There are certain possible causes of headaches—like a cerebral bleed, meningitis, a tumor in the brain—that are very dangerous and can be life threatening. Most of these can be identified by the use of diagnostic tests like MRIs and CAT scans. And there is no question that these types of tests should be run in the case of severe headaches.

But what happens when all the tests come back negative? With no “cause” established, the goal simply becomes finding ways to reduce the intensity of the headaches. This leaves medical practitioners with little alternative but to prescribe pain medications or Botox injections. The problem here is that the side effects of most of these medications can be worse than the headaches they are intended to address…and Botox is only temporary. The headaches could continue indefinitely!

I would like to present an alternative cause of chronic headaches that should only be investigated after following the proper medical procedures to rule out a more serious cause. I have been able to resolve the headaches of many people—including those suffering with migraine headaches and cluster headaches—by addressing a postural deviation called “forward head and shoulder posture,” where the head is forward and the shoulders rounded.


When standing with proper posture, your ears and shoulders should be directly aligned over the hips.

Forward head and shoulder

Forward head and shoulder posture is where these landmarks are in front of the hip when looking at a person from the side. The posture creates a hunching at the upper back.

This hunched posture is caused by a muscle imbalance between the chest muscles, front (anterior) shoulder and biceps versus the muscles between the shoulder blades, rear (posterior) shoulder and triceps. And it’s this imbalance that could be the root of migraines and other chronic headaches.


If you just want to trust me and don’t want all of the details, scroll down for the exercises that can relieve your headache pain…but my patients do better when they understand the mechanism they are working to correct. Here’s what happens, step-by-step, when headaches are caused by poor posture…

  • The front set of muscles (chest, front shoulder and biceps) tend to be excessively used because everything we do with our hands is done in front of us.
  • When this imbalance grows, the chest muscles can especially shorten. Shortened chest muscles pull the shoulders forward, creating rounding of the upper back.
  • At the same time, the shoulder blades will be moving laterally farther away from the spine. The muscles that support the head (called the levator scapulae and upper trapezius) attach from the shoulder blades to the upper cervical spine and skull. When the length of these muscles is increased, they can lose their ability to support the head.
  • These head-supporting muscles will strain, which can create pain at the upper neck region and cause the head to move more forward.
Muscles of the upper back and neck
  • As the head moves more forward, it increases the load on those supporting muscles because the weight of the head is moving farther away from being properly supported over the cervical spine.
  • Since the upper trap muscles attach to the skull at its base, the forward tilt of the head will begin to create an excessive pulling. Muscles don’t actually attach to bones; they attach to the periosteum, connective tissue that surrounds bone. Connective tissue has a very high density of pain receptors in them. By pulling excessively on the periosteum, there is a good opportunity for the pain receptors to be ignited anywhere around the skull—causing headaches—because periosteum also surrounds the skull.

    To resolve headaches generated by poor posture and the resulting muscle imbalance, you simply need to strengthen the weaker muscles. As these muscles are strengthened, you’ll see improving posture and a reduction in headaches. Then you can say farewell to painkillers and bye-bye to Botox. Here are the four exercises—all you need is a resistance band, a door and a chair!

    For each exercise, perform three sets of 10 repetitions with a minute rest in between each set. The series of exercises are performed three times a week with a day rest between. Resistance should be progressed to eventually get the muscles strong enough to perform all functional tasks without straining and eliciting symptoms.

    1. Lat Pulldown (interscapular muscles: midtraps and rhomboids):
    Tie a knot in the center of a resistance band and secure it in place at the top of a closed door. Sit in a sturdy chair and lean back with an angle at the hip of about 30 degrees. Reach up for the ends of the band so that the start position begins with the arms nearly straight and the elbows just unlocked. Pull the band down keeping your arms wide and bringing the elbows just below shoulder height and slightly behind the line of the shoulders. At this point, you should feel the shoulder blades squeeze together (the elbows will barely reach behind the line of the shoulders if performing this exercise correctly). Then return to the start position. Important: If the elbows start to drop so they are lower than the shoulders, you are using the incorrect muscles to perform the exercise.


    2. Lower Trap Exercise (lower trapezius muscle):
    Sit in a sturdy chair with a back and lean back slightly—about 10 degrees. This posture will prevent the resistance from pulling you forward. Step on one end of the resistance band to secure it and hold the other end in your working hand. Start with your arm halfway between pointing straight forward and pointing straight to the side, with your hand at shoulder height and your elbow just unlocked. Begin to raise the resistance until the arm reaches about 130 to 140 degrees (about the height of the ear). Then return to the start position at shoulder height.


    3. Posterior Deltoids (posterior deltoids):
    Stand with your feet more than shoulder width apart, knees slightly bent and your butt pushed behind you. Your weight should be mostly on your heels. Step evenly on the band and hold the ends in front of your thighs with your palms facing in and your elbows unlocked. Begin to move the resistance out to your side from the shoulders like a pendulum. Go out until you feel the shoulder blades start to move inward (about 60 degrees), and then return to the beginning position.


    4. Skull Crushers (triceps, single and both arms):
    There are a multitude of exercises that strengthen the triceps. This particular one is the most effective because it puts the long head of the triceps in the optimal position. The long head of the triceps is the only part of the triceps muscle that passes the shoulder joint. Therefore, it is the only part of the muscle that can affect the position of the arm bone in the shoulder joint. The exercise can be performed with one arm or both, depending on whether your pain is associated with one side or requires both arms to be strengthened to resolve it.

    To perform the exercise, tie a knot in one end of a resistance band to secure it behind a closed door. Sit upright in a chair, back supported facing away from the door, with your legs comfortably open and feet firmly on floor. Start with your arm in front of you, upper arm just above parallel to the floor and elbow bent at 90 degrees. Keeping the upper arm in place (you can support with your other hand), begin to straighten the elbow, lowering the forearm until the elbow is just short of locked. Slowly return to the starting position.


    Click here to buy Mitchell Yass’s books,The Yass Method for Pain-Free Movement: A Guide to Easing through Your Day without Aches and Pains, or check out his website.

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