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Common Postural Deviations

There are a large number of postural deviations from "normal" that we see on a daily basis.
​Some of the more common conditions are listed on this page, with their descriptions and causes...

Forward Head Posture (FHP)

Forward Head Posture (or FHP) is possibly the most common condition we see. As this diagram shows, it is caused by a "cross over" effect of tight and inhibited muscles around the neck and shoulder region. When the head is sitting forward of the shoulders, there is a 

Forward Head Posture

substantial increase in muscle tension and compressive forces through the cervical spine which can lead to various symptoms such as neck pain, headaches, upper back and shoulder pain. Left unchecked, it can also lead to nerve symptoms such as referred pain, tingling or numbness through the arms, hands or fingers. Commonly seen in people who spend a lot of time sitting at a desk, using a computer or looking at mobile devices, FHP is far too common, and is very treatable. In mild cases corrective exercises can completely fix it, in more severe cases a combination of exercises and physiotherapy techniques may be required.

Increased Thoracic Kyphosis

Your upper and middle back is your Thoracic area. In normal alignment it has a mild curve called a Kyphosis. Often however, this curve is exaggerated due to poor postural habits and a combination of muscle imbalances where some are too tight and some are too weak.

Increased Thoracic Kyphosis

Again, this condition is seen in office workers, but also in teenagers, especially those who may be taller than their peers. A combination of protracted shoulder blades, a sunken chest and internally rotated shoulders gives the classic "slouched" posture. The chest and anterior shoulder muscles are tight and need to be stretched, whereas the "anti-gravity" muscles around the upper back and shoulder blades are very weak and need to be strengthened.

Rounded Shoulders

The old favourite- how many times did your Mum tell you to "pull your shoulders back" and "don't slouch" when you were younger?! As you can see in this image, rounded shoulders commonly go along with an Increased Thoracic Kyphosis, as well as internally rotated arms, shown by the palms facing backwards instead of in towards the body.

Rounded Shoulders

We are cursed with needing to do so much work with our hands in front of our bodies that it is inevitable that we are prone to rounded shoulders. This causes tight chest and anterior shoulder muscles in particular, and can lead to such conditions as shoulder impingement, bursitis, or rotator cuff tendon issues. Many simple exercises can help this postural deviation, but the key factor is becoming aware that you have it in the first place, so you can seek help and not let it become a longer term problem.

Anterior Pelvic Tilt (APT)

You may have heard of the lumbar lordosis. This is the natural, inward curve of the lower back that we see in normal posture. If you have an Anterior (forward) Pelvic Tilt, this pulls your lumbar spine into an exaggerated curve known as a hyperlordosis, and seen as a very "hollow" lower back.

Anterior Pelvic Tilt

As you can see in this diagram, this is another postural deviation caused by a cross over effect, known as the "lower crossed syndrome" of some tight, and some weak, muscle groups around the trunk and hips. APT can cause such problems as hip flexor injuries, lower back spasms and compressed vertebrae just to name a few. Fortunately, there are corrective exercises available to minimise the effects of this deviation, as well as specific physiotherapy techniques if you are already feeling pain because of it.

Posterior Pelvic Tilt (PPT)

The opposite to the anterior pelvic tilt described above is the Posterior Pelvic Tilt. This occurs when the pelvis rotates back and flattens the normal lumbar lordosis, giving the appearance of a "flat back", and a tucked in bottom.

Posterior Pelvic Tilt

Once again the product of the lower crossed syndrome, but in the opposite direction, of some tightened and some weakened muscle groups, PPT tends to be more common in males than females and is caused primarily by tight hamstrings and abdominal muscles. This opens up the possibility of lumbar disc injuries, hamstring strains and other soft tissue problems. Again, it can be addressed with corrective exercise prescription very effectively if it hasn't been present for too long.

Lateral Pelvic Tilt (hip hitch)

Looking at the body from the front instead of from the side, it can become apparent if a person has a "hip hitch", with one hip appearing lower than the other. This is due to a Lateral Pelvic Tilt, and can give the impression of an apparent leg length discrepancy, where one leg seems shorter than the other!

Lateral Pelvic Tilt

A reasonably obvious postural deviation, a hip hitch affects the rest of the body, as shown in the diagram, where the shoulders and knees also become asymmetrical, with one dropping and the other one "hitching". Many muscle groups are involved in this condition, so many exercises may be required to help correct it, depending on the case. It really does need to be corrected though, to avoid longer term issues such as chronic muscle shortening, lumbar facet joint injuries, hip joint impingement and knee dysfunction, among others.