. If standing front on, only the lower ribs of the chest should be touching the wall, the nose should be free from the wall.
It is certainly not easy to learn and maintain such good posture especially when the patient is in pain. Therefore, plenty of encouragement and reassurance must be given and the patient should understand the long-term benefit of such posture. Of course, there are many specific hands-on techniques available to loosen up the neck and back so the patient may achieve and maintain such posture more easily. Again, you may like to leave such hard work to the musculoskeletal physiotherapists.
Luck LI
Musculoskeletal Physiotherapist
Musculoskeletal Physiotherapist