Forward Head Posture
We’ve all seen the classic scene in a cartoon or movie where the characters try to get the piano into the loft upstairs. There’s a pulley system and some workers are lifting the baby grand up onto the top floor… suddenly the rope begins to fray and the piano’s fate becomes uncertain as does that of the unsuspecting passers-by. Your neck lives in the same suspense every day.
This is my analogy for your neck, in forward head posture. The enemy is the same. The rope is the erector spinae group, and your head is the piano. The erectors are often in a constant state of tension, trying to keep that bowling ball-sized head off the ground. But our enemy has something different in mind. Constantly pulling us forward. We all love to blame technology for this, but the habit predates screens—it started with books and handwriting. And who has been there all along, tugging our head, neck, and shoulders downward? Gravity!
It is a natural tendency to look down at your work—to place your project on a table or desk, lean over, and hunch down.
Parents and anyone who works with small children can attest to this, too. If you're taller than the person you're speaking with, chances are you unconsciously round forward so your eyes align with theirs. The same goes for any object you’re concentrating on; we have a natural tendency to move our eyes closer to it.
Public speakers exhibit a different flavor of the same habit: the more passionate they get, the farther their heads jut forward. And when they glance down at their notes, that head position shifts both forward and down.
The human head weighs, on average, about 11 lbs. Any time the head is slightly off its axis, it requires a renegotiation of tension in the ropes that hold it up. If it's off to the left, the muscles on the right are in an elongated position, but it's not a stretch. Remember, they are fighting gravity… so they are long but holding tension. If it's jutted forward or down, the erectors in the back are held in what is called an eccentric (elongated) contraction. Over time, if this posture becomes a practice, the muscles will learn and eventually grow into this posture. Muscles on one side become “locked-short,” and the ones on the other become “locked-long.” So it's not enough to say, “this muscle is tight” and “this muscle is loose” because there’s tight long and tight short. And sure, you can have some effect on softening both over‑lengthened and bunched‑up groups with most kinds of massage and bodywork. But if you want to fix the pattern, you need a different strategy for those in an elongated contraction and those stuck in a concentric one. And to implement such a strategy, you need to have the skills and training to decipher who is doing what.
In my earlier post, Headaches: They're a Pain in the Neck, I laid out the pain referral patterns of the neck muscles and how they can cause headaches. The protocol I use today for acute migraines and headaches hasn't changed that much in over 20 years of practice. I've only refined my assessment skills and techniques for addressing the trigger points and fascial maladies. However, I've come to realize that once you have gotten the client out of the acute pain stage, you have to change up your strategy, otherwise you might be contributing to the problem that got them there in the first place, their posture.
So in the case of forward head posture, the muscles in the front have shortened while those in the back have become overstretched. And therefore, the strategy would be to get those short muscles to lengthen and those long muscles to shorten. This is done with a different approach for the front and the back. And, if we use the same technique (always softening anything that is tight) we actually risk pushing our client further into their pattern.
Remember the rope and the piano? Would you really want to try and stretch that rope further?
Try this:
Quick Spinal Check-ins
Whether you're doom-scrolling, deep into your next masterpiece, or just cooking dinner, when you catch yourself slouching or jutting your head forward, check in with your posture throughout the day.
Take a deep breath.
Elongate your spine.
Imagine a rope gently lifting the crown of your head.
Tuck your tailbone slightly, as if an anchor is drawing it downward.
Take another breath.
Roll your shoulders back with ease—not stiff military posture, gently roll them up, back, and down.
One more breath.
Return to what you were doing, just a little taller.
Make Gravity Your Friend:
If you’d like guided help untangling your own “piano rope " or if working with your posture for overall health and wellness sounds appealing, consider a Structural Integration Series!
We’ll get those lines balanced so gravity works with you and not against you!
