Have you ever noticed that when we look ahead, we tend to shift our head and neck forward? This is something called “Forward Head” posture. This is a common problem from a Pilates and postural alignment perspective that we want to avoid! 

Forward Head is misalignment of the head and neck, in which the head juts forward from the shoulders. Rounded shoulder syndrome often causes this problem.  Long periods of working at a computer and/or staring at devices also contribute to forward head posture. Sound familiar?  We are all guilty of these poor postural habits!

Why Forward Head Posture Matters 

Forward Head posture affects the whole body.  Over time it creates an improper curvature of the cervical spine and an excessive rounded, reverse curve of the mid spine. Think of a straight line at a forward angle shown above in the first image. Now review the correct backwards C curve shown in the second image.  

Compare the differences.  Forward Head Posture causes neck pain, removes the natural shock absorption necessary for a healthy spine, and causes pressure between the joints.  

As the head shifts forward, it changes a person’s center of gravity. For every inch the head shifts forward, the neck bears an additional ten pounds of weight!   This can cause muscle strain and extreme joint stress.  

To compensate for this change, the upper body shifts backwards into a rounded shoulder posture.  This also places a compressive load upon the upper thoracic vertebra (your rib cage region).  Over time, a thoracic hump as shown below will develop.  We move from a straight, elongated, aligned spine toward a rounded, hunched, compressed postural position.


The body works as one organic unit. If the spine is misaligned, it can impede the chemical and electrical transmissions of the nervous system responsible for controlling all body functions.  This can lead to problems with digestion, illness, fatigue, or depression, just to name a few.  In addition to being painful and damaging to the skeletal system, Forward Head is unattractive. 

 It also creates severe tension, compression and pain in the occipital ridge where the skull meets the neck on the posterior side (back of the head and neck).  This area contains many nerves and soft tissue.  If the posture is severe, it can result in Occipital Neuralgia.  This is a painful condition that occurs when the occipital nerves that run from the top of the spine to the scalp are compressed or irritated.


The Forward Head Solution

 Pilates and movement education are great ways to combat forward head. Both Pilates and neuromuscular re-education help strengthen the muscles surrounding the thoracic spine, especially the muscles on the back of the ribcage. Incorporating Pilates a few hours per week , at a minimum, is an effective way to strengthen the often-underdeveloped core muscles responsible for helping your body stay in healthy alignment. 

However, to strengthen these muscles, you must first activate them by building the brain/muscle connection. How can you accomplish this?  Repetition with precision by incorporating the SAID principle. 

The precision training of Pilates combined with mindful, disciplined repetition will help you wire these muscles to the brain.  By doing so you will activate the underutilized core muscles and bring your body into proper alignment.  Spending a few hours a week activating these muscles will protect you from Forward Head Posture and many other misalignment injuries. 

BUT Forward Head is a posture challenge that must be addressed at its source – your bad posture habits!  Outside the studio and your weekly Pilates practice, you must make a constant effort to be present in your body and work on maintaining good posture.  Becoming aware of your posture on a regular basis and identifying causal behaviors of this condition in your life is necessary for achieving real and important change.

Plumb Line Posture

One of the most effective ways to realign your body is to strive for plumb line posture throughout the day.  Think of a line running from the crown of your head to your foot. From the side view, this line should pass through your ear, shoulder, rib cage, ASIS (hip bone), knee and ankle bone. Try to keep these points stacked vertically one on top of the other – especially ears over shoulders to correct Forward Head. 

Try these exercises: 

  1. Imagine your chin is on a shelf.  Without breaking the line of the shelf, slide your head backwards towards your back body.  (Be sure to bring the head back without lifting your chin.)  
  2. Now, try standing or sitting against the wall until the back of your head touches the wall. (Again, don’t lift your chin.)  

These movements will help you recognize what proper alignment feels like in your body.  Then try to maintain this postural feeling as you are working at your desk and moving through the day.

Other useful tips to avoid Forward Head posture

Adjusting your workstation to a standing desk, getting a proper supportive pillow for sleep, and adjusting your car seat can also make a big difference.  With challenges caused by habit multiple strategies are needed as well as a great deal of effort and commitment.  However, in the end your efforts will go a long way towards preventing further injury, illness, and discomfort.

Want to learn more?  Here is a helpful neural drill for the cervical spine.  This particular drill will give you feedback as to where your neck and head need to be in relation to your shoulders and the plumb line we discussed above.  

Forward Head is an insidious, potentially painful and damaging postural alignment for the entire spine.   But there’s hope! With mindful intention, a commitment to change, and some simple shifts in your daily postural habits you can prevent or reverse this condition.  Practice the exercises and drill above and join me for a Pilates practice that will change your alignment and your life.

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