Deep Dive into Forward Head Posture

Our increasing use of computers, tablets, cell phones, and other handheld devices in combination with sedentary lifestyles and poor posture habits at work are all causes of forwarding Head Posture, AKA Text Neck. A condition more and more chiropractors are seeing in their patients. Without treatment, Forward Head Posture can cause an antalgic posture, stance, and gait. This will result in low back pain which will make standing, walking, and sitting difficult.

The spine is a closed kinetic system. It is a physical structure and follows Newton’s third law of motion, “for every action, there is an equal and opposite like reaction.” When one loses the cervical lordotic curve, forcing forward head posture, they become unbalanced within their environment of gravity. This forces their musculoskeletal system to react. This reaction is an attempt to realign with gravity. This will result in a head forward, pelvis back posture stance and gait.

As the head extends forward relative to the line of gravity it puts strain on the neck and shoulder muscles thus putting strain on the thoracic spine and lower back as well. Pain can show up in any or all parts of the spine; however if not corrected over time it can settle in the low back and pelvis.

Over time poor postural habits will cause text neck and antalgic postures over time. Forward flexion of the head, neck and back while operating their computers, cell phone, and other handheld devices and gravity all contribute to this problem.



The Psoas major and minor muscles originate from the front of all lumbar vertebrae and the lower ribs then insert through the pelvis and attach to the upper femur. When these muscles spasm they contract to hold the body in the painful antalgic bent forward posture, stance, and gait.

Correcting Text Neck:

Correcting the cause of “Text Neck” and antalgic posture requires the following rehabilitation procedures.


  • Engaging the righting reflexing through using the head weight will bring the head back into the line of gravity. Daily use of the Adjustable Head weight Harness with the Cervical Posture Strap and/or forward/lateral head weighting with cervical posture strap and shoulder weights. Use of the hip weight may also be necessary.



  • Daily use of the 6-way stretch strap to exercise, stretch and strengthen the atrophied multifidus muscles. Jowett et al, found that the fast-twitch phasic muscle fibers in the multifidus, as well as other involved muscles, changed into slow-twitch postural fibers on the convex side of displacement in the lateral and A-P spine while the fibers on the opposite concave side atrophied because of disuse. It is also necessary to rehabilitate the muscles that have atrophied due to disuse on the concaved side of the angle.


Muscle changes from:

Fast-twitch to slow-twitch at obtuse angles side of displacement.

Muscles atrophy on the opposite acute angles.

Multifidus muscle origin:  The back of the sacrum, mammillary processes of the lumbar, transverse processes of the thoracics, and articular processes of the lower four cervicals.

Insertion: Spinous process above vertebra of origin.

Kader DF, Wardlaw D, Smith FW, published research titled: Correlation between the MRI changes in the lumbar Multifidus muscles and leg pain in the Journal of Clinical Radiology.   A retrospective study of 78 patients, ages 17–72, presenting with low back pain (LBP) with or without the association of leg pain was undertaken.  The study showed that muscle atrophy was present in 80% of the patients with LBP.

This correlation between MF and involved muscle atrophy and leg pain was found to be significant. Nerve root compression and herniated nucleus pulposus were statistically not significant.

  • To keep the thoracic spine supple, stretched, and moving freely. Daily use of the Thoracic Exercise Roll may be used.