It’s Not All in Your Head
Why the common understanding of forward head posture is wrong
As it seems that everyone these days is constantly looking down at their phones, there has been increasing general worry over what’s often called forward head posture (though it’s known by nicknames like “nerd neck” or “tech neck” as well). You’ll find plenty of people of various levels of knowledge advising you to pull your head back as the solution to this problem of the head being too far forward. Though on its face that may seem sensible, it’s complete nonsense.
These images are what you find if you search for advice on how to deal with “forward head posture.” The solution they give is sometimes called a McKenzie chin tuck, but amounts to recommending you simply pull your head backward.
In many of the “helpful” diagrams concerning forward head posture, the torso of the person remains nearly identical before and after the “correction.” And worse, in both the before and after, the torso is completely misaligned and out of balance. In the before pictures, the head is certainly in a bad position, but moving it without changing the torso will come with serious problems. Since most people never address the general malfunction of their torso, they don’t know how much they could benefit from actually fixing their entire body’s posture, as opposed to trying to make one direct adjustment of their head with total disregard for their torso.
The tilting back of the upper torso is unchanged by a chin tuck or movement of the head.
In genuine good posture the back of the head is not in line with the back. Having the head pulled so far back like that is in fact a serious impediment to free breathing. Since nearly everyone already has impeded breathing, they may not register the problem, but having the head pulled back in the way advised by these diagrams will restrict your airway and will make breathing problems impossible to eradicate.
After “correction” the back of the head is brought backward to be more in line with the back. This restricts the airway and leads to breathing difficulties. Neither before or after “correction” is optimal, but the idea that the back of the head should be in line with the back is as widespread as it is wrong.
On the left we see a figure with his head pulled back to be in line with the back. As a result the airway (colored blue) that leads from the back of the nose down into the lungs is constricted. On the right we see a figure with his head forward of the back, with the sternum flat. As a result the airway is unrestricted. This image was made by Jeando Masoero and can be found in this article by Masoero.
When the head is at rest, the back of the head should be forward of the back. There should be a slope going from the height of your armpit (on the back) forward up to your head, and the sternum should be vertically flat. This last criteria will never be found in someone with “forward head posture,” and nor will they be found in someone who is pulling their head back in an attempt to combat “forward head posture.”
These pictures of F.M. Alexander are annotated to show that the back of his head is forward of his back. Clearly this is nothing like “forward head posture.” The difference is in the torso. The annotations were done by Jeando Masoero and this image can be found in this article by Masoero.
Here is a picture of Jeando Masoero demonstrating a procedure where one hops their feet up and down without disrupting the structure of the back or poise of the torso. It’s been annotated to show how the head is forward of the back, but again, it looks nothing like “forward head posture.” This image can be found in this article by Masoero.
To understand the problem, we have to know what pulling the head back is actually doing. Most people already have their upper torso tilted back and down all the time. This causes the bottom of the upper torso to come forward and up. This rotation of the entire upper torso is held frozen out of place, and is unaffected by moving the head back. This is the case in people with and without “forward head posture.”
Before and after “correction” the upper torso it tilted. The very upper back is tipped back and down. This causes a rotation of the entire upper torso. As a result the lower part of the upper torso (the ribs) is pushed forward and up. The overall effect of this frozen rotation is that one’s stature is shortened.
In the particularly jarring images of “forward head posture” you can see that the upper torso is still significantly tilted back. This leads to a severe angle between the neck and the upper torso, which is somewhat alarming to look at from the side.
Even in the “correct” example we see that the upper torso is very much still tilted back.
In many cases there is no difference in the torso after “correction,” but when there is a change in the torso, it’s almost always for the worse. Usually the change is just that the upper torso has been rotated even further back to get the head to go back. This results in a look that is close to what we might imagine a drill sergeant’s posture to look like. Far from the head being in balance, it’s now retracted as if the person is surprised by some horror. The lower chest is pushed further forward, the slope of the sternum becomes more severe, and the structure of the back is lost even more than before the “correction.”
The entire upper torso is even more tilted back and down after “correction.” The slope of the sternum is more severe. The ribs are pressed further forward. The head is retracted as if in surprise. The throat is considerably constricted after the “correction.” Both the before and after pictures show a person with a malfunctioning torso.
The form of a drill sergeant. The head is so retracted we might call it “backward head posture.” This picture was used by F.M. Alexander in his final book The Universal Constant in Living. Jeando Masoero has added visuospatial instruments. Taken from this article by Masoero.
