As your awareness of your body grows more subtle, you become more mindful of the shape of your spine, and you may notice that your head is not really where you thought it was, namely balancing on top of your spine. An overly rounded upper back combined with a forward head position is not simply an aesthetic issue, and it is no longer something only affecting older people. In fact, these days it is not uncommon to see this postural misalignment—technically called hyperkyphosis/head forward position—in people as young as 25 and younger. Why should you care? Because once hyperkyphosis sets in, it tends to worsen inexorably with age, and leads to a host of health problems, including neck and shoulder pain, migraines, chronic stress, shortness of breath (which in turn increases risk of cardiovascular and lung disease and type 2 diabetes), anxiety and depression, and ultimately, to a greater risk of death (up to a shocking 44% greater in one study, report Terry and Eva Norlyk Smith on yogauonline.com).

How does all this happen?

Your head weighs about 10-12 pounds (4.5-5.5 kg) and if it is balanced on top of your spine, that is how much pressure it exerts. When it is stacked on top of your spine, the cervical vertebrae can easily hold up that weight, and the neck muscles only need to maintain the vertical alignment that allows the neck bones to do the heavy work. But for each inch (2.5 cm) that your head moves forward of its neutral location, an additional 10 pounds of force are exerted on your neck muscles, your spine, and your chest cavity. Basically the farther forward your head, the greater its leverage and thus the greater the force exerted. Since this misalignment occurs gradually, we don’t really notice the additional pressure or the resulting rounding of the back. As the rounding of the back increases, the head tilts farther and farther downward. in order to look straight ahead, we end up tilting the head back on top of the spine because that requires less physical and mental effort than to correct the rounding of the upper back. Tilting the head back in turn leads to chronically tight and painful neck extensors, and a tight neck is one of the most common complaints people have about their body, and contributes to a host of other health problems.

Why haven’t you heard about this?

Until recently hyperkyphosis was assumed to be a side-effect of osteoporosis, which is already recognized as a major health issue. But it now appears that hyperkyphosis is unrelated to osteoporosis in two thirds of cases, and may actually be a greater health risk than osteoporosis.

What can you do about it?

Make sure that your computer screen’s top edge is level with your eyes or slightly higher. This is extremely important if you spend a lot of time in front of the computer. If you have a laptop, that means buying an external keyboard and placing your laptop on a box (or a special laptop stand) on top of your desk to bring the screen high enough. If you spend a lot of time on your smartphone or tablet, reduce those hours, because any device that puts a keyboard on the screen you are looking at is going to wreak havoc on your posture. If you do use smart phones and tablets, make sure that you hold the device relatively high for reading, and the same goes for books and magazines, too. If you do a lot of typing on your tablet or phone, and thus need to place it lower, make sure that you look at the device by looking down past your nose while keeping your spine relatively neutral, rather than rounding your upper back and collapsing your chest. Also make taking frequent breaks a priority, during which you consciously realign your spine towards its natural double S-curve by rolling your shoulder blades down your back and extending upward through the back of the head.

In addition to these adjustments of your computer space and mobile device usage, there are several ways to approach this issue in your yoga practice that we will focus on this week. Building body awareness to help you notice poor posture is an extremely important first step, because if you don’t know there is an issue with your posture than you can’t even begin to change it.

Leading with the chin (in your daily life and in your yoga practice) is one of the main contributing factors to hyperkyphosis, because sticking your chin out tightens the muscles at the base of the skull. Tight neck muscles in turn chronically weaken the muscles of the middle back, through a reflex called reciprocal inhibition. And it is the middle back muscles that you need to activate to reduce the over-rounding of the upper back and the collapsing of the chest.

Any longterm change in posture results in some muscles tightening and shortening because they are working overtime, while the opposing muscles are growing weaker from disuse through reciprocal inhibition. In addition, connective tissue on the side towards which the spine is bending ends up being slack all the time and as a result tightens up, while connective tissue on the other side is gradually getting overstretched.

