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The Spine: The impact of head position

Posted By Elsa Urmston on behalf of the IADMS Education Committee, Monday, April 06, 2015

This blog post from the IADMS Education Committee brings focus to the importance of spinal alignment and its role in aiding the efficient and effective mobilization of the body in dance.  Specifically this week, we will look at the cervical spine and the all too common problem of the forward head posture.

In recent weeks I’ve been aware of the images on social media about the impact of smartphone and tablet use on the alignment of the upper body in everyday life, bringing about the forward head posture which drops the shoulder girdle down and forwards, bringing with it the cervical spine and skull.  The middle back or thoracic spine area has a tendency to drift backwards and, to accommodate the upper back shift, the hips tip forwards, creating a domino effect of increased force on the central line of the body.  Herein lies muscular and skeletal imbalance as the center of gravity is pulled anteriorly and posteriorly off the midline – the result – pain, discomfort and inhibited movement range.  Here we see the resulting force placed on the spinal column, relative to degrees of anterior cervical spine flexion.


In my own classes I often see this forward head posture - whether it is a result of increased screen use is up for debate!  I’d like to think it is the students’ eagerness to learn but this forward head posture may come about because of students looking down, lack of confidence, concentration or any multitude of reasons.  But balancing the skull on the spine is critical in helping young dancers to find efficiency in their whole body movement, and tackling it early on in the training journey seems a prudent step in finding fluency of movement and avoiding injury risk. 

Ideal spinal alignment requires the skull to be balanced on the occiput, creating a central line through the spine which minimizes stress on the body.  And once the skull is balanced on the spine we can ensure that the natural curves of the spine are supported for maximum shock absorbancy in jumping and support for the dancing body in motion.  As soon as the head moves off this central line, forces impact on the joints of the body; of course sometimes we want that to happen as this initiates movement, or balances movement in other parts of the body.  But equally, we need to ensure the efficient balance of the skull on the spine to enable safe and effective practice.  Any distortion in the spine because of head position can impact balance and how we move – pirouetting with a forward head stance is nigh on impossible!  

The impact of the forward head posture on the spine is varied, but as I mentioned earlier there is always a domino effect on the spine and indeed the joints of the lower limbs.  This image below really illustrates this clearly – with the arrows indicating the stress points rippling down the body from poor head position.

So what can educators do to enable efficient head position amongst our youngsters and avoid the impacts on the spine we see above.  We have probably all experienced the image of the string coming from the top of the head, to ‘lighten’ the skull on the spine and allow length in the spinal column.  This can be helpful but I think can sometimes result in the chin being pulled inwards towards the throat, the head falling slightly back and in turn, creating the flat back posture, also often associated with young dancers as they try to find that length we all seek.  Those vital spinal curves disappear. 

Multidimensional images of the head-spine relationship seem to create a better balance amongst the students I work with.  For example, whilst standing we consider the string from the crown of the head, alongside marionette strings which cluster above the ears and draw upwards to help students understand the volume of the skull balanced on the spine.  Often I will have students working in trios, one partner clustering their fingertips firmly on the sides of the skull just above the ears.  They press gently on the flesh for 30 seconds or so, so that the dancer can feel the touch of their partner, the partner then draws the fingertips up to the crown of the head to unite and lengthen up into the space above, often drawing the hair with the fingers.  The other partner lightly cups one hand on the forehead and the other on the posterior curve of the skull and remains there whilst the marionette strings are drawn upwards.  Students’ reactions to this tactile task are always positive and they observe in their partners the lengthened spine and ideal head placement we seek but also the spinal curves remain intact.  They are able to recall the tactile memories of the hands-on work in their dancing as a reminder. 

For me, I have learnt a lot from Alexander Technique (AT).  The verbal directions, “to let the neck be free, to allow the head to go forward and up, so that the back can lengthen and widen”, alongside hands-on work in class as shown below, reiterate the balance of the head whilst dancing.  Examples of AT in practice are widely available on the web; these short films are a great visual introduction to the basic principles of AT, and their specific application in dance. 
Video 1
Video 2

I have also found these dance-specific AT podcasts helpful in developing my own understanding and taking these ideas into the classroom to help my students.  I strongly recommend a listen!


At the DanceEast Centre for Advanced Training we spend a lot of time team-teaching in technique classes – a luxury I know.  I will work within ballet and contemporary classes, the class teacher leading the class in the normal way, whilst I circulate to work with students individually, reminding them quietly of teaching points covered in dance health classes, using tactile feedback from the examples above as well as many others, to try to support the transfer of learning of principles from our health classes to their application in technique and performance.  So in fact we are trying to overcome habitual movement patterns such as the forward head posture through re-education.  We find a sustained deepening of the students’ understanding when we work in this way, which enables an enquiring learning approach from the students in which they ask questions and interrogate their own practice.

There are numerous videos including stretches for forward head posture available on the web.  In my experience some people, sometimes find these useful, but the focus is on treating the pain caused by poor alignment rather than tackling the root cause.

For further resources, take a look at the following:

A great collection of Alexander’s writings:
Alexander, F. M.
The Alexander Technique: The Essential Writings of F. Matthias Alexander. Lyle Stuart. 1990.

Batson, G. Somatics Studies and Dance.  IADMS Resource Paper. 2009.

The Complete Guide to the Alexander Technique


Elsa Urmston MSc PGCAP AFHEA is the DanceEast Centre for Advanced Training Manager, Ipswich, UK and a member of the IADMS Education Committee.



Tags:  dancers  ergonomics  neck  spine  teachers 

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Comments on this post...

Juon Pointe says...
Posted Wednesday, April 08, 2015
Thank you for a wonderful post. Have read it carefully and passed it on to all I know! :)
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