Every day in our office, I see staff members with horrible desk posture. You can see them stretch their necks in pain and try to self-manipulate their cervical spines to release tension. Some lie on a foam roller for few minutes and take a massager to their desks to work on their trigger points.
Many office workers today suffer from forward head posture. This is the result of years of cumulative trauma and poor ergonomics mixed with sustained hours of sitting. Soon they develop upper cross syndrome, which consists of tight anterior muscles such as the pectoralis major/minor, sternocleidomastoid and anterior scalenes. With this syndrome comes weak posterior muscles, such as a weak rhomboid major/minor and lower trapezius. The cervical extensors become neurologically shut down, causing loss of the cervical lordosis widely seen on radiographs in the lateral position. Due to the righting reflex, the upper cervical and the occiput adapt by hyperextending the fulcrum at the C1/occiput junction,
paving the way for occipital neuralgia and chronic headaches.
Many in practice have seen this type of patient who presents with upper-back pain, burning, headaches, neck pain, stiff neck, sharp stabbing pain in the mid-back or scapular pain. Most have desk jobs and sit for hours at a time with no breaks. When this occurs day after day, structures other than myofascial pain become involved, creating the perfect storm.
As the head moves forward beyond the ideal postural alignment, discs begin to shear, facet joints become jammed and irritated, ligaments become overstretched, and muscles become tired and angry. Over time, the cervical spine becomes fatigued, and poor movement patterns may develop, causing increased intradiscal pressure, in turn causing a herniated disc.
Therapists can quickly help patients fix these issues and stop them from progressing into a full blown pathology. Therapy can start with a pectoralis stretch to stretch tight anterior muscles.
Using a Head Weight
Exercises we have found to have significant effect involve using a head-weighting system by Halo Posture. The Halo Posture uses an anterior head weight load to neuromuscularly activate the cervical extensors. Using surface EMG, we were able to document active recruitment of the cervical extensors with the Halo Posture.
Once patients start off with a 1-pound headweight, the therapist transitions them to a balance board to increase proprioceptive response with the anterior headweight. After one week, the therapist then increases the headweight to 2 pounds. When using the headweight, therapists need to be careful to assess for any dizziness or balance issues. Some patients may exhibit this at first due to the hyperexcitability of the cervical mechanoreceptors, but with training they will overcome this the first session.
Educating patients on home use is key as they can use the anterior head weight even when they work at their desk. Once successful practical alignment is achieved, the therapist then can transition the patient into the Halo Rejuvenator for continued cervical stabilization. We have seen a 50-percent reduction in forward head posture on radiographs with the anterior head weight in place on the first visit. Having the patient use a HaloreJuvenator as a home exercise program ensures
the posterior and anterior cervical support structures stay rehabilitated.
At our rehabilitation center, we offer the HaloreJuvenator as a take-home support, which patients purchase at the end of their formal care. Once patients can demonstrate usage correctly, they are followed up from two and four weeks post-care to document successful strengthening and endurance training for the cervical spine. The HaloreJuvenator plays an important role in addressing the body’s natural healing process. Patients will start to see dramatic changes in their posture, decreased frequency of pain, and overall endurance in their neck throughout the day. Studies show that cervical strength training with head weighting affects mechanoreceptors positively, providing neural feedback and facilitating pain inhibitory mechanisms.
Restoring the Neck
Using specialized equipment is essential to restoring the normal curve in the neck. According to the Journal of Chiropractic Research and Clinical Investigation (1994), in an article regarding the relationship of changes in neck posture to neck pain, as neck pain patients had their normal neck curve restored over a 12-week period, improvements were noted in all measurements
of clinical symptoms. The patients’ improvement correlated with an increase in the degree of curvature of the cervical spine. The HaloreJuvenator reinforces better functional movement patterns that allows even the worst computer desk worker to feel better. n
Danny Song is a doctor of chiropractic, licensed physical therapist assistant and a qualified medical examiner. He is also credentialed as a Diplomate through the American Academy of Pain Management. Dr. Song specializes in chiropractic, physical rehabilitation, exercise physiology and nutritional counseling.