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Head and Neck Posture

The head is a significantly heavy object balanced at the end of a long column, the neck. As such the neck has to manage to hold the head steady for long periods of time so we can pay attention without eyes, cope with moving the head precisely to see or hear something and stabilised the head whilst we do quick and powerful movements with the arms or the whole body. Due to our main sensory organs being located on the head, the stability and control of this part of the body is critical in understanding the world and coping with physical challenges. As time goes on our postural habits become more entrenched and can cause gradual physical changes in anatomical positions and in the nature of the tissues.

The most common postural problems in the neck relate to sitting, the posture in which we now spend so much of our time from school days onwards. When we are standing the head is usually balanced above the body naturally and this continues in walking, but in sitting we typically slump our lumbar spines and this has significant effects on the posture of the neck. The flexion of the lumbar spine puts the thoracic spine into a curve which takes the top end near the neck forwards to some degree, taking the head into a forwards and downwards position. Because we do not want to look down as the ground all the time we correct the posture by bringing the head up with extension of the neck.

This results in the typical poking chin posture of the upper thoracic and cervical spine, where the head is held forward of the body with the lower neck and upper thoracic area flexed and the mid and upper neck extended. This puts the lower neck at end range stretch in flexion and higher in the neck at end range stretch in extension. This puts strains on the neck which can result in neck and shoulder pain from the lower neck and headaches from the upper neck.

Physiotherapy assessment and treatment includes looking at the overall posture of the patient and the ranges of movement of the neck. Correcting the lower back posture can enable the physio to significantly correct the neck posture, bringing the neck joints back from their end range stress points and reducing the forces involved.


Author: Jonathan Blood-Smyth

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