One of the most common postures that I see in the clinic is the forward head posture which is often caused by our daily postural investment in how we sit whilst driving, sat at the office and relaxing on our couch in the evening. That being said anytime we then walk, hit the gym or take care of the kids, unless we are very attentive to our head alignment, due to the hours we have invested during the day training our head to be forward, it feels natural for it to be off center. Think prevention because unless we experience some kind of symptom or someone kindly points out how much our head is forward of the spine (try that one in the grocery store!) then we don't usually recognize this, sometimes subtle, misalignment of our body.
Simple Facts
The human head is approximately 8% of total body weight, so for a male weighing 180-lbs, his head would weigh approximately 14-lbs. Now for every 1-inch the head migrates forward of its ideal alignment its weight increases by 10-lbs. I have seen forward head postures as severe as 4" which meant that there was an increase of 40-lbs to the weight of the patient's head. Add in a dash of gravity and we have some major development of muscle imbalance leading a myriad of symptoms such as headaches, nausea, nerve related pain/numbness, vision issues, brain fog, visceral disruption, reduced neck, shoulder and thoracic range of motion.
Upper X Syndrome
Naturally if we are not paying attention to our posture and every day investing many hours in training our head to sit forward of the spine, as we age we will develop what is clinically identified as an upper cross syndrome. In essence, this 'X' is created by some muscle becoming short-tight (or hypertonic - red muscles in the image) and their opposite muscles becoming long-weak (or hypotonic - blue muscles in the image). This significantly alters breathing patterns, shoulder and thoracic spine range of motion and vastly increases the risk of upper extremity injury and/or pain symptoms. 
This image shows the exit points of the vein, artery and major nerve vessels (brachial plexus) which can easily become compressed by altered head posture. Particularly, the scalene muscles in this scenario become hypertonic and add pressure to these vessels creating symptoms such as poor circulation to the arm, cold hands, prolonged healing time for other arm injuries such as tendinitis and numbness/tingling. This is clinically identified as a Thoracic Outlet Syndrome.
The Postural Athlete
My goal with any of my articles is to 'educate-to-motivate'. I encourage you to become your own postural coach and athlete all wrapped into one. By understanding the basic foundations of how forward head posture develops here are some key action points to immediately put into play:
Breathing:- The only time the neck, shoulders and chest should elevate and expand is during more challenging activities that require increased oxygen. Otherwise reviewing the image below we should be aiming for a natural expansion of the abdomen during inhalation and flattening of the abdomen during exhalation. This one correction alone will serve up 25,000+ repetitions every day (this number is your approximate number of breaths per day) of reinforcing good head alignment.
Sitting Ergonomics:- The below image illustrates an ideal sitting posture to adopt for your workplace and even whilst driving your vehicle or sat in an aircraft. Imagine another black dot to the centre of the ear on this image. The four black dots, from the hip, elbow, shoulder and ear, should all align vertically. This is your goal to maintain as long as you can, as often as you can to break the current faulty postural pattern.
Activity:- The big one. When you exercise you are either going to perpetuate the existing head forward posture OR truly start to correct the alignment through neuro-muscular (fancy word for exercise) education. All important is your attention to head and spinal positioning throughout all movemment patterns. I encourage you to even lower your exercise intensity if this assists you in the correction. A good example of our goal is the push up posture in the image below. You will see a patient performing the exercise with a dowel rod placed on his back. This dowel rod would help you to pay attention to optimal alignment of the head, neck and spine whilst performing this exercise. You can then translate this alignment to every other movement in the gym.
Become a postural athlete and consider your daily postural investment!
Yours In Health,
Jason.
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