Posture Insights

Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?

Forward Head Posture

Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it's important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.

Postural Deviation

• The head is in a healthy alignment with the neck when the ears line up with the gravity line.
• The gravity line is an imaginary straight line that represents gravity's downward pull.
• It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
• A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
• Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)

Muscle Imbalances

• Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
• The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.

Kyphosis

Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.

• This occurs because the upper back area supports the neck and head.
• When the upper back moves or changes position, the head and neck follow.
• The majority of the head’s weight is in the front, and this contributes to the forward movement.
• An individual with kyphosis has to lift their head to see.

Treatment

A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.

• Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
• Targeted stretching can help if the neck muscles are tight.
• At-home stretches may also relieve pain.

Risk Factors

Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:

• Constantly looking down at a phone and staying in this position for a long time aka text neck.
• Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
• Driving for a living causes prolonged back, neck, and shoulder positioning.
• Sleeping or reading with a large pillow under the head can contribute to forward head posture.
• Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
• Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
• An example is carrying a child or another load in front of the body.
• Large breasts can also increase the risk of kyphosis and forward head posture.

Neck Injuries

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. https://doi.org/10.5535/arm.2012.36.1.98

Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. https://doi.org/10.24171/j.phrp.2018.9.6.04

Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. https://doi.org/10.13075/ijomeh.1896.01293

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.

Body stiffness is common, especially as the body ages. Stiffness can result from intense work, lack of physical exercise, or specific conditions. The reasons vary from individual to individual. Some feel stiff when they wake up, while others become stiff after stopping physical activity. For others, stiffness can result from practicing unhealthy postures, intense workouts, or something new that the body is beginning to get used to. There are several ways to prevent and treat stiffness, no matter the cause, including targeted physical movements, posture corrections, body decompression, chiropractic realignment, stretches, and therapeutic massage.

Body Stiffness

Knowing the cause of body stiffness and how to relieve it can help prevent and treat the condition so the body can function better. It’s vital to see a health care professional immediately if stiffness results from an injury, accompanied by pain, it does not go away with home treatments, or if an insect bite or infection could be the cause.

• Individuals should speak to a healthcare professional for frequent stiffness that interferes with their quality of life.
• Most of the time, stiffness can be treated at home and reduced through preventative measures.
• Stay active but not too hard until the body gets used to the activity.
• Various relief methods include a warm bath, massage shower, or self-massage.

Intense Work or Exercise 

• The muscles incur tiny tears when exercising or performing heavy labor, especially when the body is not used to the intensity or duration.
• These tears are normal and help build larger and stronger muscles.
• Individuals may feel stiff and sore for 24-72 hours as the body repairs itself.
• Inflammation surrounding the joints/synovial fluid after heavy activity or repetitive movements is another cause.

Inactivity

• Moving around generates the synovial fluid that lubricates the joints.
• When body movement stops, like going to sleep or long periods spent sitting, working, or watching tv, fluid production slows down, resulting in body stiffness.
• The lack of fluid after movement can make the body feel stiff when returning to activity.

Unhealthy Posture

• The body can become stiff and sore when routinely holding the body in a way that strains the muscles, tendons, and ligaments.
• Sitting or standing incorrectly from an unhealthy workstation setup or postural habits contributes to stiffness and musculoskeletal problems.

Medical Conditions

• Medical conditions can cause stiffness like rheumatoid arthritis, Lyme disease, thyroid disease, strains and sprains, and low vitamin D levels.
• See medical attention if you suspect any medical causes are behind the body stiffness.

Prevention

Depending on the reason behind body stiffness, there are ways to prevent it.

Warm-Up

• Warming up before any physical activity loosens up the muscles before fully engaging.
• Soreness will present and is part of the muscle repair process.
• Properly warming up can help the repair go faster.

Mobility and Flexibility Breaks

• Taking breaks from inactivity by getting up and moving around, walking, or performing mobility movements could increase the secretions of joint fluid, prevent stiffness, and relieve the effects of poor postural habits you may have been making.
• Set a timer to break up periods of inactivity and move around.
• Get up for 5 minutes every hour to move the muscles and get the blood flowing.

