Posture and headaches… Does poor posture contribute to headaches? How do I improve my posture?

Posture and headaches are often discussed in the same sentence when it comes to improving headache symptoms. I have been treating patients with headaches since 1998, but it wasn't until 2004–05 that I saw headache patients all day. I had just moved to Austin, Texas, and was in the process of opening CORE Therapy & Pilates.

I started working for a headache and pain specialist just down the street while I was building my clinic from scratch. So, I told the doctor that I would move on as soon as my clinic was busy. He agreed, and I saw 16 headache patients a day for him twice per week for 8–9 months.

I worked with occipital neuralgia, migraines, tension headaches, cluster headaches, neck pain, fibromyalgia, and herniated disks in the neck. Headaches are a common diagnosis we treat at CORE Therapy & Pilates in Westlake Hills, Texas. One of the most frequent questions I get is about posture and headaches and how they are related. 

Poor slouched posture is much more common today for all ages due to our unquenchable thirst for technology and having our phone in our hand. Improving your poor posture is one of the most important things you can do to help your headaches.

No amount of medicine, injections, or procedures is going to improve your posture! 

You have to learn what to do to strengthen your posture, do it, and keep putting in repetition in order to make new motor memories.

These are the top six questions we get about posture and headaches.

1. How does poor posture contribute to headaches?

The most common posture that I see that causes headaches is called a "forward head posture." Forward head is a description of the position of the head in relationship to the spine. Imagine the head is a 15-pound bowling ball, and it sits on top of a wooden dowel.

Now imagine that bowling ball sitting 3 inches forward instead of being centered on the dowel. That becomes an immediate problem for the bowling ball and dowel. The same goes for the head and spine.

For every inch the head is displaced forward, there is approximately 10 pounds of force transmitted to the spine at the base of the neck, where the cervical and thoracic spines come together. When the head is sitting forward, it ends up causing imbalances in the muscles of the neck.

The occipital nerve is a cranial nerve that exits below the skull and just above the first cervical vertebra on both sides of the back of the neck. The compression of this nerve due to the forward head causes irritation of the nerve, resulting in a headache known as occipital neuralgia.

Once this nerve is compressed and irritated, the pain can be at the back of the upper neck, behind the eye, or anywhere in between those two spots.

2. What self-test can someone do to tell if their headaches are from poor posture?

If performing a chin tuck relieves your headache, then it is a pretty good indication that forward head posture is causing your symptoms.

1. Sit up tall, squeeze your shoulder blades together in the back, and perform a chin tuck by bringing your head over your spine. 
2. Bring your chin towards your throat as if holding the bowling ball over the dowel.
3. Repeat 2-3 sets of 10 reps and check the response. 

If there is a reduction in your symptoms, then that is a good sign that postural strengthening exercises would help with your headache. Try these advanced chin tuck exercises with a towel.

3. How can people improve their headaches caused by poor posture?

A series of stretches and release exercises, followed by strengthening exercises, is the most effective way to improve your posture. Imagine that the muscles in the front of the neck are locked in a shortened position and pulling your head forward.

We call that "locked short." The muscles in the back of the head are then locked long in response to the fact that the muscles in the front are locked short all the time.

So by stretching and releasing the "locked short", tight muscles and following that up with strengthening of the "locked long" muscles, we get postural balance.

Try these stretches and exercises to alleviate your headaches…

4. What exercises and stretches can people try at their desk and as part of their workout routine to prevent headaches caused by poor posture?

The first one is the chin tuck described earlier. This should be done multiple times per day if you are sitting at the desk for long periods.

1. At the desk, I like to teach my patients to sit tall, grasp their hands together behind the base of their skull, open the elbow wide, pull the head to the ceiling slightly, and extend the upper back. 
2. Repeat this 10 times, and you may feel or hear a few gentle cracks in your upper back.
3. For your pre-workout routine, grab a 36-inch foam roller and lay on it from your head to your tailbone.
4. Bend your knees and bring your arms out to the side at about 80–90 degrees. Relax into this and take deep breaths for 3-5 minutes to open your chest.
5. Follow this up with scapula stabilization exercises like rows and lat pulls.

5. Do posture correctors help people maintain proper posture?

I am not a fan of posture correctors for the long term, but I am ok with using them at the beginning of the rehab and postural reeducation process. It's kind of like the back braces you see the guys wearing at Home Depot and big warehouses.

They do not help those suffering with back pain and, in fact, end up causing more harm than good. If you rely on an external stimulus to correct your posture, then your brain will never develop the awareness and strength to do it on its own.

6. When should someone see a physical therapist about their bad posture and headaches?

Go now if you are experiencing headaches! There is no reason to suffer with headaches and hope they get better on their own. Medications and postural correctors will not solve your postural problems, so go see a physical therapist and get a plan.

Get guidance on what muscles are "locked short" and need stretching and what muscles are "locked long" and need strengthening. Posture does not improve overnight and necessitates the formation of new motor memories in the proper posture.

I am a licensed physical therapist and experience occasional neck pain and headaches from poor posture using my cell phone and computer. These tips and tricks that I have shared today are the things that I do on a consistent basis to keep my posture as tall as possible. 

Pilates exercises were the thing that improved my posture the most. It was awareness exercises incorporating core strength with coordination of the abdominals and shoulder blade stabilizers on the Pilates equipment that improved my posture significantly at age 28.

Call 512-215-4227 now to get started on improving your posture and decreasing your headaches and neck pain.

Check out my YouTube videos with demonstrations of these tips and many more at

Learn more about posture and headaches from the American Migraine Foundation.