The head is a heavy weight to balance on top of the rather thin spinal column. The average head weighs somewhere between 8 and 12 pounds if it is balanced happily atop the spine. But if the head moves forward to any degree, the weight the spine has to bear increases.

The downward force on the spine can easily double or triple as the head moves forward.
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That extra weight can be a problem, because the human spine is a slender thing, held upright through the alignment of the bones and the tension of connective tissues such as muscles, tendons, ligaments and fascia. Our spines determine the quality of our lives in a number of ways—protecting the spinal cord and central nervous system, and allowing us to stand and walk on two legs. One of my favorite phrases is “How the spine goes, you go.”

See Normal Spinal Anatomy

Poor posture can put your spine at risk.


Forward head posture

Forward head posture, which is exactly what it sounds like, is one of the most common problems for the upright skeleton.

Because we tend to take standing and walking for granted, the ability to align the head correctly is often out of reach.

But if your head is forward, trying to pull it back into a better position is not really the answer. You have to realign the rest of your posture to enable the head to move backwards.

Keeping the top of the sacrum parallel to the ground helps maintain a neutral pelvis (middle). Any deviation from a neutral pelvis also affects the head, placing extra weight on the spine (right).
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The role of the pelvis

The support of the heavy weight of the head is determined by the alignment of the pelvis. If the pelvis is not well situated there will be a great deal of stress on everything above it.

To enable good alignment of the head requires what we call a neutral pelvis. When we stand upright a neutral pelvis means that the top of the sacrum is parallel to level ground. A similar landmark for the head is to have the eye sockets parallel to the ground in the same way.

The top of the sacrum is referred to as the sacral plate and the bottom of the lumbar spine sits on top of this forming one of the body's more important joints, the lumbosacral joint.

See Sacrum (Sacral Region)

The alignment of this joint has a tremendous influence on the support of the rest of the spine, but the head in particular. It is almost impossible for the head to sit well on top of the spine if the bottom lumbar (L5) vertebra doesn't sit properly on top of the sacrum.

See All about L5-S1 (Lumbosacral Joint)

The all-important curve of the lumbar spine which is a distinctly human feature is what allows us to stand, walk and hold the head up. Any deviation from a neutral pelvis changes the degree of curve in the lumbar spine which explicitly affects the head.

One way to try and feel this is to sit or stand and rotate your pelvis (stick your butt out and then tuck it under) and feel the effect this has on the head and neck.

Don’t worry about getting the head into the right place. Start with realigning the pelvis in a way that allows the legs to get underneath the hips and the lumbar spine to curve correctly, and over time it will become possible to move the head backwards to a better position.

Learn more:

Posture to Straighten Your Back

Ten Tips for Improving Posture and Ergonomics