Stay Aware of Posture and Form

• Postural awareness can help prevent muscle strain that leads to stiffness.
• Adjusting the workspace and posture can help prevent stiffness.
• The posterior chain: head, neck, torso, and legs are aligned with the feet flat on the floor and back supported.

Stay Active

• Maintaining muscle movement maintains blood circulation, which can help reduce stiffness.
• Exercise helps reduce inflammation, increases synovial fluid production, and helps strengthen the muscles.

Active Recovery 

• Participating in active recovery can help bring blood flow to the muscles and prevent inflammation.
• Light cardiovascular activities include swimming, cycling, walking, or bodyweight movements.

Anti-Inflammatory Nutrition

• Anti-inflammation nutrition like the Mediterranean diet, which includes healthy fats, plenty of fruits and vegetables, lean proteins, seafood, and whole grains, can help reduce aches and stiffness.
• Getting enough vitamin D can reduce stiffness.

Chiropractic Flexibility Restoration

Chiropractic adjustments, decompression, MET, and therapeutic massage techniques can relieve muscle soreness and stiffness and restore body function. The chiropractic team will evaluate the individual, diagnose the cause/s, and develop a personalized treatment plan. The team will provide posture training, stretching the body, using a percussive massager or foam roller to break tight, stiff muscles and release adhesions of tissues.

Enhance Your Lifestyle

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Mailey, Emily L et al. “Comparing the effects of two different break strategies on occupational sedentary behavior in a real-world setting: A randomized trial.” Preventive medicine reports vol. 4 423-8. 9 Aug. 2016, doi:10.1016/j.pmedr.2016.08.010

Schleip, Robert, and Werner Klingler. “Active contractile properties of fascia.” Clinical Anatomy (New York, N.Y.) vol. 32,7 (2019): 891-895. doi:10.1002/ca.23391

Shimoyama, Daisuke, et al. “Reliability of shoulder muscle stiffness measurement using strain ultrasound elastography and an acoustic coupler.” Journal of medical ultrasonics (2001) vol. 48,1 (2021): 91-96. doi:10.1007/s10396-020-01056-0

Trube, Niclas, et al. “How muscle stiffness affects human body model behavior.” Biomedical engineering online vol. 20,1 53. 2 Jun. 2021, doi:10.1186/s12938-021-00876-6

Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004

Can musculoskeletal therapies treat individuals with upper crossed syndrome to relieve pain, improve posture, and strengthen the muscles in the neck, shoulders and chest?

Upper Crossed Syndrome

Upper crossed syndrome is a condition in which the muscles of the shoulders, neck, and chest become weak and tight, and is usually brought on from practicing unhealthy posture. Symptoms typically include:

• Neck stiffness and pulling sensations.
• Jaw tension and/or tightness
• Upper back tension, lack of flexibility, stiffness, and aching soreness.
• Neck, shoulder, and upper back pain.
• Tension headaches
• Rounded shoulders
• Hunched spine

Upper Crossed Syndrome and Posture

• The condition affects healthy posture by creating imbalanced muscles between the upper back and chest.
• The tight short muscles in the upper chest get overly stretched and remain in a semi-contracted state pulling on the back muscles.
• This causes the muscles in the upper back, shoulders, and neck to get pulled and weaken.
• The result is a hunched back, forward shoulders, and protruded neck.
• The specific muscles affected include the trapezius and the levator scapula/side of the neck muscles. (Hospital for Special Surgery. 2023)

Individuals having back pain lasting two weeks or longer are recommended to consult a spine specialist or healthcare provider to examine and determine the cause of the pain symptoms. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)

Lingering Pain

• The imbalances in muscle activation and movement and unhealthy posture all contribute to the symptoms.
• The syndrome is characterized by chronic stiffness, tension, pain, and increasing immobility of the chest and shoulder muscles.
• Over time the tightness and pulling, combined with weakness can lead to shoulder joint damage. (Seidi F, et al., 2020)

