Tuesday, April 19, 2016

Be Careful Going Head First

By Dr. R. Greg Lusk, DC

Going head first, as the expression goes, refers to not taking time to think about your actions before starting whatever it is that you're doing.  The results with this sort of approach, as one can imagine, can be mixed.  On the other hand, the "head first" scenario that I am referring to, from the perspective of a health care practitioner, is that of anterior head carriage (AHC), where the potential for negative outcomes is the clear winner.  AHC refers to loss of vertical alignment of your head over your torso, where a plumb line should pass through the flap at the front of your ear and the tip of your shoulder when viewed from the side.  Instead, the head is shifted forward in relation to the shoulders.  It is synonymous with forward head posture or simply "bad posture" as so many of us have been told.  In this position the lower neck and upper back are excessively bent forward whereas the upper neck, the area just below the back of our head, is in hyper-extension.  This causes increased strain on the tissues at these levels and frequently results in pain and/or other symptoms.  Neck pain, headaches, jaw (i.e. TMJ) pain, pain into the upper back or around the shoulder blades, and symptoms such as pain, tingling, numbness, or weakness in the arms and hands are common examples.
 
It is easy to appreciate the increased strain on the body in this position.  I often pose a question to patients - "Would you rather hold a weight in front of your chest all day or with your arms fully extended with the weight as far away from the body as possible?"  Unless your goal is to get an exhausting workout the answer to keep the weight close and decrease leverage is obvious.  However, to correct this problem, the direct approach of saying "improve your posture", "sit up straight", or "don't slouch", doesn't work well in my experience.  Similarly, how often does saying don't smoke or don't eat junk food really work?  Ultimately, you need to create an environment for success.  With the goal of a better head position, you can support a better posture by setting up your desk, computer, car seat, etc. in such a way that you don't get lured forward.  Keep your chair close to the desk, your computer monitor or steering wheel close to you, and your buttocks all the way back on the chair.  Better yet, employ a good lumbar support to keep your low back curved nicely and you'll notice that it is much more difficult to poke your chin out.  Your neck and low back will thank you.
 
An exercise for your deep neck flexor muscles can also be done periodically to improve the alignment of your head and neck and to balance out strains in the involved tissues.  Often called chin tucks, neck retractions, or the "give yourself a double chin" exercise, you can do it in either a seated position or lying on your back.  While keeping your eyes looking forward, the object is to draw your chin back as far as possible.  This extends the lower neck and flexes the upper neck, the exact opposite positions involved with poor posture.  Hold the end position for 1-2 seconds and repeat for 10 repetitions.  Doing a few sets daily can go a long way in preventing pain and symptoms related to AHC
 
This article is for general information purposes only and is not to be taken as professional medical advice.