Anterior Head Carriage – and what can you do about it?

Welcome to the most visited, and arguably, the most important page on the blog.  It looks at Anterior Head Carriage (AHC).  This is also known as Forward Head Syndrome, Crossed Syndrome, Tech Neck or Student Neck.  

What is AHC all about?

The underlying cause of all the issues of pain and dysfunction linked to AHC is that you hold your head forward of its proper anatomical position.  Normally, the centre of gravity (COG) line of your head sits directly over the centre of gravity line of the rest of your body.  If it is, then your ear-hole will appear to be directly above the point of your shoulder.  With AHC your head is forward of your body’s imaginary COG line.  This means your head is not balanced and is, in effect, falling but very, very slowly on to your keyboard.

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You’ll see examples of AHC everywhere.  Look round your office and I bet you can see  it in a few in your colleagues from where you are sitting.  I found these classic examples in a well-known, and pretty cool, clothes shop on Park Street (the staff were great and really helpful so if you can recognize the shop from the pictures go and buy something and cheer them up).

As you can see the ear-hole is way too far forward of the COG line passing through the tip of the shoulder.  Is this what’s happening with you?

What are the main problems associated with AHC?

These problems are varied, significant and widespread.  A brief summary is that you get:

  • Trapezius muscle trigger points and tightness.
  • Trigger point referred pain into the head giving you migraine-like headaches.
  • Infraspinatus muscle trigger points leading to diffuse, but at times, intense arm pain.
  • Mid-thoracic joint jamming and muscle guarding pain.
  • Low-neck joint compression and pain on rotation.
  • Sub-occipital muscle trigger points and associated face and head pain.

Now that you know what AHC is, and you are aware of the problems it causes, what to do about it?  Prevention would be ideal.  So, all the workstation evaluation effort and not using the laptop too much is important.  However, it will not make a massive difference.  You’ll still have to spend time in front of a computer and sat at a desk.  So, let’s assume you are not going to stop working just yet, so:

Cure?

Well, this is far trickier, and remember:  it has taken years for you to put it there so it will take time to get rid of it.   The most significant aggravating factor will be you peering into your computer, laptop, tablet and phone for, say, over 8 hours in a day.  Until this stops you will still tend to get the problems associated with AHC.  However, it can be tackled with this stretch but needs work by you and time – so be patient.

The Stretch

This is the process:

Firstly, get your chiropractor to check that your neck is working right before you start these stretches.  Why? Because the aim is to address the problems you have with your brain’s understanding of where it is in 3D, or its proprioception.  If you don’t then you’ll spend time training your neck to work in the wrong way.  This will then become the default position and you will always try to return to this position and it’ll all go wrong again.  So, don’t do these if your neck is painful, wait until your chiropractor tells you it’s O.K. and then ‘go crazy’.

The aim of the stretch is to put back into your neck all that the day takes out of it.  You’ll be doing the reverse of what causes problems (which is usually forward flexion as you stare at the screen).  This means we’ll be asking you to put some full-on rearwards flexion into your neck.  You’ll be delighted to know that this is all stuff you can do lying in your bed as this is the best place to do the stretch.

The first time:  pay attention here as this is important, most people have a couple of large arteries each side of their neck supplying blood to their head.  However, there are some crazy anatomical variations out there where a few people only have one.  Now, if this lot try the stretch they can feel pretty weird and unhappy about it.  The good thing is you will already know that you are one of these few because you’ll have felt very strange previously.  This is not the usual blood rush to your head stuff that we’ve all felt whilst looking under the bed for monsters as a child but more significant dizziness and even nausea.

So, the first time you do the stretch we just want to test to see how you feel about it.  What we’ll do is start the stretch and increase the amount of stretching in small steps.  Lie on your back with your hands on your tummy or by your side, with the edge of bed just under the bony lump at the base of your skull, like this:

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Wait for 20 seconds and if you feel fine, wriggle backwards further off the bed so that the edge is now about 2 cm further down your neck and the stretch is a bit more obvious.  Like this:

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Again, wait for 20 seconds.  If it is fine, progress in this way until the whole of your head is hanging off the edge, like this:

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If it feels weird at any time then stop and come and tell you chiropractor.

Now, in relation to the rest of your body your head is a heavy structure, so gravity working on it will do the trick and there’s no need to shove it about.  Just let it do its own thing.

Stretches beyond the first time:

Just go straight to the last stretch shown above and go to it!  Good luck!

What should it all feel like?

Well, you will have stretched your throat and windpipe to their full anatomical length.  Swallowing and breathing may be a bit difficult; a bit difficult but not impossible.  You will also have stretched the ligaments of the neck to their full range of motion.  This is a really good thing as this is where the proprioceptive organelles live and they’re the ones we are after.  This will give you that classic, deep stretch and burn feeling in your neck.  You may also get some tension in your chest where all your pipes attach.  Again, this is normal – just not fun.  However, if it really hurts then stop.  So, this will need a bit of differentiation by you: pain = bad but deep ache = good.

How often?

Well, tricky one.  This is the equation:

8 hours at work + 4 hours of gaming does not equal 3 minutes of stretching.

So, start by doing it for 3 minutes each day and then be prepared to up the time.  This sounds easy but you wait.  We recommend that you ‘fix’ yourself to the bed by listening to one track of music (choose carefully now!) as that’ll give you about 3 minutes’ worth of stretch.  After a week of this go and see your chiropractor again and see if you can up the time.

I now have patients who spend 20 minutes in the stretch position and one, Tom, has been told he’s looking taller by people already.

Finally, if this makes sense and you like what you read here please hit the twitter button and let the world know or go to our Facebook page and tell us you liked it.  It will help loads of others if we can get this message out there.

Rupert

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