Causes

There are certain activities and jobs that can contribute to the development and worsening of the syndrome. Factors that worsen symptoms include: (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023) - (Seidi F, et al., 2020)

• Physical trauma/injury to any of the muscle regions.
• Occupations with high amounts of physical exertion, heavy lifting, and injury risks.
• Practicing incorrect postures and positioning.
• Jobs requiring extended periods of sitting and/or standing.
• Inactivity and/or sedentary lifestyle.
• Over athletic activity.
• Smoking.

However, the syndrome is preventable and manageable.

Therapies

Working with a chiropractor and physical massage therapy team can help determine and develop a personalized treatment plan that is the most effective and suitable. A chiropractic and physical therapist will provide several options, which can include: (Cedars-Sinai. 2022) - (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023) - (Bae WS, et al., 2016)

• Bracing
• Massage therapy to increase circulation, relax, and retrain the muscles.
• Chiropractic adjustments for spinal realignment and posture retraining.
• Non-surgical mechanical traction and decompression therapy.
• Kinesiology taping - recovery and preventive. 
• Posture retraining.
• Muscle movement training.
• Exercises targeting soft tissues and joints.
• Core strengthening.
• Steroid injections to a specific area.
• Prescription anti-inflammatory medication for pain symptoms - short-term.

1. Individuals may be advised by the chiropractic therapy team to avoid too much bed rest and to limit or avoid activities that can cause pain or worsen symptoms. (Cedars-Sinai. 2022)
2. Studies have shown chiropractic spinal manipulation effectively reduces neck, spine, and low back pain symptoms. (Gevers-Montoro C, et al., 2021)

Self Management

There are ways to self-manage upper-crossed syndrome and associated symptoms. Common techniques include: (National Institute of Neurological Disorders and Stroke. 2023) - (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)

• Practicing correct posture.
• Increasing or decreasing physical activity as recommended by the therapy team.
• Using ice or heat packs to relieve pain and increase circulation to promote muscle rehabilitation and healing.
• Using topical pain creams or gels.
• Over-the-counter nonsteroidal - NSAIDs, like Advil or Motrin and Aleve.
• Muscle relaxants to relieve tension short-term.

Enhance Your Lifestyle

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Hospital for Special Surgery. Move with the purpose to combat upper and lower crossed syndromes.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back pain.

Seidi, F., Bayattork, M., Minoonejad, H., Andersen, L. L., & Page, P. (2020). Comprehensive corrective exercise program improves alignment, muscle activation, and movement pattern of men with upper crossed syndrome: a randomized controlled trial. Scientific reports, 10(1), 20688. https://doi.org/10.1038/s41598-020-77571-4

Bae, W. S., Lee, H. O., Shin, J. W., & Lee, K. C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. Journal of physical therapy science, 28(5), 1636–1639. https://doi.org/10.1589/jpts.28.1636

National Institute of Neurological Disorders and Stroke. Back pain.

Cedars-Sinai. Back and neck pain.

Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piché, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Frontiers in pain research (Lausanne, Switzerland), 2, 765921. https://doi.org/10.3389/fpain.2021.765921

For individuals with aches and pains after walking, the first thing to check is posture. How an individual holds their body is important in walking effortlessly and comfortably. Improving walking posture will make it easier to breathe and walk farther and faster. Injury Medical Chiropractic and Functional Medicine Clinic can treat back problems, restore mobility, and retrain individuals on achieving and maintaining healthy posture.

Walking Posture

Sitting for extended periods weakens neck and back muscles and decreases spinal mobility, making it more difficult to maintain a healthy walking posture. Improving and maintaining healthy walking posture can go a long way regarding the body's health.

Benefits

The benefits include:

• Strengthened core, back, leg, and buttock muscles.
• Improved balance and stability.
• Easier breathing.
• Increased energy levels.
• Improved walking speed, distance, and gait.
• Back and hip discomfort symptoms prevention.
• Decreased risk of injury and falling.

