A Real Pain in the Neck: Forward Head Carriage

About forward head carriage
Forward carriage of the head is a principle cause of neck and shoulder pain, as well as tension headaches. As an ongoing, chronic pattern, it puts the discs of the cervical spine at risk of herniation, and has been linked to high blood pressure and pinched nerves. In Physiology of Joints, vol 3, author Kapadji states that for every inch of forward head posture, the weight of the head on the spine can be increased by an additional 10 pounds.
Whew! And that additional weight takes a hefty toll over time.
The flattening of the neck curve creates pain and puts the cervical discs at risk, and it also contributes to gripping tightness of the shoulder and neck muscles. I’ve met quite a few people with forward head carriage who try to relieve this muscle tension with neck rolling and massages. This is generally not as effective as they’d like, as any mild relief will be temporary until the postural issue is addressed.
Why this pattern emerges, and how to diagnose it
In short, this can often be attributed to our extensive screen time and text messaging habits. I sometimes jokingly refer to it as ‘iPhone neck’ (Android and other phone users- sorry, you’re just as susceptible!).
To determine if you have forward head carriage, have a friend observe your postural profile (see below video). Ideal healthy posture will have the ears positioned over the shoulders (and follow a plumb line down the body to the center of the hips, the knees, then the ankles). It’s important to note here that with forward head carriage, there is often also a rounding forward of the shoulders. So be sure to assess shoulder position when you’re observing the larger pattern of the neck and head.
What to do
If you have a desk job, one effective thing you can do immediately is notice how you sit at your desk (hint: it’s likely with forward head carriage). I’ve had success with clients reorganizing their work stations, moving the keyboard and screen higher and closer to help mitigate that forward tendency.
There are also some simple, accessible exercises you can do to help realign the head and neck. This video details how to do a quick postural assessment, and how to use the wall to build strength and integration.
And this is my favorite simple yoga pose to bring your head and neck back towards a more optimal position. In both of these exercises, work up to holding these positions for 30 seconds.
Best wishes for a healthy neck, and be in touch with any questions.

Justicia DeClue (E-RYT 500) has been teaching since 2005 and is the owner and director of Maha Yoga in Philadelphia. She is most sought after for her detailed alignment instruction and open-hearted teaching style. She really loves Instagram, and can also be found on Facebook.