Ideally, the head should rest on the neck with the external auditory meatus (ear opening) aligning with the acromion process (bony end of the shoulder) when viewed from the side. When we have good neck posture, it’s hard to believe the head weighs the same as a recreational bowling ball. Unfortunately, most people don’t have ideal posture. Studies estimate that a significant portion of the population—especially those who spend prolonged hours on screens—exhibits forward head posture. Research suggests that for every one inch the head shifts forward, the load on the cervical spine increases by approximately 10 lbs., placing excessive strain on the neck muscles and joints, which can result in neck pain. Forward head posture can also affect balance and breathing. Here’s how…

Our body maintains balance through the careful coordination of three systems. Most people are familiar with the vestibular system in the inner ear and our visual system as being important for balance, but many are less familiar with the proprioceptive system. Proprioceptors are special nerve cells in tendons, muscles, and joints that provide feedback about where the various parts of the body are in relation to one another. The soft tissues in the neck are particularly rich in proprioceptors, and the excess stress and strain caused by forward head posture can impair their function, which in turn can affect balance, coordination, and spatial awareness.

Forward-head posture leads to a rounded upper back (thoracic kyphosis), restricting lower rib mobility and diaphragm efficiency. This may reduce forced vital capacity, inspiratory reserve volume, and peak expiratory flow, leading to shallower breathing and decreased oxygen intake. Essentially, forward head posture means you can’t breathe as deeply and have less lung capacity and oxygen intake, potentially leading to lower fitness, less vitality, brain fog, and difficulty maintaining focus. Patients with forward head posture also tend to overuse the chest and neck muscles when breathing, which can affect the ability of these muscles to contribute to other activities.

Chiropractic care for forward head posture typically involves a multimodal approach, including spinal adjustments to improve cervical mobility, myofascial release to relieve muscle tension, postural retraining exercises to strengthen stabilizing muscles, and ergonomic recommendations to help patients maintain proper head positioning throughout daily activities. If proprioception or breathing deficits are observed, additional strategies will be employed both in the office and at home to help restore normal function as quickly as possible.