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Forward head posture: Fixing excessive thoracic kyphosis

Advancing last week’s discussion of neck pain, we next need to develop a plan to reverse forward head posture, because when the head is held forward of its optimal position, the neck is going to hurt. When the back neck muscles do all the work fighting gravity to hold the head up instead of the foundation of the body carrying the weight, the muscles get stressed and painful.

Excessive thoracic kyphosis – too much bend in the upper spine – goes hand in hand with forward head posture. Regaining thoracic mobility greatly contributes to fixing that, and subsequently eliminating neck pain.

For tips on how to do this, let’s go back to Anthony Carey, the guy who designed the Core-Tex reviewed a couple of weeks ago. Anthony presented his session, Advanced Strategies for Correcting Kyphosis, at this year’s IDEA conference, and guess what… I took notes.

A huge percentage of adults have excessive bowing in the upper back; in some, it’s a congenital structural issue and in others, usually the elderly, it’s a result of increasing osteoporosis and weakening bones unable to support the torso. But in most of us (you can guess what’s coming next), it’s postural… plain old bad habits.

Take a look at this image:

When the upper spine bends into kyphosis, it creates an excessive stress above in the cervical spine. Over time, that’s going to hurt. It’s also going to begin to move less, as will the thoracic spine; there will be less rotation and it will be harder to turn the head and shoulders. That’s probably the top reason older drivers back into things: They can’t rotate very well.

With the upper spine bent in that position and decreasing in mobility, it’s going to put more stress on the shoulder joint. Most people with shoulder issues have a t-spine mobility problem, and since a lot of us have both, what’s next?

One point Anthony made in his presentation and one I’ve heard whispered occasionally is about excessive foam rolling. When we start rolling over dense foam, most of us really respond to rolling the t-spine region, and because we like it so much, we go back to it often, perhaps too often. If we continually move the same spot by rolling, we may be creating hyperextension of certain areas over time. Segments above and below may be less mobile, and he suggests we not use foam rolling as our sole corrective strategy.

My favorite t-spine mobility exercise – the one I started with and regularly return to – is segmental mobility gained by working over a pair of taped tennis balls. I picked this one up from Mike Boyle a couple years ago; two used tennis balls and a roll of athletic tape and you’re making progress in about ten minutes.

Here’s what it looks like in action:

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As you begin to loosen the upper spine, regaining youthful mobility, you’ll want to bring in a bit of rotation. Watch Mike working on thoracic rotation.

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Here’s another example of t-spine rotation, this time in quadraped position from strength coach, Dewey Nielsen. Notice how his athlete is sitting deep in the hips; this is to keep the lower back from taking the rotation.

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Anthony’s corrective exercises are a step above those basics, are a little harder to explain and aren’t available online as far as I’ve seen. So I again (yes, again… I think this must be the tenth time) refer you to his book, The Pain-Free Program, where you’ll find these unusual exercises described, with photos, plus a revolutionary way for laymen at home to sort out their personal postural issues. Can’t recommend it highly enough.

If you’ve worked your way through the neck pain ideas from last week and this week’s upper back suggestions, but your real concern is low back pain, click on over to Function First for Anthony’s tips, 25 Things You Must Know About Lower Back Pain.

If you work on those two or three moves five minutes a day for the next two weeks, I guarantee your back and neck will feel better. Not much time for a huge payoff! Add some aggressive pec stretching and you’ll be truly amazed at how much younger your upper body will feel.

I keep harping on this stuff because for me it’s made the difference between able and… well… unable. There’s no way I’d still be publishing books or dvds had I not taken the time to address mobility. No possible way.


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