Treatment of Myofascial Pain Syndromes
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
In the forward head posture, total body alignment is severely affected. There is posterior cervical rotation with hypomobility of the upper cervical and subcranial motion segments and hypermobility of the mid and lower cervical spine. Muscle imbalances occur between the anterior and posterior cervical muscles and between the anterior and posterior shoulder muscles. The shoulder girdle protracts, and there is an increase in thoracic kyphosis, a loss of lumbar lordosis, and an increase in posterior pelvic rotation. Muscular imbalances may lead to abnormal afferent input and MTrPs (Cantu & Grodin, 2001). There is a statistically significant relation between the degree of forward head posture, posterior cervical rotation, and pain (Haughie, Fiebert, & Roach, 1995). Poor body alignment, forward head posture, and muscle imbalances predispose and perpetuate chronic pain problems including MPS.
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
Studies have shown that a TMJ disorder has some effect on head and body posture (Kritsineli and Shim 1991, Lee, Okeson, and Lindroth 1995, Zonnenberg et al. 1996, Cuccia and Caradonna 2009, Ciancaglini, Testa, and Radaelli 1999, Ayub, Glasheen-Wray, and Kraus 1984, Kaplan and Assael 1991). Figure 8.16 shows posture changes in patients with malocclusions, asymmetries, and forward head posture. These can create kyphosis and lordosis postures with resulting pain syndromes. It stands to reason that whole-body wellness is dependent on a treatment plan that focuses on realignment of this crucial system.
The role of physiotherapy for musculoskeletal disorders in primary care
Maneesh Bhatia, Tim Jennings in An Orthopaedics Guide for Today's GP, 2017
A clear explanation to alleviate patient’s concerns is very helpful as patients are often anxious about ‘tears’ and ‘frozen shoulders’. It is useful to give simple postural advice to limit thoracic flexion and forward head posture. If there are concerns in relation to work position, then advice about ergonomic assessment is appropriate. If pain is an ongoing significant feature, then consideration of a subacromial injection is worthwhile adjunct to physiotherapy.
Effects of adjustments to wheelchair seat to back support angle on head, neck, and shoulder postures in subjects with cerebral palsy
Published in Assistive Technology, 2021
Afnan M. Alkhateeb, Noha S. Daher, Bonnie J. Forrester, Bradford D. Martin, Hatem M. Jaber
Inadequate sitting posture impacts control of head position, which is necessary for orientation, communication, and functional performance in daily life at home or in the community (McNamara & Casey, 2007). One of the most common head alignment issues regarding inappropriate sitting position is forward head posture, which transfers the cervical spine into a forward orientation. Moreover, forward head posture includes integration of extension in the upper cervical region, flexion of the lower cervical region, and protraction of the shoulders (Nam, Son, Kwon, & Lee, 2013). In order for those with CP to orient their eyes to the horizontal level and improve their visual field, their head should be close to a neutral alignment (Fitzsimmons, 2014). There are many physical complications related to forward head posture which negatively impact appropriate posture, such as upper cervical extension (C1-C4), lower cervical flexion (C5-T1), increased upper thoracic kyphosis, scapular protraction with elevation and downward rotation, humerus internal rotation, and first and second rib elevation (Donald et al., 1999). Correcting the position of the head can improve breathing, swallowing, heart rate, communication, learning, visual field, comfort, and can also reduce the effect of abnormal reflexes and tone (Fitzsimmons, 2014).
Impact of rest-break interventions on the neck and shoulder posture of symptomatic VDU operators during prolonged computer work
Published in International Journal of Occupational Safety and Ergonomics, 2018
Montakarn Chaikumarn, Nuttika Nakphet, Prawit Janwantanakul
In the present study, there were no significant differences of group effect on the CV angle. However, the stretching and dynamic contraction groups revealed an increase in the CV angle after the typing task for 60 min compared with that of the reference group. In contrast, Szeto et al. [15] reported that symptomatic office workers demonstrated an approximate 10% increase in forward head posture when working with a computer. This result showed that stretching and dynamic contraction activities during rest-break interventions are assumed to have a positive influence on the CV angle among the symptomatic VDU operators during prolonged computer typing tasks. It was suggested that this was because the larger the CV angle, the better the posture of head/neck alignment in the sagittal plane of young females [42].
Forward flexed posture: reliability and determinants of tragus-to-wall measurement
Published in Physiotherapy Theory and Practice, 2022
Frank T. Tudini, Bradley J. Myers, Richard W. Bohannon
We are the first, to our knowledge, to compare isometric neck retraction strength to TTW distance. Our initial hypothesis was that neck strength may be a determinant for TTW distance. There is evidence that individually, neck strength (Falla, Jull, Hodges, and Vicenzino, 2006; Madsen et al., 2016; Rezasoltani, Ali-Reza, Khosro, and Abbass, 2010) and forward head posture have implications for a variety of patients, including those with neck pain and headaches (Kim, Kim, and Son, 2018). It is also known that both neck strength training and forward head posture impact quality of life (Salo, Häkkinen, Kautiainen, and Ylinen, 2010; Sangtarash, Manshadi, and Sadeghi, 2015). Yet, we found no difference in TTW distance between those with less than 252 N of isometric neck retraction strength compared to those above this median value (p = .368). This may indicate that both of these measures would be appropriate as part of a physical therapy assessment and that neck retraction strength deficits may not be the cause of a forward flexed posture. However, this study was not powered for this analysis (Tudini, Myers, and Bohannon, 2019).
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