THE 40 POUND HEAD - DAMAGING EFFECTS OF FORWARD HEAD POSTURE

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.

TEMPORO-MANDIBULAR-JOINT DYSFUNCTION AWARENESS

TMJ Dysfunction Awareness

In 1997 November was officially declared as the "Jaw Joints-TMJ Awareness month in the United States of America.
Temporomandibular Joint Disorders, commonly referred to as “TMJ,” afflict millions of people not only Americans but worldwide, both children and adults of both sexes and all races. TMJ dysfunction is a painful and often disabling disorder that emanates from the Jaw Joints and can affect the health of the entire neuro­musculo-skeletal system often spreading and dysfunction throughout the entire body. 
Understanding the complex relationship of temporomandibular disorders to overall health requires broad understanding of not only the anatomy and physiology of the head and neck but also the cervical spine and upper quarter complex.



There are over 120 known signs and symptoms related to TMJ dysfunction. Some of the extra oral signs and symptoms include:

• Jaw joint noises-clicking, popping, grading noises
• Headaches
• Sore muscles of the face and jaw
• Limited ability to open the mouth
• Teeth sensitivity to temperature
• Ear symptoms such as fullness, ringing in the ears
• Dizziness
• Facial asymmetry
• Pain behind the eyes
• Numbness and tingling of the hands and fingers
• Neck and shoulder pain
• Lower back pain
• Postural issues
• Nervousness
• Insomnia

Some of the intra oral signs and symptoms may include

• Crowded and crooked teeth
• Narrow upper and lower arches
• Worn lower front teeth
• Deep bite (over lapping of upper front teeth over lower front teeth)
• Cross bites
• Anterior open bites
• Missing teeth
• Broken back teeth
• Tongue thrust habits
• Grinding and clenching
• Phantom tooth ache

The aforementioned are just a small example of the myriad signs and symptoms related to TMJ dysfunction. If you are experiencing any of these symptoms and non of the medical interventions have helped or you are a victim of over prescription of an array of medications, you are not alone. According to National Institute of Dental and Craniofacial Research NIDCR, TMJ disorders are the second most common pain causing musculo-skeletal conditions after chronic lower back pain. It is estimated that 5-12% of the population is affected by TMJ dysfunction.

This awareness can be increased among all the countries and not just the USA (where this awareness month was instituted), and in particular those in a position to help treat, insure, provide appropriate research, and ultimately to prevent this scourge everywhere.