The second (major ) type of muscle which can cause Forward Head Posture ( FHP ) is the STERNOCLEIDOMASTOID ( or SCM ) muscle. There are others which affect posture, but it is not necessary to discuss these here. The SCM muscle connects to two places on the chest. One part connects to the breastbone or sternum ( which is where we get the ?STERNO? part from ). Another part connects to the clavicle or collar bone. At the other end of the muscle, there is an attachment behind the ear ( what is called the MASTOID PROCESS ). We mentioned previously that when a muscle contracts ( either by our brain commanding it, when we wish to put our head down to read something for example, or due to stress etc ), the bones at both ends ( if attached ) will try to be pulled together.
Note the term ?BRACHIAL PLEXUS? seen at the bottom of the picture. This refers to the bunch of nerves that exit the Thoracic Outlet mentioned before.
In the case of the SCM, the bones around the chest will not move much ( think of them as a fixed point ). However, in most cases, the head will be pulled forward easily. If we spend too much time in this head down position ( working on laptops, PDAs, video games etc ), the usual problems of waste buildup, knots and adhesions etc will start to appear ( if no corrective measures are taken ).
The following picture shows both attachment points on a famous movie star:
The SCM muscle is a very powerful ?head puller ?.
Have you ever seen elderly people at the supermarket with their heads hanging down, and their upper backs all humped over ? Usually they have a walking frame.
What is strange is that I cannot remember ever seeing any children at school like that. Neither can any of my friends or neighbors. Over the last five years, I have spoken to several dozen people like that at my local Publix supermarket. Upon asking them some questions, I usually get very interesting answers. When asked if they had this condition at childhood, not one has said ?yes? so far. Nearly all have said ?I noticed it as I got older, but then within a year, it really got worse?. I then ask them ?Are you able to stand upright?. Nearly all of them were able to. They then reply ?I can only do this for a minute then I?m pulled back down?. I then ask them if their doctors have said it?s a bone disease or something else medically related. None of them have said ?yes? so far. So what is going on here ? Bye the way, out of all those people I spoke to, three took the time to visit the therapists who treated me. All three are now standing straight. One poor old soul of 80 held one of the therapists so hard after being able to stand straight for the first time in two decades and burst into tears. Of the others, most spoke to their doctors and were told "If it could be corrected, don't you think we would have done it already". Sad really.
Many of them worked in offices or as craftsmen hunched over a work bench. The muscles in their chests and necks became tighter as time went on. The head went forward, then forward some more, gradually over time. The muscles at the back of the neck and upper back ?took the strain? and were able to ?hold the head back a bit?. A point is reached however ( which varies from individual to individual ) where finally the turning moment of the head becomes too much for the poor muscles at the back of the head and neck, and then it?s literally all downhill from that point on. Because the neck muscles at the back have not been exercised properly, they exhaust easily, causing pain in the upper shoulders and back ( most of the aches and pains office workers get in these areas are casued by this ). At this point, the head can no longer be supported on it?s own , and hangs down.
Unfortunately, a whole chain of bad things now starts to happen. We mentioned in a previous post that when the head goes forward, the brain causes changes in the spine elsewhere to literally stop you from falling over. Now, the curves of the lower back and thoracic regions change dramatically. Multiple problems can then occur?disk herniations, disk bulges, disk degeneration etc.
The most dangerous situation occurs when the body detects that the intervertebral disks are literally shrinking, and the spine is becoming unstable. Calcium is laid down in the form of bone spurs or osteophytes, and the spine will literally try to fuse itself to prevent further degeneration in terms of curvature. Once the bones are fused, there is very little that can be done for those poor unfortunates.
One of the therapists who worked on me has found a very interesting thing. The walkers themselves that most elderly people use are almost never adjusted to take into account the user?s height. This means that for some people, an already bad situation can be made worse by having the person stoop even further over to hold on.
In the next series of posts, we?ll start to look at what can be done to correct some or all of this.