Posture from a Physio Point of View

NECK – Forward head posture – This can contribute to the increased compression of the upper cervical spine.  It can also put a strain on the cervical-thoracic junction.  It can be a cause of headaches and neck pain.  Be careful with weight training that you don’t strain and poke your chin forwards.  This is made worse if the weight is too heavy.  Also that you don’t have your chin up and therefore compressing the middle joints of the neck.

SHOULDERS – drooping shoulders and tight posterior capsule will lead to poor activation of the rotator cuff muscles and can cause an elevation of the humeral head with any upper limb activities especially at or above 90 degrees.  It will cause a loading of the rotator cuff tendons causing tendonitis as well as the subacromial bursa leading to bursitis.

PELVIC STABILITY & CORE – Weakness in the deep pelvic stabilisers and core can lead to a loading of the lumbar spine and can bring about lateral hip pain as the outer muscles (such as TFL) are used to compensate.

HIP FLEXORS – Are they tight or lengthened?  This can bring about a weakness in the hip flexors and therefore the hamstrings overcompensate leading to tightness and possible injury or hamstring tendonitis.  There may be an increased loading of the lumbar spine and shortening of the erector spinae in the back.  We can check your standing posture with a plumb line.

KNEE – Patella tracking position.  This is made worse with overpronation of the foot or poor pelvic control.  This will load the patellofemoral joint and lead to knee pain.

ANKLE – Stiff?  Knee to wall – is it the same on both sides?  The stiffness will load the ankle and can lead to ankle impingement and overpronation.  It can lead to pain in the front of the ankle, patella tendinopathy in knee and heel pain.  Do you overpronate or roll too far in with walking?  This can lead to tendonitis of tibialis posterior, peroneals or Achilles tendon.  The overpronation may be due to tight calves or a stiff ankle and may be made worse by footwear so the stability of shoes needs to be checked.  You may need orthotics to correct the overpronation.

By Melanie Roberts

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