Does your neck hurt regularly? You are not alone. At any given time, approximately 10% of the adult population are suffering.

It is no wonder. Many of us unintentionally hold ourselves in such a way that pain is inevitable. Many of us are overcurving at one or multiple points along our spine meaning we are constantly overworking some of the musculature that controls our spine and underworking the rest. Note here that consciously trying to stand differently or contract the underactive muscles will do very little to help you and could make things worse as at that time, the connection between your brain and those muscles is not working optimally so you will not be doing what you intend to do with them. It is also often the case that the muscles of the spine may not be the only part of the jigsaw that need addressing.

Many of us exhibit what I'll refer to as a 'head forward posture'. We have all seen older people who require zimmer frames because they are so hunched forward with their head jutting far out. This is an extreme depiction of the head forward. If looking at somebody from their side, imagine drawing a vertical line down from their ear. In ideal posture, this line will pass through the centre of the ear and then through the centre of the shoulder joint. Many of us aren't ideal in this respect – our heads are forward of our shoulders.

Maybe you are reading this, don't suffer any neck pain and notice that your head is forward of your shoulders. No big deal, right? That depends on your definition of a big deal.

Let me lay out a few facts.

Your head requires constant action from the muscles at the back of your neck to stay upright because of its position on your spine. If those muscles were completely relaxed or severed, your head would nod forward.

The average mass of a human head is around 4.5kg/10 pounds which is around 8% of the entire weight of the body for those with an average frame. The head is pretty heavy.

When the ear and shoulder line up ideally, the muscles of the back of the neck do the minimum possible work to keep the head upright. For every inch the head is forward of the shoulder, the head effectively becomes 4.5kg heavier for the muscles at the back of the neck. So for a conservative, common inch shift forward, the neck muscles have to work at least twice as hard as they ideally would even at rest(I will come back to this later). This shift is so common and so long standing in most of us that we are completely habituated to it and this extra work and tension is the norm. It would feel weird for our head to be in its ideal position!

Picture a cylinder with a rod through its centre that it can spin around. Using this as a very basic model for the head that can rotate around the spine, I calculate (my physics degree has finally came in handy) that in this basic mechanical model where we don't take muscles into account, with the head shifted an inch forward it would take around 40% more energy to rotate the head at a given speed.

In this model, I also calculate that given the same energy used, the head would rotate 15% more slowly with the head shifted an inch forward.

Let us then consider the muscles again. The head is mechanically twice as heavy, meaning the muscles at the back of the neck are having to perform more work. The are habitually shortened. A muscle that is habitually short of long does not operate efficiently. To provide the doubled force required, the muscles will work more than twice as hard. The cylinder spinning on the rod requires 40% more energy to move at a given speed and moves 15% slower for a given force applied. Given the inefficiency of the neck muscles at rest, I believe we can safely assume that a human with their head an inch forward will have to work harder to rotate their head and will do so even more slowly than in the basic mechanical model.

If you don't have neck pain, how is this a problem?

The muscles at the back of the neck are functionally linked with those of the lower back. Dysfunction in one can be linked to dysfunction and pain in the other.

If the muscles in the back of the neck are overworking, the muscles at the front of the neck are often underworking. This relationship often indicates underworking core muscles. Underworking core muscles make everything we do harder than it ideally would be.

The muscles at the back of the neck being constantly stiffened will have reduced  blood flow and this will impact the bloodflow to the head, leading to increased risk of headaches, migraines and cognitive underperformance.

If you are an athlete, many sports require constant turning of the head to scan for environmental information. Turning at least 15% slower (I believe this figure is conservative) can be the difference between you seeing an opening or missing it or the difference between you seeing your opponent come to hit you and not. For the non-athlete, driving with slower head turning is a more dangerous activity.

A forward head causes a complex chain of shifts down to the feet that change the habitual centre of gravity. It isn't just the head turning that becomes more cumbersome. 

Sometimes, an inch is more than just an inch. Whether we feel it or not, an inch can be a real pain in the neck.


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