Forward Head: Where Does It Begin?
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Rounded Shoulders, Forward Head and Breathing
I recently did a movement/posture coaching session with a woman who came to me complaining of pain in her shoulder. She pointed to the spot and said that all her stress "always goes right here.” Okay, I thought, and I began the session by doing what I always do which is look at the whole person. I watched her walk and asked her a few questions about her impressions of her movement, questions that helped me understand the depth of her body awareness.
This woman was right on board with herself. She felt right away what I was seeing, that the lower half of her body was moving fairly freely, while everything above the waist was rigid.
A Childhood Breathing Problem
I’m grateful for those lucky moments when a body’s truth is crystal clear to me. Without even taking her history, I asked whether she’d ever had any breathing problems. Her eyes got very wide, and then she told me that when she was a very small child, under 4, she'd had a severe case of pneumonia. It had lasted for a long time.
From that point I could guess that the shoulder problem wasn’t about shouldering burdens of career and family, as is so commonly the case with women. The genesis of my client's shoulder issue was her breathing history. What happens to our little bodies can plague us throughout our lives.
Emergency Breathing
When the lungs are in jeopardy, the body will recruit its emergency breathing mechanisms to enlarge the air space within the ribcage. The scalene muscles lift the upper ribs, and the levator scapulae and upper trapezius lift the shoulders.
Mouth breathing is common when there has been an emergency involving respiration. Mouth breathing slackens the jaw while increasing tension in the hyoid muscles, the ones underneath the chin and tongue. Those muscles help pull the head forward.
When my client grew up, breathing was no longer an acute issue, but the emergency breathing pattern remained coded in her breathing brain map. Now, in middle age, she was suffering from forward head and shoulder pain.
To Tuck or NOT To Tuck Your Chin?
This woman’s chiropractor had told her to correct her forward head by tucking in her chin to pull her head back, and to practice holding her head that way.
When I heard that, I couldn’t help myself, I got mad! I’m very tired of hearing people tell me that their DC or PT told them to do this crazy thing. It loads extra tension into the jaw muscles and the muscles of the neck, further rigidifying the upper body. And, not incidentally, it restricts airflow!
Exhalation = Relaxation
As my client explored her breathing, she discovered that she didn’t fully breathe out. If you’ve been reading my stuff, you know that exhalation is the prime ingredient in our bodies’ ability to relax. Relaxation of all muscles, including the diaphragm, depends on the parasympathetic activation that occurs during exhalation. If exhalation is truncated, the muscles remain in sympathetic activation, the arousal state, and therefore stay tense.
To facilitate her out breath, I asked my client to explore the sensations of allowing the weight of her body to fully yield to the table. This idea engaged her for many minutes. Suddenly she remembered that as an older child she had spent many years trying to walk softly. You know, from trying to do this yourself on occasion, that your whole body tenses up in the effort to lessen gravity’s influence. Imagine doing it for years.
This isn’t the whole story of the session, but it’s enough, I hope, to show you that your forward head, too, probably has an interesting history. And tucking in your chin is not the answer!
For related posts see: Tongue Tension, Computer Neck Pain, Stiff Eyes.