Forward Head Epidemic is a Pain in the Neck

Happy New Year, Dear Lovers of Movement ,

As you and I know, our health is an important part of our wealth. As we age, or if we suffer from an injury or a disease that limits our ability to move well or take care of ourselves, this becomes more and more apparent. My New Year wish for all of you and me and everyone in 2016, and beyond, is that we are healthy and move with awareness and ease. Let’s toast to Intelligent Movement Forever!

In this column, we are going to explore how the head sits on top of the cervical spine and how that head position is often compromised by the repetitive movements that we make while we use our computers and our cell phones.

Before we go any further, take a minute to check on your own head position as you read this paragraph. Is your head out in front of your shoulders and the rest of your body? If it is, you are not alone. You are one of many, including myself, who often or always live in Forward Head Carriage. This postural imbalance, when repeated often enough, becomes a Repetitive Stress Injury (RSI) creating pain and discomfort in our necks and shoulders and curtailing optimal movement and optimal breath.



Anatomy and Biomechanics of Head and Cervical Spine

Your head is designed to sit directly on top of the cervical spine, with the ears over the shoulders and the eyes on the horizon. But, look around you. Most of us habitually move our heads in front of our shoulders to work on our computers, use cell phones, and even when driving, reading, watching TV, reading books, sewing, performing craft work. The list goes on and on.

Our bodies adapt to any shapes and movements that we repeat. The body is smart that way. It responds to our cues. Ant these adaptations can affect our health and our movement.

In my classes and private sessions, I see many people who are experiencing the neck and shoulder issues that come with a Forward Head Carriage and rounded shoulders. The longer we live and repeat this misalignment, the more like we will experience RSI in the neck and shoulders. However, this is not just the domain of seniors.  Text Neck, a modern version of Forward Head Carriage, is being seen in children as young as 7-years-old, as they spend hours rounding over cell phones and video games. Movement scientists say we hunch over our cell phones an average of 2-4 hours a day, the perfect environment for RSI.

Yes, the cervical spine is designed to support the skull, but it can only do that when the skull is in its right place, which is directly on top of C1, the first cervical vertebra. With a neutral upright head position, the head balances freely on C1, hinging and nodding at the atlanto-occipital joint.

An adult head weighs between 10 to 12 pounds. When the head is dropped forward to an angle of 60 degrees, which is common when we look down at our cell phones, the weight of the head on the neck is the equivalent of 60 pounds. This forward pull of the weight of the head stresses the vertebrae of the lower neck, contributing to degenerative neck problems. The small muscles in the back of the neck tighten as they try to hold the weight of the head and the muscles of the upper back overwork to counterbalance the pull of gravity on the forward head. The upper back may also round and cause shoulder pain. The spine compresses, vertebral discs wear out, and optimal circulation is cut off.

This is not a pretty picture. The good news is that, with awareness, attention, and some intelligent movement, we can create new patterns that will help us move better and use our necks the way they are designed to move. Check out my suggestions below.

Note: The information provided here is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.

Self-Care for Forward Head Posture and Text Neck

Our body is intelligent. It responds to the cues we give it. With awareness, attention, and better movement, you will be able to make steady progress toward Good Posture and reduce the pain in your neck and shoulders. But this is not an overnight fix. Start where you are, be gentle and patient with yourself, and begin to unwind the habitual movement patterns that got you there.

Awareness and Attention

What is Good Posture?

A Forward Head position is a postural imbalance. Look at yourself in the mirror to determine if your head and ears are forward of your shoulders. If they are, move them back over your shoulders. Do you carry your head forward? Often? Always? If you spend a lot of time forward, that position is your normal until you teach the body otherwise.

Becoming aware of the elements of Good Posture is the first step toward addressing Forward Head Carriage. Here is a link  to a Good Posture chart I like. Print it out and post it on your refrigerator to remind yourself that, in Good Posture, the head is generally straight, with the ears directly over the shoulders and the eyes on the horizon.

