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Forward head posture can be attributed to a number of factors, is generally a chronic condition, and is becoming increasingly prevalent in society. Typically, it results from a combination of tight or overactive upper traps and pectoralis muscles and inhibited or weak neck flexors, rhomboids, and serratus anterior muscles.

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In terms of stretching, we would want to target the pectoral muscles, intrinsic cervical extensors, and the upper traps. One method of stretching those tight and nasty trapezius fibers, is to:

Lean your head forward and to the left while using the ipsilateral arm to gently pull down; as seen in the image.

Perform 5 repetitions, alternating between right and left sides while holding for 20-30 seconds.

To gain a maximal stretch in the muscle, allow yourself to fully exhale into the stretch while continuing to keep strong intra-abdominal pressure.

If, at any time, you feel neck pain or pain referral elsewhere, stop the stretches. These stretches should be performed prior to the strengthening exercises daily.

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With this condition, we would want to strengthen the neck flexors, rhomboids, and serratus anterior. Targeting the neck flexors, and important strengthening exercise would be repetitive chin retractions.

Placing one hand at the back of your head and gazing straight ahead, tuck your chin to your throat while keeping your head pulled towards the ceiling to lengthen the spine.

If this is difficult to execute, you may place one finger on your chin to help push it back until you are able to coordinate the movement.

Perform deep diaphragmatic breathing as these reps are performed, maintaining strong intra-abdominal pressure.

Try to avoid allowing your head to fall back into extension, avoid rolling your shoulders up towards your ears, and stop as soon as form begins to degrade or movements become painful.

Perform 10 repetitions 8x daily.

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Acute/non-traumatic Torticollis also known as "Wry Neck" develops overnight and results in painful, palpable neck spasms the following morning. Most commonly, it is unprovoked, but exposure to cold, or after sleeping in an awkward position may cause acute torticollis. Symptoms include sudden onset of neck pain and stiffness, as well as difficulty turning the head in one direction.

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Hello my name is Gio and I chose blue tiles as my background color. I enjoy playing chess, puzzles, and hiking with my spare time.

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Ryan / Purple/ Fitness and golf

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Black - Golf and Fitness

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My name is Shawn, I chose to post with green tiles for this project. In my spare time I enjoy golfing, running, and being outside which has been great living in Portland when the sun comes out.

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My name is Stefan, I chose to post with orange tiles for this project. In my spare time, I enjoy taking part in outdoor activities and working out.

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Aka "Washboard Syndrome"/ "Scapulothoracic Bursitis"

Snapping scapula syndrome is defined as an audible or palpable clicking, grinding or crepitus noise of the scapula during movements which involve the scapulothoracic joint. It is often accompanied by a history of pain, discomfort, and weakness with overhead movements, possibly stemming from sport activities or overuse.

Symptoms of Snapping scapula syndrome may be insidious or due to a result of trauma or excessive grinding of the scapula and the thorax lying beneath. Pain is typically not reproducible with isometric movements, and the clicking/popping as well as pain tends to decrease when crossing the arm across the chest, allowing the scapula to lift from the rib cage,

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Improving cervical spine alignment and deep neck flexor engagement to reduce strain on the neck, paravertebral muscles, and other upper back muscles. Without proper cervical spine alignment and activation of the deep neck flexors, the upper trapezius, levator scapulae, and surrounding musculature are likely to remain overloaded, leading to continued discomfort and dysfunction.

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In Forward Head Posture (FHP), the sternocleidomastoid (SCM) and suboccipital muscles tend to become overactive and tight, while the deep neck flexors, such as longus coli and longus capitis, are often weak or underused. This imbalance pulls the head forward, increasing the load on the cervical spine and upper back muscles. Over time this can lead to muscle tension, headaches, reduced range of motion, and even joint degeneration or disc compression. FHP can also affect proper breathing mechanics by restricting proper function of the diaphragm, which encourages shallow chest breathing. By stretching the SCM and suboccipital muscles and strengthening the deep neck flexors, the head and neck can return to a more neutral position. This reduces strain, improves posture, and restores better neck function before focusing on more specific problem areas.

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In order to stretch the pec minor and major you can perform a variety of doorway or wall-assisted stretches, one example is pictured above.

