The head should be directly over the shoulders, shoulders directly over the ribcage, ribcage directly over the hips, hips directly over the knees, and knees directly over the feet.
Most of us don’t stand that way. Many of us stand (and sit) with our heads in what’s called a “head-forward position”. The head is a bowling ball, weighing about 12-15 lbs., held onto the neck by many, little, tiny muscles. If the head is forward of the shoulders, the shoulders might be behind the vertical line to compensate for the weight of that “bowling ball”. If the shoulders are behind the vertical, the spine might be bent more in the upper thoracic area resulting in kyphosis, or dowager’s hump. If the spine is bent this way, most likely the ribcage is “sunken” back in a way that limits lung capacity. Moving down, the lumbar (lower back) area of the spine could also be bent forward (flexion), continuing the slump, or it could have too much extension or arch resulting in lordosis. Many people suffer lower back pain because of lordosis.
From here the legs could “over straighten” or be in hype-rextension with the knees behind the vertical line. Depending on how your body compensates, the weight in the feet could be in the heels or in the toes. If the weight is in the heels, your body might reach even farther forward with the head, increasing the kyphosis. Or the body might throw the hips forward and be leaning backwards with the upper body. There are many ways to be very crooked and out of true vertical alignment while the body is trying to find a compromise stance that achieves overall balance.
This head-forward position also happens when lying down. If you have this posture, you may find that you need a small cushion under your head to be comfortable, resembling the head-forward position in a horizontal plane. Without the support, there is too much tension in the neck and, eventually, pain. Exercises in this position without the head support will become uncomfortable and you won’t want to do them.
One way to improve the head-forward position is to lift the breastbone as if you’re a puppet with a string attached to the breastbone and someone is pulling up on the string. What this action does is lift the ribcage up, opening up space for the lungs, settling the shoulders into better alignment, and bringing the head back over the shoulders and the chin downward. Suddenly you have that posture that your mother kept harping at you about! You can now walk around with a book on your head!
If, however, you have lordosis, lifting the breastbone will accentuate the lordosis. So now you get to do pelvic tilts or tucks to help with the lordosis. This is the crux of Pilates – using the deep abdominal muscles (the core) to improve posture.
The muscles, bones, ligaments, connective tissue are all interconnected so that it’s a challenge to isolate one part. If one part is out of alignment, then other parts get crooked, too, and it just compounds as you go the length of the body.
Start at the head or at the feet and work toward the other as you assess where things are. Just feel it out and take mental notes on where you are crooked. Look in a mirror or get a friend and help each other. Move body parts around and see which other body parts are affected. Try to pick one change that you can do every day and see what happens. Have fun!