Moving back towards a more neutral posture thus involves stretching the tissues that have gotten tight, strengthening muscles that have grown weak, and relaxing chronically contracted muscles. Thus reversing hyperkyphosis involves A) lengthening the connective tissue at the front of the thoracic spine and at the front of the rib cage, B) strengthening the musculature of the middle and upper back which progressively weakens with hyperkyphosis, and C) relaxing the back of the neck. The lengthening of the front of the chest can be accomplished through passive backbends of the upper spine, while the strengthening of the upper back muscles is best achieved through emphasizing the arching of the upper back in gentle active backbends like Sphinx and Locust pose. Lastly, the relaxation of the back of the neck is an act of undoing that you can practice in every yoga pose, once you learn how in the next few paragraphs.

Try it now:

There is an easy way to check whether you have hyperkyphosis. Stand a few centimeters in front of a smooth wall, close your eyes, and assume your typical posture. Then shuffle your feet backwards until your buttocks and your upper back just touch the wall. Is the back of your head touching the wall as well? If so, you are among a tiny percentage of people with relatively neutral posture. If not, you have hyperkyphosis/head forward position, though head shape causes enough variation that some researchers argue that a centimeter of space between wall and back of the head can be considered neutral in some people. The greater the distance between the back of the head and the wall, the more advanced the hyperkyphosis. Try moving your head towards the wall, and you will notice that you end up tilting your head back on top of the spine to move it to the wall. In case the resulting increased neck tension doesn’t make it obvious, this is not the solution to the problem!

However, tilting the head farther back may help you find the solution by fatiguing the muscles you need to learn to relax, and thus facilitating that relaxation. Tilt your head so far back on top of the spine that your shoulder blades are being pushed away from the wall (while keeping your buttocks at the wall). Observe for a breath or two how unpleasant this increased neck tension feels. Then on an inhale slowly and deliciously slide your head up the wall (maintaining contact between head and wall throughout) while simultaneously rolling your shoulder blades down the back.

If you can feel muscles contracting in the front of the throat, then you are using the wrong muscles and the action will not actually relax the back of the neck. The action should feel effortless, because the muscles you are contracting (called the deep neck flexors) to lengthen the back of the neck are so deep inside your neck that they lack the sensors that tell you that they are contracting. In other words, you can feel the relaxation of the muscles in the back of the neck, but not the contraction of the muscles that are responsible for that relaxation via reciprocal inhibition. The muscles that take the shoulder blades down the back, by the way, also reciprocally inhibit the neck extensors, so the shoulder blade action also contributes to the relaxation of the neck. At the same time, the contraction of the middle back muscles and of the deep neck flexors rearrange the upper spine towards a vertically aligned, gentle S-curve, so that the neck extensors don’t have to grip any more because the head is once again balanced on top of the spine.

Sliding the head up the wall is a very challenging exercise for many because it requires you to engage muscles that you didn’t even know you had, but it is incredibly worthwhile. If you find the action of sliding your head up the wall very challenging, hyperextend your neck more strongly before you begin sliding the head up the wall and hold this strong contraction for a few breaths in order to fatigue the muscles you are trying to relax in the next step. (However, if such a strong contraction of the neck feels very uncomfortable or even painful, then ease off immediately.) Sliding the head up the wall should feel positively marvelous. If it doesn’t, you are using the wrong muscles. Don’t concentrate on the muscles you need to contract, because some of them you can’t feel anyway. Instead focus on the desired results, relaxing the back of the neck by increasing the distance between the back of the head and the shoulder blades.

Once this movement becomes second nature, you will want to incorporate it in any yoga pose in which you feel excessive neck tension, or on which you find yourself leading with your chin, two phenomena which are really two sides of the same coin. Such poses will probably includes backbends, forward bends and folds, and spinal twists, and any pose that feels physically very challenging, like arm balances. Physically challenging poses encourages neck tension because such tension triggers the stress response, and the one positive effect of being in stress mode is that you get physically stronger. However, stressing yourself out just to come into Crow pose is the wrong compromise, as you then merely use your yoga practice to reinforce the poor habits that you are already practicing all day long.

PS: For more information on neck tension and why it matters, see my neck tension video on youtube.