everything about the cervical spine and the physiotherapy. Anterior head posture deformity.

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2. The joints and all of the structures that move and support them are subjected to degenerative forces arising
from repeated movements, prolonged postures, and simply through the process of aging.
The cervical spine is particularly susceptible to degenerative changes because normal day-to-day activities
require frequent movements of the head and cervical spine.

3. Cervical extension secondary to a forward-head posture, which is often associated with a thoracic kyphosis, is the
most frequently observed alignment impairment of the cervical spine.
A forward-head position is described as excessive extension and forward translation of the cervical vertebrae7,8.
Thoracic kyphosis commonly results in increased extension of the cervical spine contributing to the forward-head
positionl l ,12.
The extended position of the cervical vertebrae increases the compressive loading on tissues in this region,
especially the facet joints.7

4. The focus of our strategy of alleviating symptoms and improving function of the cervical region is to start with
exercises that correct any faults in the alignment of the cervical, thoracic, and scapular regions before focusing
on the correction of faulty cervical movements.
Based on clinical observations, the principal movement impairments in the cervical region involve faulty
patterns of extension and rotation.

5. Maintaining precise movement in the cervical region is a challenge because of
many factors, including the number of intervening segments, their degrees of
freedom, and the influence of the alignment of the thoracic spine and the shoulder
girdle musculature.
Treatment of the cervical region requires attention to all of these key regions.

6. IDEAL ALIGNMENT OF THE CERVICAL REGION
Ideal alignment of the cervical region allows the head to be positioned with minimal muscular effortY Ideal
alignment is an inward lordotic curve with both the upper and lower cervical region in a position of slight
extension
With aging and the inevitable degenerative changes
occurring in the cervical discs,
the lordotic alignment decreases and there is an increase
in forward translation.

7. Distribution of Motion in the Cervical Spine

8. Most common alignment impairment observed in the cervical spine is a forward head posture.
The forward-head posture is characterized by forward translation of the lower cervical region and
hyperextension of the cervical region with typically, an increased kyphotic curvature in the thoracic
region,
Patients with chronic neck pain have a decreased ability to maintain a correct alignment when distracted.

9. The muscular adaptations associated with a forward head position are shortening of the cervical
spine extensors and a lengthening of the intrinsic cervical spine flexors.
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10. The forward-head position also requires increased activity of the extensor muscles of the cervical spine to
counter balance the head against the effects of gravity.
The muscular adaptations that occur with a forward-head position results in an increase of compressive forces
acting on the articular facets.
In addition, changes may also occur in the ligamentum nuchae that may increase demand on the upper
trapezius muscle to stabilize and move the cervical spine

11. A forward-head posture is a common physical finding in patients with chronic tension headache and patients with
unilateral migraine.
Additional alignment faults that we have observed with headache patients include an increase in the degree of upper
cervical extension in comparison to that of the lower cervical spine, suggesting possible muscular adaptations in the
suboccipital region.