Jul 30 2011
Neutral Neck Posture (?)
There is no such thing as neutral posture for the neck. There, I said it. After years of joining ergonomists, physical therapists and others in describing neutral neck posture, I’ve decided it doesn’t really exist. If we look at the concepts of neutral posture perhaps you’ll see why I’ve come to believe this.
One of things we most often hear about neutral posture is that the parts of the body are balanced over one another – ears over shoulders over hips over knees over ankles. Gravity pulls down on us, and we withstand it by “stacking our joints” one over another. This makes perfect sense and works well for most of the joints. But the center of gravity for the head, it’s “balance point,” is a little bit in front of the center of the skull. This means that we would have to tip our heads slightly back, looking up instead of straight ahead.
If you try holding your head in this position for any amount of time, you’ll find that it becomes very uncomfortable for your sub-occipital muscles. This is because tipping your head back breaks one of the other rules of neutral posture – muscles should be at their “resting length.” For most muscles, this is the mid-range of motion for the joint or joints that they cross. Shorten or lengthen a muscle too much, and you place it under tension and potentially reduce blood flow to it.
Another rule of neutral posture is to position a joint so that the larger muscles bear any of the load that the joints aren’t carrying. In the case of the human head, you’re talking about a 10 to 12 pound object on top of a very mobile portion of the spine. That’s a lot of weight for any one group of neck muscles to hold up.
Certainly there are postures that are worse for our neck than others. In addition to tipping your head back, tipping it forward more than 45 degrees for long periods of time can result in neck injury. So can holding it twisted to the side or tipped to one side, a position that some people get into when cradling the phone between their ear and shoulder. Forward head posture, where the head translates forward
The problem is that keeping your head in a “good posture” – head level or tipped slightly downward, looking straight ahead, ears over shoulders – doesn’t necessarily prevent neck strain if you hold it long enough without moving. Just think about any of your clients who spend a lot of time working at the computer. They probably spend a good portion of the day looking at the monitor, and where the eyes go, so goes the head. How many of those clients have tight muscles in their necks, likely due to holding their head in position for long periods of time.
There’s a saying in ergonomics: “The best posture is the next posture.” Of all the parts of the body, I think this applies most to the head and neck. The best advice I can give is to avoid any of the “bad postures” and keep shifting your gaze to keep your head and neck moving. Look at your client to assess the area you’re going to work on, but don’t look down continuously as you work. Trust your hands to “see” what’s going on with their tissues and give your eyes, and neck, a break.
