079 - Posture Isn’t Just a Symptom - It’s a Signal: FHP, Muscle Stiffness, and Tactical Readiness
Neck and shoulder pain are rampant among young tactical professionals, especially with prolonged screen time and gear-laden postures. But does forward head posture (FHP) really cause muscle stiffness and pain, or is it just a cosmetic issue?
This study used ultrasound elastography to investigate whether the angle of head posture correlates with the stiffness of the upper trapezius in young men, and if those with neck/shoulder pain actually present with measurable differences.
What They Found:
Researchers evaluated 40 young men by measuring the craniovertebral angle (CVA) for posture and the shear elastic modulus of the upper trapezius (UT) for muscle stiffness. Participants were divided into symptomatic (neck/shoulder pain or stiffness) and asymptomatic groups. Key points:
A weak negative correlation existed between CVA and UT stiffness (ρ = –0.338). Greater FHP (smaller CVA) slightly aligned with higher stiffness.
No significant differences in CVA or UT stiffness between the symptomatic and asymptomatic groups.
Time of day, severity of symptoms, and postural habits were not standardized, and subjective pain did not align clearly with objective findings.
What This Means:
Greater FHP might contribute to stiffer trap muscles, but not always. The weak correlation suggests that posture alone doesn't tell the full story. Young tactical personnel may show poor posture and even elevated tissue stiffness without overt symptoms. Likewise, those reporting pain might not exhibit measurable postural deviations or muscular rigidity.
In tactical environments, posture isn't just aesthetics—it’s functional alignment under load. But this study shows clinicians and coaches must combine subjective complaints and objective data when evaluating neck pain or stiffness. Treating based solely on "bad posture" could miss deeper factors like load tolerance, fatigue, or stress.
Tactical Implications:
Don’t judge posture by pain alone: A young operator might have textbook FHP but no symptoms—or the reverse. Evaluate both posture and function.
Include objective stiffness testing when possible: Shear wave elastography, while not always accessible, provides valuable insights. At minimum, prioritize consistency in assessment.
Design posture protocols with function in mind: FHP isn’t just an alignment issue—it affects movement readiness under gear, vision lines during prone work, and cervical stability under load.
Focus on strength, mobility, and awareness: Interventions should include cervical stabilizer training, thoracic extension work, and scapular control, not just ergonomic cues.
Monitor symptom trends over time: Fluctuating neck/shoulder symptoms might align more with fatigue, recovery, or operational volume than static postural assessments.
Questions To Consider:
Are you tracking posture dynamically, or just snapping a static photo?
Could trap stiffness in your population be more about load and recovery than head angle?
How much of your neck pain protocol is based on assumed posture-pain relationships?
What systems are in place to correlate subjective complaints with objective metrics?
Is FHP being overcorrected at the expense of real-world tactical movement demands?
Suzuki H, Ohara Y, Iwata M, Asai Y, Matsuo S. Relationship between the degree of forward head posture and the shear elastic modulus of the upper trapezius in young men, and the difference in these variables between those with and without neck/shoulder pain and/or stiffness. J Phys Ther Sci. 2025 Jun;37(6):250-255. doi: 10.1589/jpts.37.250. Epub 2025 Jun 1. PMID: 40511318; PMCID: PMC12153242.