Anyone who has “forward head posture” has not had their head that way for only an hour or a day, they have been stuck that way for significant period of time. Their entire body has undoubtedly adjusted to this out of balance positioning of the head. Moving the head back will not solve anything, it will simply put you in another out of balance position. It may look aesthetically more pleasant, but the damage it will do to your back will remain; the resulting consequences (including pain) will still come. And naturally what’s most aesthetically pleasant is for you to achieve genuinely good posture.
When the people in the examples pull their head back in attempt to correct their head posture, their sternum and ribs come along too. This is because most people have become incapable of articulating their spine. So when they move their head back, their entire upper torso gets rotated backward and down with it. As a result, their sternums, which are already sloped back, become more sloped. Their ribs, which are already pushed forward, are pushed even further forward. The top of their sternum, which is already pulled back (and is part of why the sternum is sloped), remains pulled back or gets pulled even further back. All of these movements are making problems worse.
The person in the picture can’t move their head back without pulling the upper torso back. This results in a rotation of the upper torso that pulls the top of the torso back and down, and pushes the lower part of the upper torso forward. Arrows indicate how the ribs and bottom of the sternum are pulled forward, and how the top of the sternum is pulled back and down. The entire upper torso is rotated back and down. The sloping of the sternum is made more severe.
If these people were able to articulate their spine, they would be able to pull their upper torso up while moving the top of their sternum forward. This would require their spine to bend in a way that they are very much unused to and unfamiliar with. If they were able to pull the bottom of the sternum and the lower ribs back, while bringing the top of the sternum forward, the head would finally be able to come into its natural position. Although I must note that the position of the pelvis, abdomen, legs, and feet are also relevant to maintaining good posture for any period of time.
The figure on the left demonstrates drill sergeant posture. The result is that the head is back and the sternum is sloped. On the right we see a figure showing genuine good posture. The back of the head is forward of the back and the sternum is flat. Though the head is “forward,” it looks nothing like “forward head posture” because the torso is properly aligned to support the head and neck. This image was made by Jeando Masoero and can be found in this article by Masoero.
Here, in an example of genuine good posture, we see that there is no angle between the sternum and neck because the sternum is flat, so it doesn’t meet with a line drawn through the neck and ear. The original image can be found in this article by Masoero. The black lines have been added by me.
Here we see another “correction” where the sternum (and entire upper torso) has been tilted back to get the head back, which increases the slope of the sternum by bringing the top of the sternum back while pushing the bottom of the sternum and ribs forward. Here is a clear example of going from one unbalanced position to another. In the figure on the left, the pelvis is quite severely rotated forward and the upper torso, still rotated back, is brought down. This is likely because the demonstrator is attempting to show a bad posture he’s not used to. In the figure on the right we see the upper torso quite significantly tilted back and down. Compare the backs of both figures here to the back of Masoero in the example of genuine good posture. That is the difference between a hollow back and a back that has its natural structure in tact.
The reason that most people are incapable of just doing the actions I’ve described is because they have no understanding of how to articulate their spines. They have never been taught, and they have been put into a life where unreasonable demands are placed on their bodies. If they were to make the actions I have described, they would feel quite strange and out of balance. This is because their feeling sense is completely confused. This fact is obvious: they felt it so normal to have “forward head posture” (and a tilted upper torso) that they held themselves in that position all the time. Most people feel more comfortable slumped in a chair than sitting autonomously. Years of bad habits disorient and damage our feeling sense and we come to find ridiculous and unbalanced positions to be comfortable. We then come to feel anything but our particular bad habits to be uncomfortable.
But the reason people do not even try to do the actions I’ve described is because most experts are not experts, and they do not advise sensible things. They advise you simply pull your head back. They take you from one unbalanced position to another.
To really fix the position of your head, you would need to address your entire body; you would need to learn to articulate your spine; you would need to learn to do what you know is correct even when it feels wrong. In time your feeling sense will catch up, but after years or decades of bad habits that will not come immediately. Fortunately, you are capable of reasoning. Once you have developed some skill in reasoning your movements, you can consciously choose how to use your body, and even choose to go against what your faulty sensory perception tells you is comfortable, but which you know is unbalanced and causing you pain.
This journey into postures that are strange and unknown to you is what learning to gesture is all about. You can learn to guide yourself into making movements you have never made, and thereby free yourself from the trap of going from one unbalanced position to another. Then you will find out what balance really is.