Both pictures show very similar postures. Here is a breakdown of what is happening in both pictures: the chin is jutted forward, tightening the muscles in the upper neck where the skull is connected to the spine and shortening the SCM (the primary muscle responsible for turning your head, connecting your sternum and collar bone to your skull just behind your ear); both shoulders are raised, making the distance between the ears and shoulders shorter than it should be (this can cause more trigger points in a different muscle called the levator scapulae, the muscle that is used whenever you shrug your shoulders); lastly the upper back is rounded, adding to the compensation that must be made by the neck.
In addition to causing trigger points and muscle fatigue in the upper back and neck, this posture can be the cause of headaches. When the chin is jutted forward the muscles of the suboccipital triangle are engaged (rectus capitus posterior major, obliquus capitus inferior and obliquus capits superior). Check out the picture below to get an idea of where these muscles are, all the muscles mentioned are highlighted in pink:
The nerve that goes through this triangle is called the dorsal ramus of the C1 sub occipital nerve (basically just a small portion of the sub occipital nerve). When we are stressed or spend long amounts of time in a forward head posture these muscles will contract and eventually form trigger points which can then cause headaches. Headaches caused by this mechanism are usually located around the base of the skull.
Another cause of headaches, due to the same posture, is from trigger points in both the upper trapezius (which lay between your shoulders and neck) and the SCM (the same muscle discussed earlier). When trigger points can either be active or latent. When they are active that means that you can experience pain in a referral pattern without any pressure being applied to the trigger point. On the other hand if you have a latent trigger point (which are more common), you only experience pain in a referral pattern when pressure is applied (like when you get a massage or when someone rubs your shoulders). Below are the referral patterns for the upper trapezius and SCM (respectively):
So what can be done to avoid these headaches? First off if you drive a lot during the day or if your job requires you to be in front of a computer screen for most of the day you will want to pay attention to these tips:
1. Make sure to take breaks. Get up and move around during the day, taking at least a minute or two every 15 minutes to stretch your neck and walk around. This goes for people who are work as truck drivers too, just make sure to be safe while driving and take walking breaks every few hours or more often if needed.
2. Try the following stretch. Note that the patient is reaching over his head and pulling it down towards his one shoulder while he stabilizes with his other hand on the table. When you first start to use this stretch, try it without the stabilizing hand. As you get used to the stretch you can hold on to your seat with the other hand or sit on it to get a deeper stretch. An easy modification to this stretch is to turn your head in toward the armpit of the hand that is raised. This modification will help stretch out different muscles.
3. Be mindful of your posture. While you are driving or sitting, check every few minutes to make sure that you are not slipping into a forward head posture. Activate you abdominal muscles, sit up straighter, and tuck you chin in and down.
Even with all these helpful tips, it is still possible that you can get trigger points in the muscles mentioned. That is why I recommend that my patients come in for a 'tune up' every few weeks. With a little muscle work and a gentle adjustment you can help fight the battle against bad posture and dull achy muscles.