Place your arms outstretched behind you, allowing your chest to open up.

Keep your shoulders back and down.

Lean forward with your whole body as a unit.

Drop your pelvis down to increase the stretch in your chest.

Repeat 5x twice daily.

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To strengthen scapular stabilizers like the rhomboids, perform IYT's (aka WYTs) either lying prone or on a bench.

Lie face down with arms extended in front and legs straight, palms down.

I Position: Lift arms straight in front, palms down, and lift chest slightly off the floor. Hold for 3–5 seconds.

Y Position: Move arms to a 45-degree angle (forming a "Y") and lift chest and arms. Hold for 3–5 seconds.

T Position: Move arms out to the sides (forming a "T") and lift chest and arms. Hold for 3–5 seconds.

Perform 5–10 repetitions of the I-Y-T sequence.

Keep core tight to protect your lower back.

Move slowly and focus on activating the upper back muscles.

Doing this exercise with no weight, bands, or dumbbells is a great way to progress the exercise to strengthen the mid-lower back.

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The third stretch I would recommend is to stretch the rest of the cervical extensor muscles like levator scapulae, semispinalis cervicus, and spinalis cervicus. To stretch these muscles we can perform a towel-assisted stretch. Wrap the towel around the base of your skull

Wrap the towel around the base of your skull

Look upwards towards the ceiling.

Apply slight overpressure with the towel to pull your head into a stretch.

Hold for 5-8 seconds while breathing deeply and controlled. Repeat

If this is uncomfortable, you can also lie prone and hang your head off a bed in a controlled, slow manner to also execute a stretch of the intrinsic cervical extensors.

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Upper fibers Trapezius stretch: (assuming left torticollis)

Sit or stand with your back straight.

Drop your right ear toward your right shoulder, keeping your shoulders relaxed and down.

Use your right hand to guide your head closer to your shoulder gently. Avoid pulling forcefully.

Hold this stretch for 20-30 seconds while taking deep breaths, calming the body, and then slowly release.

Perform this 2-3 times daily, beginning in the morning for a week. If it increases the symptoms, back off or stop completely.

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SCM stretch (assuming left torticollis)

1. Sit upright in a chair with your shoulders relaxed.

2. Tilt your head to the right as much as possible, without pain.

3. Rotate your head to the left and tilt it backward slightly, as if you are looking at the ceiling over your left shoulder.

4. Use your right hand to stabilize your left collarbone by gently pressing down.

5. Ensure you are taking deep belly breaths as you are holding this stretch as you try to relax these muscles.

6. Hold this stretch for 20-30 seconds

Perform this 2-3 times daily, beginning in the morning for a week. If it increases the symptoms, back off or stop completely.

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The therapeutic goal for acute torticollis is to reduce pain and muscle spasms, restore neck mobility, and help the person return to their normal activities as quickly and comfortably as possible. This involves relaxing the overactive muscles, like the trapezius and SCM, and improving blood flow to ease tension and promote healing. It’s all about helping the neck move more freely and reducing that "stuck" or stiff feeling so the person can feel like themselves again

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Stretching these muscles helps elongate tight fibers and fascia, relieving tension and reducing stiffness. This activates Golgi tendon organs, calming overactive muscles like the trapezius and SCM through autogenic inhibition. Stretching also boosts blood flow, delivering nutrients and clearing waste, which helps reduce inflammation and pain.

Adding strengthening exercises is just as important. Strengthening builds muscle control, endurance, and balance, preventing spasms and improving stability in the neck. It retrains weak or inhibited muscles to work properly, supporting better posture and reducing strain on cervical joints.

For torticollis, combining stretching and strengthening:

Relaxes tight muscles while strengthening weak ones to restore balance.

Improves neck mobility for more natural, pain-free movement.

Supports posture and stability, reducing strain and preventing future issues.

Together, these strategies ease symptoms and promote long-term recovery.

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Another exercise that can be performed to provide strength and joint stability are wall angels.

Stand with your back against a wall.

Place your feet shoulder-width apart, about 1.5–2 feet from the wall.

Bend your knees slightly, keeping your knees behind your toes.

Lean your mid-back on the wall, flattening your lower back.

