Posture Problems

In the first chapter of every physiology book you’ll find the phrase, “Anatomy dictates physiology.”  In other words, our structure dictates our function or how well things work.  This is certainly true in your neck.  A normal neck has a 35-45 degree curve as measured on x-ray.  Think of this like the bow in a dam or a bridge.  The curve provides flexibility and strength amongst numerous other functions.  When the curve is lost or especially reversed, problems can arise with our physiology.  These include chronic aches and pains, but also bigger problems with overall health. 

The normal curve (lordosis) of our neck develops as an infant when we begin to hold our head up and crawl.  As mentioned, this curve reduces stress on the soft tissues of the neck and provides flexibility – think of it like a spring or shock absorber for the weight of the head.  This normal curve keeps the vertical pressure and weight of the head on the backs of the vertebrae rather than the fronts where the discs are.  Likewise, the curve allows the numerous little muscles on the back side of the neck to stay relaxed.  Poor posture from driving or sitting at a desk or especially looking down at a phone, tablet, or laptop for hours will change the muscle balance of the neck; stretching the muscles of the back side while shortening those in the front.  Some studies have shown that this phenomenon will happen 80% of the time after a whiplash accident from a car wreck or other injury.  In previous articles, we called this “upper-crossed syndrome.”  This syndrome results in a straightening of the neck or sometimes even a reversal of the curve.  Either way, when the curve is lost, you lose the functional advantages mentioned above and forces are shifted to the front of the vertebrae and onto the discs.  The result will be chronic tightness of the muscles in the back of the neck, chronic neck pain and stiffness, tension headaches, shoulder tension, and loss of normal range of motion in the neck.  Over time this imbalanced pressure creates excessive wear-and-tear that causes degenerative changes such as arthritis of the spine and breakdown of the discs.  Worse than this, as the head starts to drift forward from these changes of the neck, our shoulders won’t move the same.  Also, breathing will become more difficult.  You can try this on your own – just push your head forward and attempt to rotate your shoulders like you were swimming or take deep breaths.  A landmark 2004 study looking at thousands of subjects found that the loss of curve in the neck will increase tension in the spinal cord and stretch the cord up to 5-7 centimeters.  The study found that people that had this loss of curve on average lived two years less than those who retained the normal curve in their neck.

The good news is that all of this can be prevented and many times reversed.  Obviously, focusing on normal posture is critical.  But even when the curve is lost, there are neck and shoulder exercises that work to undo the damage.  Contoured cervical pillows help prevent the problem, but only if you sleep on your back.  When the curve is already lost, in most cases, you will need to practice some form of neck traction/extension regularly over a period of 6-12 months and there are various products that are designed for this retraining of the neck.