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Forward head posture affects more women then men!

Posted Dec 18 2009 2:50pm

There are two very specific anatomical differences in females and males…well, there may be one more, but that is not what I am talking about! However when it comes to exercise, maintaining structural balance throughout these areas could mean the difference between undesirable pain, aesthetically displeasing features such as sagging breasts , a pooching belly and a “dowagers hump” and  having the body you desire while avoiding injury!

The very things that exacerbate these differences, creating the issues that many women struggle with are going to be dependent upon the individual demands placed on the body. For example, forward head posture and rounded shoulders, along with their associated imbalances, can begin early on as women will adopt a slouching posture in an attempt to hide developing breasts.  As well, later on in life, our lifestyles begin to influence repetitive movement patterns which lead to imbalances and the development of compensatory patterns.  Over time this will lead to the development and/or susceptibility to injury and a decrease in functionality.

Our goal here is in creating an awareness to our differences and understanding the effects of these differences on our overall wellbeing.

As mentioned, forward head posture can be a result of several different factors and whether rounded shoulders came first or vise versa women are more susceptible to the structural imbalances and stresses placed on the body as a result of both.

In placing this into perspective lets first consider the fact that an average human head can weigh up to 11lbs or 8% of your body weight, and with every inch the head migrates forward that weight will increase by 100%.  To get a better understanding of the impact this can have on you, just imagine hanging a 20lb. watermelon around your neck and begin to ask yourself if this could be the cause of any of your aches and pains? In addition, females possess 30-40% less cervical muscle mass then males!

As the upper quarter of the body falls into a forward head position, many of the component joints are taken to the extreme of a particular ROM in an attempt to maintain the three planes of horizontal reference with the eyes, ears and teeth. This is for a number of survival reasons some of which include (respiration, balance, mastication, vision, etc.). Over time, due to adaptive changes that occur in and around the joints, the joint cartilage and ligaments are overstretched resulting in compression, shearing and degeneration of the intervertebral discs.  Antagonistic muscles groups can no longer balance the head and neck and the muscles become hyperactive and prone to dysfunction and pain.

First rib angle alterations are influenced by forward head posture and rounded shoulders and tend to be more prevalent in women as the manubreum of a female sternum sits one segment lower in females, placing the anterior and medial scalene muscles closer together.  This steepened angle decreases the space of the pathway through the clavicle in which, the brachial plexus nerves, subclavian artery, vascular and lymph vessels all pass causing an entrapment of the brachial plexus nerves (nerves that feed the arm), known as Thoracic Outlet Syndrome (TOS) .  Some of the symptoms accompanied by TOS include; constant headaches, shoulder impingement, neck pain, tingling or numbness, muscle weakness, disturbance in equilibrium, interscapular pain and/or irritable trigger points.

In addition, persistent forward head posture (a.k.a hyperkyphotic posture) as well as improper shoulder girdle position, puts compressive loads upon the upper thoracic vertebrae at C7/T1.  These compressive forces are a stress to the body and as a protective mechanism, the nervous system will respond by  adding more tissue.  This build up of tissue is called a “Dowagers Hump.”  Aesthetically speaking ladies…not so good!

As mentioned forward head posture can lead to an increased rib angle and altered shoulder girdle position but it can also influence the position of the lumbar spine and lower extremities as the pelvis is a major posture control center on structures both above and below the pelvis.

Other major influences that effect the pelvic position in females are pregnancy and high heeled shoes. Pregnancy causes stretching of the abdominal musculature, shortening of the hip flexors, hyperextension in the knees and disrupts normal weight bearing relationships in the lumbar spine. While high heeled shoes are capable of the same, the entire kinetic chain must progressively compensate for every inch of heel height as once again, as a survival mechanism, the body will do whatever it needs to in order to maintain eyes, ears and teeth level with the horizon. Imagine, if the joints of the body were held rigid…this would mean that for a 2″ heel the body would lean forward 22.5 degrees and a 4″ heel would require the body to lean forward by 45 degrees!

I think it has been made pretty clear that it is bio-mechanically impossible to have an upper extremity imbalance without having a lower extremity imbalance and the effects of the types of exercise we are doing, our ergonomics at work, home and in the car must be evaluated prior to making any extreme decisions in surgically altering any part of your body.  Whether you are considering plastic surgery for aesthetic purposes or are tired of being in pain and are resorting to the all too common “ectomy” my recommendation to you is consider this first.

As well, find a CHEK Practitioner in your area that is trained in the assessments that identify these common imbalances and get on a corrective exercise program! Begin improving your posture by getting all the muscles working synergistically,   so that when the shoulder girdle is weighted down with the extra weight you can dissipate it through your rib cage, through your legs and into the ground not through your scalene muscles, neck and back!

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