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Forward head posture and its effects on health and the craniomandibular complex

The effect of posture on health is becoming more evident. “Spinal pain, headache, cranio-mandibular-joint effects, mood, blood pressure, pulse and lung capacity are among the functions most easily influenced by posture.

One of the most common postural problems is the forward head posture (FHP). Since we live in a forward facing world, the repetitive use of computers, TV, video games, trauma, compromised occlusal plane and even backpacks have forced the body to adapt to a forward head posture. It is the repetition of forward head movements combined with poor ergonomic postures and/or trauma that causes the body to adapt to forward head posture.

A review of literature substantiates that "For every inch of forward head posture, it can increase the weight of the head by and additional 10 pounds." It's not uncommon to have TMD patients walk into my office supporting a 10-12 lb head that has migrated 3 inches forward of their shoulders. It isn't difficult to recognize prior to any palpation that their cervical muscles are in a losing battle attempting to isometrically restrain 40-42 pounds against the unrelenting forces of gravity.

Ideally, the head should sit directly on the neck and shoulders, like a golf ball sits on a tee. The

weight of the head is more like a bowling ball than a golf ball, so holding it forward, out of alignment, puts a strain on your neck and upper back muscles. The result can be muscle fatigue and all to often an aching neck. Head forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment.

Because the neck and shoulders have to carry this weight all day is an isometric contraction, this causes neck muscles to loose blood , get damaged, fatigue, strain, cause pain, burning and fibromyalgia. When spinal tissues are subject to a significant load for a sustained period of time,

they deform and undergo remodeling changes that could become permanent.

It also has been noted that forward head posture may result in the loss of 30% of vital lung capacity.

These breath related effects are primarily due to the loss of the cervical lordosis which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping the first rib during inhalation. Proper rib lifting action by the hyoids and anterior scalenes is essential for complete aeration of the lungs.

Head Posture and Cranio-mandibular posture

The relationship of the mandible to the cranio-maxillary complex, the temporomandibular joints, the atlas and the cervical and thoracic vertebrae are orthopedic in nature. In addition the shoulders, clavicles and sternum are all affected during the action of mastication and swallowing. Many of theses structure either share the same neuro-muscular system or have close commonalities.

Patients with deep bites, retruded lower jaws (Class II mal-occlusion), deficient vertical dimension, narrow introral arches typically present with a forward head posture and a variety of symptoms related to TMJD.

Often seen as a structurally subtle body segment, the neck is burdened with challenging task of supporting and moving the human head. Because of tension and poor postural relationship of the craniomandibular complex and habits inherent in today's workplace and society it comes as no surprise that associated neuromuscular disorders rank high as the most common pain generators. Correction of the upper cervical area and the mandibular relation to the cranio-maxillary complex is key to stoping and reversing degenerative joint disease and pain from headaches, breathing abnormalities, TMJ dysfunction and other postural effects. Any loss of function sets off reactions within the body's open, dynamic system which manifests as structural abnormalities throughout the entire body.

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