Neck and shoulder pain are among the most common complaints reported by new clients. Recent developments in pain science have largely debunked purely structural models as explanations for pain. However, structural analysis is still relevant as a piece of a larger paradigm, particularly when it comes to the neck and shoulders. So while biomechanics may not be everything, in most cases of neck and shoulder complaints, consistent forward head posture greatly contributes to the root cause of the pain. In some of these cases, there is an accompanying uncomfortable “dowager’s hump” at the base of the neck that forms when the vertebrae become compressed. Neurological overstimulation can also result from sustained tension in the suboccipital muscles on the first two cervical vertebrae, causing headaches, anxiety, dizziness and other related symptoms. Additionally, jutting the head forward places incredible tension on the muscles below the jaw, as the body is using the jaw to pull back on, and counter the weight of, the head. This can manifest as neck tension or TMJ. Given that many of our daily activities involve staring straight ahead, it’s not a surprise that our heads tend to gradually lean forward on our necks rather than sitting upright fully supported by the spine.
A simple chin tuck can gradually reverse this development, and it actually feels great to do. I show this exercise to almost all of my clients, and I do it daily myself, particularly when I find myself hunched over the wheel while driving. Tucking the chin elongates the muscles in the back of the neck and can relieve nerve compression by creating more space on the back side of the vertebrae, where the nerves exit. This position can relax the jaw and the front of the neck, too, particularly if you use your finger to support your jaw. The most basic version involves simply backing up your head and rotating it slightly forward so you are tucking your chin into your neck. You will end up with a “double chin” type of effect. You should feel a pleasant stretch at the back of your neck. If you are chronically in forward head posture, you might even feel a rush of sensation up your neck and into your head. If it feels easier, you can use your finger to push your head back. It looks like this:
You can also stand with your back up against a wall, with your feet resting up to 12 inches away from the bottom of the wall. When you tuck your chin, you can aim to rest the back of your head against the wall, slightly moving your head up along it. If you are still having trouble, you can start out doing this exercise while lying down in a supine, or face up, position. You can hold the Chin Tuck for 5-20 seconds and repeat it 5-10 times throughout the day. Pay attention to your shoulders and ribcage while you do this; they should remain neutral. If you find yourself raising your shoulders or flaring your ribcage up, reset your body and try it against the wall or lying down until you can keep those in a more neutral position. I learned an advanced version of the Chin Tuck from one of Erik Dalton‘s newsletters a few months ago and I love the added benefits! So, when you are ready for 2.0, you can add a little myofascial drag to your Chin Tuck. Simply place your hand gently on your sternum, so that your thumb is on the innermost part of the clavicle on one side and your fingers are on the innermost part of the clavicle on the opposite side. Place your other hand on top of that hand, and as you tuck your chin, you drag the skin slightly downward. This creates even more of a stretch in the anterior neck muscles. The steps look like this:
The final step is to hold the myofascial drag, turn your head to the left, tuck your chin, and then repeat on the other side. If you want to follow along to a visual, I made this incredibly dorky video since I couldn’t find any on the internet: Chin Tuck Video
After a few months of doing this exercise, most clients report a decrease in neck and shoulder tension. Honestly, I attribute this at least partially to better body awareness, as doing this exercise makes it evident how far forward we are normally carrying our heads. It also makes us pay attention to how uncomfortable the forward head position is and how much better the head feels on top of the spine instead of in front of it.