If you reach around to the back of your head, just above the top of the neck, you should feel a bump in the midline. This is NORMAL, and it’s called the external occipital protuberance (EOP). The EOP serves as an attachment point for the nuchal ligament and the trapezius muscle, which function to keep the head upright and tilted backward. The size of the EOP normally varies (averaging around 5mm), depending on race, gender, genetics, and occupation.
A 2016 study revealed that an alarming number of young people had spurs (technically called enthesophytes) extending from the EOP, an occurrence associated with the wear-and-tear of osteoarthritis that can develop later in life. In the study, researchers reviewed x-rays of 218 men and women 18 to 30 years old who either had back pain, neck pain, or headaches or no history of such conditions. The research team observed an enlarged EOP (EEOP for short) in 41% of participants, regardless of the presence or absence of musculoskeletal pain. However, the data did show that EEOP was three-times more common in men than women.
The same study authors conducted a larger study in 2018 that included 1,200 adults of all ages and found that the combination of male gender, the degree of forward head protraction (FHP), and age predicted the presence of EEOP. Their results showed that being a young male with a greater amount of FHP lead to the formation of EEOP.
The researchers suspect that the age component of their finding (after all, the frequency and severity of degenerative skeletal spur formation typically worsen with age) may be due to young adults placing a greater mechanical load on their necks due to forward head posture caused by excessive device use.
The good news is that studies have demonstrated forward head posture can be improved with specific resistance and stretching exercises, monitoring your posture while using electronic devices, and reducing electronic device use. Your doctor of chiropractic can show you exercises that you can perform at home to reduce forward head posture.
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