Forward Head Posture: Examination from Biomechanical, Postural, and Therapeutic Perspectives – Current Literature and Rehabilitation Methods

Forward Head Posture (FHP) is a postural disorder in which the head shifts forward, making it one of the most common postural abnormalities affecting the cervical-thoracic-shoulder region. This displacement is accompanied by an increase in extension and lordosis in the C0-C2 segments, whereas the C2-C7 segments experience increased flexion and reduced lordosis. The surrounding muscles adapt to these postural changes by either lengthening or shortening. Considering that the spine functions as a connected kinetic chain, any deviation from the neutral spinal alignment leads to compensatory changes in other spinal curves. In this context, FHP is closely associated with postural abnormalities such as thoracic kyphosis, rounded shoulders, and scapular dyskinesis. A detailed assessment of an individual's posture, pain sources, and muscle imbalances is essential in planning the treatment of FHP. Physiotherapy methods such as stretching, strengthening, stabilization, corrective exercises, muscle energy techniques and manual therapy are used in treatment. Studies indicate that multimodal treatment approaches are more effective. While the effectiveness of exercise programs varies, the most commonly used approaches focus on strengthening weakened muscles and stretching shortened muscles to restore muscle balance. Strengthening deep neck flexors and scapular muscles plays a crucial role in correcting FHP. Reducing the activation of the sternocleidomastoid (SCM) muscle enhances the activation of deep neck flexors, contributing to postural correction. Although various treatment approaches are effective, a multimodal approach provides the most comprehensive results.