Simple Posture

Too often I will get a client who has, for the past umpteen years, sat behind a desk with little to no movement in their daily activity, or, after 20 years of trying to deal with an injury they finally reach out for help. Now they come to me because they want to be fit (or at least not in pain doing daily activities). The first thing I do is asses their basic posture. Vladimir Janda was one of the first to theorize that muscular imbalances (tight or over active and inhibited or under active) cause dysfunction in the motor system particularly around the pelvic girdle and the shoulder girdle. These dysfunctions became what are known as Upper and Lower Cross Syndrome or Proximal and Distal Cross Syndrome as they are characterized by the cross formed where the inhibited and tight muscles join (Janda1996, p. 97).

In the Performance Enhancement Specialist Certification, Clark and Russell term Lower Cross Syndrome as Lumbo-Pelvic-Hip (LPH) Postural Distortion and Upper Cross Syndrome as Upper Extremity Postural Distortion. They also discuss another common dysfunction; Pronation Distortion Syndrome aka Lower Extremity Postural Distortion (2007 p. 18-20).

Upper Extremity Postural Distortion is characterized by rounded shoulders and a forward head and may cause shoulder impingement, biceps tendonitis and headaches. LPH Postural Distortion is characterized by increased lumbar lordosis and may result in knee, hamstring, or low back pain. Lower Extremity Postural Distortion is characterized by foot pronation and internal knee rotation and may cause shin splints, knee pain, or plantar fasciitis (Clark and Russell 2007 p. 18-20).

Because these syndromes result in dysfunctional movements (overhead movement patterns, decreased spinal stabilization, and/or dynamic stabilization or deceleration), if there is excessive indication of one or more of these syndromes, you should probably do something proactive to address the issue before it results in permanent joint and/or muscular damage and pain.

There are some simple exercises that can alleviate the imbalances and restore normal movement patterns.

Lower Extremity Postural Distortion:

Characterized by - Excessive Foot Pronation and Knee Flexion/Internal Rotation

Common Injuries:

· Plantar Fasciitis

· Posterior Tibialis Tendinitis (Shin Splints)

· Anterior Knee Pain

· Low Back Pain

Strengthen:

Dorsiflex w/band

Mini squat-heel touch

Ball Squat w/ Abduction

S/L Bridge

Kick Backs

Stretch:

Plantar Flex-Invert

SMR Calf

Calf Stretch

SMR IT Band

Sit and reach

Lunge and Reach

Upper Cross Syndrome:

Characterized by Rounded Shoulders and Forward Head

Common Injuries:

· Rotator Cuff Impingement

· Shoulder Instability

· Biceps Tendinitis

· Thoracic Outlet Syndrome

· Headaches

Strengthen:

3-way rotator cuff

Cobra

Low Row

Chin Tuck

Stretch:

Doorway Stretch

Neck stretch

Lat stretch O/B

Kneeling Lat stretch

Lower Cross Syndrome:

Characterized by Increased Lumbar Lordosis

Common Injuries:

· Hamstring Strain

· Anterior Knee Pain

· Low Back Pain

Strengthen:

S/L Bridge

Ball Squat w/Abduction

Bracing

Cobra O/B

Dorsiflex w/band

Crunch w/twist

Stretch:

SMR TFL

SMR Calf

TFL Stretch

Calf Stretch

Lunge Stretch w/internal twist

S/L Butterfly

Obviously this is not an exhaustive list of compensations or corrections; however, if you have any of these issues, the problem could be in your posture.

Janda, V., (1996) Evaluation of muscular imbalance
in Liebenson, C (ed) "Rehabilitation of the spine"
Williams & Wilkins, Baltimore, MD; p. 97–112

Clark MA, Russell A. (2007) Optimum performance training for the performance enhancement specialist; postural considerations. Calabasas, CA: National Academy of Sports Medicine.