Tuck your chin in slightly and place the back of your head against the wall.

Move your shoulders away from your ears and down.

Place the backs of your hands and elbows against the wall, with your palms facing out.

Slowly raise your arms up the wall in a "W" pattern, keeping your body in contact with the wall.

Slowly lower your arms back to the starting position.

Repeat 8x three times daily.

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Strengthen Contralateral SCM (assuming left torticollis)

Sit upright with good posture, turn your head to the left as close as possible to 45 degrees, and gently press your fingertips against your forehead.

Push your head forward against your fingertips, engaging the front of your neck, while your hands resist the motion. Avoid tilting or straining your head.

Hold the contraction for 5-8 seconds, then release.

Perform 2-3 sets of 8-10 repetitions on each side, ensuring smooth and controlled effort.

Perform this 1-2 times daily, if it increases your symptoms, back off in intensity or stop completely.

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For Snapping Scapula Syndrome, the goal is to improve how the shoulder blade moves and to fix posture issues that might be contributing to the problem. When the scapula isn’t aligned properly or moving as it should, it can rub against the ribcage, causing pain and irritation. To address this, the focus is on improving posture, restoring mobility in the thoracic spine, costotransverse joints, shoulder-joint, and easing pain through therapeutic techniques like manual therapy and specific exercises. Strengthening the rotator cuff and stabilizing muscles, like the lower trapezius and serratus anterior, is also key to restoring balance, improving control of the scapula, and reducing the chances of the issue coming back.

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In Snapping Scapula Syndrome, muscle imbalances can affect how the shoulder blade moves and sits on the ribcage. Tight muscles like the levator scapulae and weak muscles like the lower trapezius and serratus anterior can cause the scapula to rub against the ribcage, leading to pain, inflammation, and the "snapping" sound. If the scapula doesn’t move smoothly, it can irritate the surrounding tissues and worsen symptoms. Stretching tight muscles, such as the levator scapulae and upper trapezius, and strengthening the serratus anterior and lower trapezius can help improve scapular alignment and motion. This reduces friction and restores stability, addressing the root cause of the problem.

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Strengthening Exercise: The following exercise will assist with engaging the proper muscles to allow the scapula to be placed in the correct position

Elbow Flares

1) Stand up nice and tall

2) Position Scapula in proper position by performing posterior tilt, retraction, and elevation movements

3) Place both hands on side of head with elbows facing forward, like shown in the picture.

4) Maintaining abdominal bracing and good standing posture, bring elbows back. Not allowing shoulders to tip forward.

5) Maintain contraction between shoulders blades and hold for 5 seconds.

6) Perform this exercise 10-20 times daily

This will allow the use of proper muscles during the exercise and improve strength

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Stretching Exercise: The following exercise will help address specific muscles to stretch them to allow shoulder blade to pull closer to the rib cage

Chest Stretch

1) Find a comfortable area up against a wall or door frame.

2) Place forearm on door frame

3) With a split leg stance, lunge forward while maintaining forearm contact on door frame.

4) Focus on not arching lower back and keeping lower rib cage down by maintaining normal breathing using abdominal bracing technique

5) Stretch should focus on chest area

6) Hold stretch for 20-30 seconds 2-3 times daily

Perform the exercise to allow shoulder blade more movement and decrease pull on area.

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Stretching Exercise: The following exercise will assist with specific muscles to stretch them to allow better shoulder blade movement.

1) Find a comfortable chair to sit

2) Slouch upper back as much as possible while focusing on bending back at the level of lower shoulder blade

3) Shrug shoulders up

4) Take a deep breath while maintaining slight abdominal bracing

5) Attempt to feel stretch in lower shoulder blade area

6) Hold for 20-30 second 2-3 times daily or as needed

This exercise will decrease pull on shoulder blade and increase mobility

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Stretch - Levator Scapulae

Stretching the levator scapulae muscle allows for improvements in scapular mobility and reducing muscle tightness/hypertonicity that may be affecting the normal kinetics of the scapula leading to dysfunctional movement patterns. To avoid these effects, a levator scapulae stretch may prove beneficial

To perform

1. Get into position - start by standing or sitting with a straight spine, finding a neutral pelvis

2. Head tilt - identify the target side before gently tilting your head toward the opposite side, as if moving your ear closer to your shoulder

