Thursday, April 12, 2018

Dropped-head Syndrome, An Update

One of the possible symptoms as Kennedy’s Disease progresses is ‘dropped-head’ syndrome (DHS). Your upper-back, shoulder and neck muscles weaken to a point where it is difficult to hold your head up without support.

Case Reports in Orthopedics describes dropped head syndrome (DHS) as a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder.

On the same website, there is a good Case Report on DHS that you might find interesting.

Two years ago, I experienced the first evidence of DHS. Neck aches and spasms signaled something was happening. Over the next few months, my head dropped more and more. At first, it was easy to correct the posture. Over time, I found there were times my head had dropped and I did not know it.

The figure below shows the increased weight of your head as it is drops forward.


A physical therapist recommended the following exercises to strengthen the muscles needed to hold your head upright as well as reduce neck pain and fatigue. These exercises should be performed daily. Start slowly and only do as many reps as comfortable. It is helpful, especially at first, to have someone use his or her hand as resistance. 



1. Bend to the Chest: Works the neck and shoulder muscles. While sitting, place your palm against your forehead. Lower your chin down to touch your chest, while having your palm apply resistance (holding your head up). Perform 10-12 reps (or whatever is
comfortable).

2. Pull the Head Up: Works the neck and shoulder muscles. While sitting, clasp your hands behind your head and lower your chin down to touch your chest. Raise your head up to the normal upright position, while having your hands apply resistance (holding your head down). Perform 10-12 reps (or whatever is comfortable).

3. Side Turns: Works the neck and shoulder muscles. While sitting, place your left palm against your cheek and temple. Rotate your chin 90 degrees to the left while having your palm apply resistance (keeping your head from turning). Perform 10-12 reps (or whatever is comfortable). Switch to the right hand and perform the same exercise rotating to the
right.

4. Bend to the Shoulder: Works the neck and shoulder muscles. While sitting, place your left palm against your temple. Lower your head towards your left shoulder (go about half way or 45 degrees) while your left hand applies resistance (to hold the head upright). Perform 10-12 reps (or whatever is comfortable). Switch to the right hand and perform the same exercise lowering your head to the right.

5. Bend to the waist: Works the back and neck muscles. While sitting and with your hands at your side, slowly lower your chest to your knees while curling your chin into your chest. As you slowly raise yourself back up to a vertical position, curl your neck up until you are looking at the ceiling (or sky). Perform 10-12 reps (or whatever is comfortable).

There are some devices developed to help hold your head upright. I cannot recommend any of them since I have not tried them. I do use a soft collar for 8-10 hours a day. It is more a reminder to me when my head drops forward. It works for me, anyway.

Another website, Absolute Life, has some additional information and tips.

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