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The case for a strong neck


By Wayne L. Westcott, Ph.D., and Rita La Rosa Loud, B.S.


Most people are unaware of how much their head weighs and what effect this 16-hour per day weight has on the neck muscles, shoulders, upper back, and overall posture. The weight of our head is between 12 and 16 pounds, which is largely supported by our neck muscles whenever we are not lying down.  As we age, our neck muscles gradually become weaker due to muscle loss (sarcopenia) and our neck vertebrae gradually become less dense due to bone loss (osteopenia).  Consequently, we become less able to maintain our head in a desirable upright position, and typically experience a head-forward, head-downward, rounded-shoulder, curved-back posture that may result in progressive discomfort, as well as difficulty looking forward, swallowing, speaking, and even breathing normally.  These are important reasons to perform regular neck strengthening exercises, as doing so may prevent or reverse poor posture, as well as reduce the risk of head and neck injuries from falls or automobile accidents.  Quite simply, unless we strengthen our neck muscles, they, as well as our cervical bones, gradually become weaker and less functional.


A few years ago, we conducted a 14-week strength training study with elderly nursing home residents (average age 88) at John Knox Village, a large residential facility in Orange City, Florida.  The basic and brief strength training program consisting of five resistance machine exercises (leg press, triceps press, compound row, low back, and neck flexion/extension), that were performed for one set of 8 to 12 repetitions, two days each week.   In addition to rebuilding four pounds of muscle, reducing three pounds of fat, increasing their leg strength by 80 percent, and increasing their upper body strength by 40 percent, the study participants experienced better posture, less forward-downward head positioning, and less neck-shoulder-upper back discomfort. Strengthening the neck extensor and flexor muscles enabled these older individuals to look better, to feel better, and to function better in essentially all of their daily living activities.  They also had a significantly lower incidence of falls following this 5- exercise strength training program.


In September of 2018, at the suggestion of his physician, philosophy professor Steve Mastropole joined our Quincy College fitness program (open to all adults).  With heart disease widespread in both sides of his family, Steve wanted to improve his blood pressure, blood cholesterol and blood sugar levels to reduce his risk of potential cardiovascular issues. He also wanted to avoid drifting into what he termed “progressive inaction and sedentariness.”  After three months of single-set strength training on the resistance machines and basic aerobic activity on the endurance equipment, Steve experienced desirable reductions in his blood pressure, blood cholesterol, and blood sugar levels.  While we were all pleased with Steve’s excellent physiological improvements, there was still another area of concern.

Steve noted that, over the years “through negligence and bad habits” he had developed an undesirable (and hard to change) posture. After performing some simple and specific muscle strengthening and stretching exercises, Steve recounted the following observations. “I became very mindful of my tendency to look down at the floor, and since incorporating the shoulder and neck exercises suggested, within a few weeks I was very much aware of my improvements and began to appreciate the benefits of an upright position. Plus, I am astonished that noticeable development is still possible in a person over age seventy!”   

Steve became more determined to correct his forward head posture after taking the Wall Test.  Due to weak and tight muscles, he was unable to touch the back of his head against the wall while standing upright.  “Rita demonstrated the extent of my regression by having me place my head, neck, shoulders, and back against a flat backdrop.  I flunked the test, but this test underscored a goal for me to work toward.”


  • First, become aware of your head placement.
  • With professional guidance, strengthen the weak muscles and stretch the tight muscles.
  • Begin with body conditioning exercises that require no equipment.
  • Eventually, strengthen these muscle groups on well-designed resistance machines.
  • Perform each exercise in a slow-controlled manner.
  • Do one set of 8 to 12 repetitions to reasonable muscle fatigue.
  • When 12 repetitions are completed with correct technique, gradually increase the exercise resistance.


  • Place one hand on your belly and the other on top of your chest.
  • Take a deep breath and watch your belly expand, chest rise, head lift, and eyes focus ahead. You should feel a little taller.
  • Hold this upright position as you exhale and contract your abdominals.
  • Practice this breathing technique whenever you find yourself leaning forward or looking downward, and especially when you are exercising

Here are four sample exercises that can help correct forward-downward head posture.


Tight chest muscles can contribute to a downward/forward head posture.

With one foot in front of you, place both arms at a 90-degree angle against the door frame.  As you breathe in and out, gently shift your weight forward to stretch your chest; at the same time squeeze your shoulder blades together.  Hold the stretch for 15-30 seconds.  Switch feet and repeat the exercise.


The Nautilus Neck Machine isolates neck muscles and enhances balanced neck development.

Neck Flexion

Adjust seat height so forehead/cheeks press comfortably against head pad.  Place hands on upright handgrips to stabilize upper body.  Keep torso erect throughout.  Push head pad forward and downward until neck flexor muscles are fully contracted.  Slowly return to starting position.  Use full range of movement unless there is a functional limitation.  Perform one set of 8 to 12 repetitions in a slow and controlled manner.

Neck Extension

Maintain same seat height as the neck flexion exercise.  Face the opposite direction and place back part of head against head pad.  Begin exercise in neck flexed position with your eyes facing the floor.  Then gently extend the neck backward and upward until your eyes are facing the ceiling.   Perform one set of 8 to 12 repetitions in a slow and controlled manner.


Sadly, many middle-aged and older adults suffer from chronic neck problems.  However, with a sensible, supervised program of strengthening and stretching exercise it is usually possible to correct many years of posture deterioration.   Doing so requires a commitment to perform the recommended exercises regularly, but the exercise protocol may be completed in a relatively short time period, two or three days per week.

About the authors:

Wayne L. Westcott, Ph.D. and Rita La Rosa Loud, B.S. direct the Community Fitness Center at Quincy College.  Together, they have written 29 books on Physical Fitness and Strength Training.