3. Rotate your head - turn your head further to the opposite side, looking over your shoulder in order to better isolate the muscle

4. Nose to armpit - slowly bring your nose toward your armpit on the same side. You should be able to feel a stretch along your neck and upper shoulder

5. Hold and breath - maintain this position for 20-30 seconds, focusing on breathing deeply through the belly to help muscles relax

6. Repeat on the other side - be sure to switch and repeat on the other side

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Prone/Bench I/Y/T Exercises

Strengthening scapular stabilizers such as the rhomboids and middle trapezius may be beneficial due to their key role in scapular stability and controlled movement

In order to perform IYT's (aka WYTs) either lying prone or on a bench;

Lie face down with arms extended in front and legs straight, palms down.

I Position: Lift arms straight in front, palms down, and lift chest slightly off the floor. Hold for 3–5 seconds.

Y Position: Move arms to a 45-degree angle (forming a "Y") and lift chest and arms. Hold for 3–5 seconds.

T Position: Move arms out to the sides (forming a "T") and lift chest and arms. Hold for 3–5 seconds.

Perform 5–10 repetitions of the I-Y-T sequence.

Keep core tight to protect your lower back.

Move slowly and focus on activating the upper back muscles.

This exercise can also be progressed to using resistance bands or weights to allow progressive overload for further strengthening

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Quadruped Scapula/Serratus Anterior Push Ups

By activating and strengthening the serratus anterior, another key muscle for scapular stability and movement control, can also be beneficial for addressing poor scapular kinetics and may assist in reducing friction between the scapula and ribcage.

To Perform

1. Start by going on your hands and knees in a tabletop position, ensuring your hands are directly under your shoulders and knees underneath your hips. Find a neutral pelvis with a flat back and keep core engaged

2. Lockout elbows and without bending them, push your chest away from the floor. You should feel you shoulder blades move apart

3. Hold this position at the top before slowly allowing your chest to lower back down, bringing your shoulder blades back together.

4. Repeat this movement 10-15 times for 2-3 sets ensuring slow movements to activate the right muscles and maintain belly breathing

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Treatment stretch for infants with acute/non-traumatic torticollis (assuming left Torticollis)

1) Hold child facing away from you in side lying position

2) Have left ear resting against your left forearm

3) Place forearm between child’s ear and left shoulder to help stretch tight muscles

4) Place right arm between child’s legs to support body

5) Grasp left shoulder with right hand

6) Use forearm as lever to left child’s head away from shoulder, allowing for side bending stretch

Perform this stretch on infant 4-5 times daily or for 30 seconds to help relieve tight muscles.

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Strengthen - Deep Neck Flexors (Chin Tucks)

Chin tucks strengthen the deep neck flexors (longus colli and longus capitis), which help improve cervical stability and posture. In acute non-traumatic torticollis, these muscles can reduce compensatory overuse of the superficial neck muscles (like SCM and upper trapezius)

Performing -

Lay on your back on a stable surface, prop the back of your head up on a towel

Perform a chin tuck as if making a double chin and maintain chin tuck as you lift head 1 inch.

Hold the chin tuck for 5 seconds, keeping the chin tucked as you lower head back down and then release chin tuck

Focus on the deep neck flexors and try to keep superficial muscles as relaxed as possible

Repeat this for 3 sets of 10-12 repetitions, 3x a day as tolerable

Progress to performing from a flat surface once tolerable

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Strengthening Exercise: Seated Lateral Head Tilts (For Gentle Muscle Activation)

1. Sit upright with a neutral spine, shoulders relaxed.

2. Slowly tilt your ear toward your shoulder on the less restricted side first, moving within a comfortable range. Hold for 2–3 seconds, then return to neutral.

3. Repeat on the more restricted side, only going to mild resistance without forcing the motion. Keep your shoulders level and avoid shrugging. Breathe deeply and keep your jaw relaxed.

4. Repeat 8–10 times per side. Stop if pain increases or if movement becomes strained.

This exercise helps improve neck mobility, reduce muscle tightness, and gently activate stabilizing muscles, providing relief of discomfort from acute non-traumatic torticollis.