Due to the prevalent use of smartphones, laptops, and sedentary lifestyles, forward head posture (FHP) has become a common problem, especially among adolescents. This condition can lead to neck pain, headaches, dizziness, carpal tunnel syndrome, and loss of function. However, FHP can be corrected with chiropractic care and muscular rehabilitation.

Stabilizing exercises for FHP are particularly effective in adolescents because their spines have not yet reached full maturity, and plastic deformation of the muscles and ligaments has not occurred. Additionally, educating adolescents on spinal hygiene and postural exercises can prevent postural imbalances, fostering healthy habits for life.

FHP presents with a pattern of muscular and functional imbalances, typically involving weakness in the middle trapezius (MT), lower trapezius (LT), serratus anterior (SA), and deep cervical flexors (DCF). Conversely, the pectoralis group (both major and minor), upper trapezius (UT), levator scapulae (LS), and suboccipital (SOC) muscles tend to become shortened and tight. Given that altered shoulder girdle rhythm and decreased scapular mobility with arm elevation are common movement dysfunctions, corrective exercises target restoring proper biomechanics.

The most effective strengthening exercises for treating FHP activate the MT, LT, SA, and DCF while minimizing activation of the UT, LS, and SOC muscle groups. Electromyography (EMG) studies show that prone external rotation of the arm at 90 degrees elbow and shoulder flexion provides excellent activation of MT:UT and LT:UT. Other effective exercises include supine wall angels and isolated scapular retraction with depression. Properly performed, scapular retraction and depression reduce UT and LS dominance. Chin tucks are also excellent for activating the deep neck flexors and should be incorporated into other exercises to maximize time and results.

Common Muscular Imbalances in FHP

Shortened & Tight Muscles

• Upper trapezius
• Pectoralis major and minor
• Sub-occipital group
• Levator scapulae

Weakened & Lengthened Muscles

• Middle and lower trapezius
• Serratus anterior
• Deep cervical flexors
• Rhomboids

The serratus anterior (SA) is best strengthened with exercises that involve arm flexion above 120 degrees in scaption with external rotation, commonly known as the “Y-raise.” This can be done prone or standing, with or without resistance. The push-up plus exercise also activates the SA more than the UT. Additionally, incorporating abdominal breathing further enhances the activation of the scapular stabilizer muscles.

Several studies have highlighted the significance of restoring spinal mechanics in correcting FHP, an area where chiropractic care excels. Once mobility is restored through chiropractic adjustments, corrective exercises can be implemented to re-establish proper muscle memory.

Treating FHP takes time. Through chiropractic care and physical rehabilitation, the pain and dysfunction associated with this condition can be relieved, and the necessary wellness tools for long-term correction can be learned. Addressing the postural asymmetries of FHP goes beyond pain management and is essential for long-term health and wellness. Incorporating the exercises mentioned will add another dimension to your overall health.