Set Up Posture

• Stand up straight.
• Engage the core.
• Relax shoulders.
• Keep the chin parallel to the ground.
• Eyes forward.
• Minimize leaning forward or backward.
• Spend the first 15 seconds of walking focusing on posture.
• Once a rhythm is achieved, periodically check yourself to ensure you stay consistent with proper posture until it becomes normal.

Stand up Straight

• Visualize standing tall and straight.
• Resist the temptation to slouch or arch the back.

Control Leaning Forward or Back

• Leaning strains the back muscles when sitting, standing, and walking.
• Leaning slightly forward from the ankles when walking up a hill.
• Going downhill, leaning slightly forward, or maintaining a straight back is okay.

Keep Eyes Forward

• Avoid looking down.
• The focus should be about 20 feet ahead.
• Maintaining a forward visual path allows individuals to see anything from the side.

Keep Chin Parallel to the Ground

• This reduces strain on the neck and back.
• A proper chin position maintains forward focus rather than down.

Shoulders Back and Relaxed

• Shrug and allow the shoulders to fall and relax slightly back.
• Loosening up the shoulders helps relieve tension and...
• Positions the shoulders to use healthy arm motion while walking.
• Shrug and re-loosen at intervals during the walk to ensure the shoulders stay relaxed.

Engage Core Muscles

• The core muscles help resist slouching and leaning.
• Keep the stomach pulled in slightly.
• Take deep, full breaths to maintain a healthy walking posture.

Maintain Neutral Pelvis

• Ensure the hips are not tilting forward or back while walking.
• Practice sticking out the buttocks, tucking them in, and finding a natural middle.
• The middle is the healthy balance that will keep you from arching the back muscles and spine.

Devices

• Resist the urge to engage with the phone or activity monitor while walking and looking down.
• Only look when necessary and then mindfully regain posture.
• Some activity monitors have vibration alerts to reduce the need to look down.
• Utilize earbuds or headphones for making and taking calls and other tasks.
• Certain earbuds or headphones allow for voice commands, so you don't have to look at the phone.

Chiropractic Realignment and Retraining

Maintaining proper posture is a gradual process. A chiropractor can correct years of practicing unhealthy postures like forward head issues or chronic slouching and realign the spine to restore optimal function.

• A chiropractic therapy team will work on bones and muscles in specific body regions.
• Massage will relax the muscle tissues to restore correct balance.
• Chiropractic techniques will realign the neck, spine, hips, and pelvis.
• Decompression therapy may be used to stretch the body. 
• Strengthening and stretching exercises will maintain adjustments.
• Posture retraining will teach individuals to stay aware of their spinal position and help create healthy habits.

Regular posture checks, whether at work, school, just walking around doing errands, or exercising, will help the body learn proper positioning until it becomes second nature.

Revitalize and Rebuild

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Buldt, Andrew K et al. "The relationship between foot posture and plantar pressure during walking in adults: A systematic review." Gait & Posture vol. 62 (2018): 56-67. doi:10.1016/j.gaitpost.2018.02.026

Hackford, Jessie, et al. "The effects of walking posture on affective and physiological states during stress." Journal of behavior therapy and experimental psychiatry vol. 62 (2019): 80-87. doi:10.1016/j.jbtep.2018.09.004

Lin, Guohao, et al. "The relationship between forward head posture, postural control, and gait: A systematic review." Gait & Posture vol. 98 (2022): 316-329. doi:10.1016/j.gaitpost.2022.10.008

Suh, Jee Hyun, et al. "The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial." Medicine vol. 98,26 (2019): e16173. doi:10.1097/MD.0000000000016173

Woollacott, Marjorie, and Anne Shumway-Cook. "Attention and the control of posture and gait: a review of an emerging area of research." Gait & Posture vol. 16,1 (2002): 1-14. doi:10.1016/s0966-6362(01)00156-4