It is important, too, to become aware of any discomfort or pain that you are carrying in your neck or shoulders. Sometimes if pain is always there we get use to it and even ignore it. But pain is always a warning that our body is not moving well. If ignored, the yellow traffic light will turn red, and pain will increase and function will decrease. Best to catch the yellow lights, so they don’t turn red.

Nodding at the Atlanto-Occipital Joint

Your upper cervical spine (neck) is comprised of the skull and C1 and C2. The lower cervical spine is comprised of the remaining 5 cervical vertebra. The skull is designed to move on top of the spine at the atlanto-occipital joint.

Here is a link to a short video of the skull moving the way it is designed to move. Moving your head and your eyes instead of your neck is good neck posture. Watch the video and then try to nod your head without using your cervical vertebrae.  Find your atlanto-occipital joint. Start with your head straight, your ears directly over your shoulders, and your head straight. You can find the hinge of the atlanto-occipital joint by putting your index finger tips in your ears just behind the ear opening. Nod your head around the straight line that runs between your fingertips. The straight line is like the rod in the video. Try it!

Notice the freedom that you experience. Nodding your head on top of your spine requires very little effort, no force, no effort, no resistance, no squashing. The upper cervical spine should be more mobile than stable, while your lower cervical spine should be more stable than mobile.  But when the head is forward over the shoulders, the reverse is true.  Return to the movement that your body is designed to make and you will find freedom of movement.

Nodding at the atlanto-occipital joint is a small movement. It does not take you as far forward as rounding your neck and shoulders forward. If you want to move in this healthy position, you will have to change what has probably been your habitual movement pattern for many years. It may feel uncomfortable at first and it will definitely feel foreign. At first. But practice creating and becoming comfortable with a new pattern of movement here. You will love the results.

In order to maintain healthy movement at the top of the cervical spine, you will have to bring your computers, your cell phones, or the book you are reading up in front of your face, so you can read the screen or the book without disturbing the balance of the head on your neck.

This will take some planning. Whenever you are working at your computer, be sure that it is placed at eye level. When you are using your cell phone, bring it up in front of your face instead of bringing your face toward your phone. These changes will take patience and practice, but the results will be worth it. Goodbye neck and shoulder strain and stress!

More Movements for a Healthy Neck and Head

Head Ramping with Resistance


  1. Stand or sit in Good Posture.
  2. Align the bottom front of the ribcage with the front of your pelvis (no rib thrusting)
  3. Fold a yoga strap in half. Hold on to the strap and place it behind your head at or just above the ears.
  4. Using the strap for resistance, push the head back and up into the towel, keeping your chin slightly tucked. Hold for 3-5 seconds. Repeat 10 times.
  5. Ramp often to strengthen the muscles that pull the head back into alignment with the shoulders, stretch the muscles that rotate the head and neck, and restore balance to your cervical spine.
  6. You can use your hands or a hand towel instead of a yoga strap. You can be standing, seated, supine, or prone.

Upper Cervical Spine Stretch


  1. Stand or sit in Good Posture with Ears above shoulders. Stabilize your lower cervical spine by making a Y with your thumb and forefinger and a fist with the rest of your fingers and placing you thumb and forefinger around the front of your neck. It will look like you are choking yourself, but please don’t!
  2. With your lower cervical spine stabilized, place your opposite hand at the occipital ridge and lift your skull up and forward (a little) to create space in your upper cervical spine. Release and repeat.
  3. This is a very small move with big results. It will increase your ability to nod freely at the atlanto-occpital joint.

