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Head protraction | Izaak Lavarenne, Masso-Kiné 


Izaak Lavarenne


There are many posture defects, which can sometimes make it difficult for someone who wants to educate themselves on the subject without being overwhelmed by its complexity. Well, today I suggest that we continue our investigation into neck pain by focusing on one of the most common posture defects at the beginning of the twenty-first century: head protraction.


Definition of the posture involved
Protraction is a postural defect concentrated at the cervical level. In layman's terms, it is an advancement of the head in relation to the rest of the body (think of a bird like a vulture).

More specifically, it is a postural feature when the earlobe rests in front of the acromion, which is a bony landmark above the shoulder, when viewed from the side. Unfortunately, this is a bit more complicated to adjust than simply acting on the cervical, as the posture of the upper spine is largely dependent on the posture of the lower segments. For example, it will be very difficult to keep the earlobes above the shoulders if the thorax is slumped forward in hypercyphosis.

Even more unfortunate is the fact that this influence actually represents a vicious cycle. The more the trunk is bent forward, the more the head will tend to protract, the more weight the back has to bear forward, the more it will bend, and so on. This is why a good treatment for head protraction will include at least some work on the thorax and lumbar.

Upper Cervical Effect
As discussed in the last installment of this series of articles, the upper cervical or suboccipital region acts as a postural buffer. Regardless of how the body is positioned below, the upper cervical levels have the task of keeping the eyes and head level for proper interaction with the world around.

In the case of head protraction, there is a significant extension of the upper cervical spine. This can cause intense and persistent muscular tension, headaches and vascular and nerve compression.

The upper cervical region is also very solicited nowadays, with an increasing dependence on visual information that we stare at via countless screens. The suboccipitals are coordinated with the eye muscles and will be even more solicited if we concentrate our gaze, since this action is often accompanied by a slight advancement of the head.

And let's not forget the impact of the temporomandibular joint on posture. Stress and anxiety encourage the development of hyperactivity of the chewing muscles, which can lead to bruxism (teeth grinding) and other problems, especially at night. Unwisely, clenching the teeth is synergistic with head protraction. Do the exercise of moving your head back as far as possible and clenching your teeth, and you will see that it is very difficult to have as much biting force as in the forward position.

Overactive and contracted masseter muscles are therefore a factor in the development of head protraction.

The effect on the front of the neck.
With the neck arched backward in protraction, it is not only the suboccipital that is affected. One of the muscles that gets shortened is the sternocleidomastoid (or SCM for short).

The SCM is the large muscle, sometimes visible in some people, that originates from the sternum and runs diagonally up to the back of the ears. It is by far our strongest muscle in the front of the neck and protraction is the position in which it will be shortened the most. The problem arises when it is shortened for too long, as a muscle in this situation loses its ability to return to normal length easily. In the case of the SCM, this phenomenon can cause neck pain and, more specifically, be a risk factor for developing torticollis.

Another muscle affected is the omohyoid. This muscle, like some others in its family, is involved in involuntary swallowing. During protraction, these muscles are very stretched and have difficulty doing their job properly. Your body is an expert at finding a way to get the mechanical work done, despite the obstacles; in this case, it will contract other nearby muscles to ensure that swallowing is done as well as possible.

These muscles, on the other hand, unlike the omohyoid muscles, have other functions than swallowing and the energy they lose in swallowing will not be available when it comes time to do their primary work. This results in dislocation, tension and pain.


Long-term risks
Perhaps you have a head protraction and it is not a problem on the day you read this article, but like any problematic situation, it can deteriorate and cause more severe damage if left unattended.

One of the conditions that can develop when the vertebrae are misaligned and are forced to work for long periods of time under these conditions is osteoarthritis. In short, compromised alignment of your bones will lead to more friction, which over time degrades the joint surfaces involved, causing a lot of pain and loss of mobility.

Second, cervical disc herniations are also a possible consequence of cervical protraction. While this article has focused primarily on upper cervical extension, it should be remembered that head protraction often includes some flexion of the lower cervical spine. Prolonged and pathological spinal flexion can lead to disc herniations: the disc that lubricates the intervertebral movement becomes displaced, compressed and inflamed. The resulting symptoms range from neck pain to loss of strength in the upper limbs.

The purpose of this last section is not to scare you into consulting, but simply to inform you so that you understand the implications of consulting or not.

Finally, if you are concerned about your new knowledge of head protraction, its postural source, the effect it has on the top or front of your neck, or if you recognize yourself and simply want to prevent more serious complications, I invite you to consult.

A variety of specialized therapists can help you, from ortho-kinesiologists to osteopaths, physiotherapists and acupuncturists. Each approach has its merits and allows you to consider the problem from different angles.