Do YOU have Turtle Neck?

The Consequences Can Be Serious

A man with turtle neck wearing a turtleneck sweater.

The Epidemic of Turtle Neck

Turtle neck is otherwise known as head forward posture. It has become an epidemic primarily born of electronic device use such as phones, computers, tablets, and televisions. Turtle neck is happening to younger and younger people. An interesting study in the International Journal of Advanced Research titled Effects of Forward Head Posture on Balance in Young Adults (Jain et al., 2019) studied college age students. The students were divided into two groups. One group had forward head posture and the other did not. Then the students had their balance tested. It’s not hard to guess which group had normal balance and which did not. Clearly the students with head forward posture demonstrated poor balance compared to those without. But why?

selective focus photography of turtle on bench
Photo by Arun Thomas on Pexels.com

Fascia’s Role in Turtle Neck

Let’s first address another question. We know head forward posture primarily develops as a result of the frequent us of electronic devices but why does the head stay forward even when we are not using devices? The answer is fascia. Our fascia is the amazing connective tissue that provides the support we need to stay upright against gravity. It is stretchy where we need it and strong where we need it. It is also incredibly adaptive and will remold itself to exactly how we need it to be to support our chosen postures. When we spend lots of time in work, leisure and sleep with our head thrust forward, our fascia is interpreting that this position is important and needs to be structurally supported. Although we are designed with the ability to pull our head forward, this position is not a “normal” or ideal position for the head for long periods of time so the fascia must lay down lots of extra layers of fascia on the upper back and neck to provide this support. When this process goes on long enough turtle neck becomes the new normal and it can be difficult to pull the head and neck into the position it is designed to be in, which is stacked on the spine. One of the consequences is that the person is now stuck in this position and there is a continued process of thickening fascia to support it. But, there are far more consequences beyond poor posture.

Consequences of Thickening Fascia and Turtle Neck

Falls

As the study discusses, balance is a consequence of being stuck in forward head posture. As a young adult this may not seem like a huge problem but as we age, the loss of balance resulting in a fall can be deadly. The Center for Disease Control (CDC) predicts by the year 2030 the U. S. will see seven deaths per hour because of falls. SEVEN DEATHS PER HOUR! In the year 2030 I will be 63 years old. I do NOT want to be part of that statistic and I bet you do not either. How can head forward posture cause a fall?

According to the study referenced above there are many reasons turtle neck can cause a fall. Here are three very important reasons:

  • The position changes the center of gravity.
  • The ability to detect our position in space changes due to the muscles, fascia and sensory structures within them are “stuck”.  
  • Reaction times are slowed.

It is interesting to note that students with head forward posture also had tight ankles, knees and hip joints compared to the students that did not. It was hypothesized that this was a result of the forward head causing a change in the center of gravity and the rest of the body having to compensate for this change. The tension throughout the body resulted in the poor reaction time.

When I teach balanced walking on a beam in natural movement classes, I teach the participants to soften their bodies when on the beam. This enables their bodies to respond more quickly when they need to shift to maintain balance. If they are holding their bodies tight, they are less likely to be able to move quickly and regain their balance to prevent falling off the beam.

Pain

Forward head posture also results in pain which can include neck, upper back, and shoulder pain. Headaches are also a common complaint from people stuck in this posture. When the tissues of the upper back are in a stuck or locked long position the fascia cannot glide and muscles cannot move as easily resulting in pressure on nerves, poor blood flow and a lack of cellular waste being able to leave the area. This can result in painful myofascial trigger points in the area. Tension headaches are another common result.

Cardiovascular Changes, Swallowing Difficulties, Airway Changes and TMJ

The head forward position not only changes the position of the musculature and fascia, but it also changes the position of all the other structures in this area. When the circulatory structures that are designed to be in one position are now in a completely different position the force of the blood running through these structures hits walls with forces they are not designed to handle. This can cause thickening of the walls of these structures which can cause a variety of problems (Bowman, 2016). In addition, the esophagus changes from the angle it is designed to be in which may result in swallowing difficulties, especially in older adults. The airway can become compressed especially when in supine (laying on the back) making breathing more difficult when sleeping, and the changes in the position of the jaw can results in osteoarthritis of the temporomandibular joint (TMJ) resulting in pain and difficulty chewing (Kang, 2020).

Reversing Turtle Neck

Reversing forward head posture can be challenging and will take time. The good news is that it is possible. The fascia literally needs to be rebuilt just as it was built into the head forward posture. The process requires focused mental and physical effort to continually break the habit of holding the head forward. Fascia takes time to remold itself. In addition to working on our own, a myofascial therapist can help break the existing collagen bonds of the fascia can help to reverse the problem.

A simple exercise is to try is to stand with your back against a wall. Keep your ribs touching the wall. If your lower ribs want to jut forward at the bottom, hold your hand over your lower ribs, then try to bring your chin down and your head back. The position of the head should be such that if you were wearing glasses, the arm of the glasses that goes from the eyes to the ears is level with the ground. If you can touch the lower part of your skull to the wall easily, that is great! If not, you have some work to do.

I’m excited to report I will have an online posture course coming very soon! The course helps you understand what good posture really is throughout the entire body and how to correct it through changing your mindset and how you move. Watch for the course in October 2022.

References

Bowman, K. (2016). Alignment matters: The first five years of Katy says. Propriometrics Press.

Jain, D., Prabhu, S., & Desai, M. (2019). Effects of forward head posture on postural balance in young adults. International Journal of Advanced Research, 7(6), 136–146. https://doi.org/10.21474/ijar01/9204

Kang, J.-H. (2020). Associations among temporomandibular joint osteoarthritis, airway dimensions, and head and neck posture. Journal of Oral and Maxillofacial Surgery, 78(12). https://doi.org/10.1016/j.joms.2020.08.006

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