Rhomboid Strengthener


  1. Stand or sit in Good Posture with Ears above shoulders. Bend your elbows and clasp your hands in front of your chest.
  2. Create resistance by pulling your arms apart while keeping your hands clasped. Hold for 3-5 seconds. Release and Repeat. 6-10 times. Feel the work between your shoulder blades.
  3. Repeat this movement often to strengthen the rhomboids and restore neck health and function

Can Opener (Ki-Hara self-stretch)


  1. Seated or standing, with Good Posture, bend elbows in front of face, chin high, and interlace fingers. Press palms together and keep them together. Start with elbows together.
  2. Imagine you are inflating a balloon that is between your elbows as you bring your elbows apart.
  3. Imagine you are deflating a balloon that is between your elbows as you bring you elbows together.
  4. Repeat 6-10 times feeling the work in the upper back.
  5. Your upper back should feel stronger and more open immediately after your after completed these moves.

Head Carrying


– from a painting of Guatemalan women going to market in Zunil by  my artist friend, Carolina McCall

If you think of head carrying as good for people living in far off places or even from another time, you may want to reconsider. Adding head carrying to your daily routine will strength and restore the muscles that you have used, abused, and overwork with Forward Head Carriage.

Your mother was right when she said you could improve your posture by walking with a book on your head. Muscles of the neck and spine activate very differently when the head is stack on the spine and loaded. Putting a small weight on the head is one of the best ways to re-align the spine back into a harmonious relationship with gravity. Carrying something on your head keeps the rest of your spine honest. You get immediate feedback if you are slumping, crunching, flatting, or exaggerating your spinal curves.

If you are ready to try it, I suggest purchasing a small round 1 or 1.25 kilo weight plate in the sporting goods section of Soriano or Walmart.  A book will work too, but  it is harder to find a book that is the right size and the right weight.


Be sure to start by bringing your head into Good Posture with your ears over your shoulders before you place the weight plate or book on your head. Placing a weight on your head when you take a break at work or when you are on a walk is a great way to address chronic neck tension and teach your cervical spine how to find and keep healthy alignment. Try it, and let me know how this works for you!

To Be Continued

As I was writing this column, I realized that this topic is bigger than one column. There is so much more I have to say and would like to say about Forward Head Carriage and related issues.  I have more helpful moves that I really love. I would also like to expand the discussion to address the related problems of forward shoulders, dowager’s hump, and thickness at C7, the most prominent vertebra on the spine. I ran out of time and space.

But there is more than enough information in this column for you to digest and practice. Please carry on! I will continue with this topic in my next column. Please add comments or questions below this column if you have specific issues related to this topic that you would like me to address. See you next time! Hasta la proxima!

Summing Up

Thank you, Dear Readers, for letting me drop into your lives for a little while. I hope the information I shared in this column will help you create a movement practice for maintaining and improving shoulder health.

Please also check out my previous columns, as you design and carry out your own personal intelligent movement practice. Any of the movements mentioned in my November Column which focused on Shoulders would also be helpful in address the Forward Head and Dowager’s Hump. And as mentioned above, I will continue to address neck and head issues in my next column. Contact me if you would like to have a private consultation about your neck and head issues.  Remember, we need to catch the yellow traffic lights before they become red lights, if we can.

Upcoming Classes

You are also cordially invited to attend my Mobility Class on Thursday nights at 7 pm at Crossfit Vallarta (free to Crossfit members, 50 pesos ($2.86 USD) for drop-ins).  This is the best bargain in town, if your goal is to create more ease and freedom in your movement. We spend a lot of time releasing fascia with Yoga Tune Up therapy balls, and some other therapeutic and corrective movements.

I am putting together a workshop of Ki-Hara Self-Stretches at the end of January. Watch for details on my Facebook Page (Intelligent Movement Forever) or my website, forever. Or contact me by email: [email protected].

I am also available by appointment for private or semi-private IMF sessions at my home studio in Versalles Colonia. I have added air conditioning to my home studio now, for your comfort! I am also available to come to your hotel, villa, condo, or apartment. I have a special offer on 5-session packages available for January and February. Contact me at [email protected] for more information.

Wishing Each and Every One of You Intelligent Movement in 2016 and Forever,


Puerto Vallarta News

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