In this era of technology, a common symptom experienced by people who sit for extended hours at a computer are neck and shoulder pain. This phenomenon is referred to as forward head posture. As Physical Therapists, we often see this prolonged posture with the person who does repetitive work in an assembly line and is stooped forward or sits forward, the commuter sitting in traffic, a student who studies for endless hours, or in adolescents texting or playing video games. There is also the executive who sits uninterrupted with his head forward. Neck pain usually impairs function in daily activities and significantly impacts quality of life. Patients present with neck and or shoulder that can refer into the mid back and scapulas.
Sitting and standing with this forward head posture shortens the muscles in the upper cervical spine, the suboccipital muscles at the base of the skull and elongates the muscles of the lower cervical spine. When the neck constantly rests in front of the shoulders, we may also see the muscles of the chest become tight and shortened. This may cause muscle spasms, neck pain and sometimes headaches and can eventually lead to shoulder pain.
Flexibility exercises can be used for patients with neck symptoms, that target specific muscles such as pectoralis major and minor, levator scapulae, upper trapezius and scalenes. Flexibility of these muscles can ensure proper posture in all realms of daily living. Strengthening cervical stabilizer as well as shoulder stabilizers are key factors to decrease neck pain and improve posture. Having good desk ergonomics with feet on the floor, screen at eye level and proper lumbar support can help maintain cervical alignment. Education is key to reducing neck pain by interrupting the prolonged forward head position.
