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As therapists, we are constantly looking at the posture of our patients. We just can’t help ourselves. Ask any therapist, and they will tell you they are constantly people-watching and noticing movement patterns. Once you know what to look for, it’s hard to look away. Whether it’s watching someone’s gait running in front of you at a 5k, seeing someone holding a sleeping toddler in line at the airport, or heck even watching the walking dead, we are always watching. And it’s not all bad, sometimes it’s in admiration. I mean hello, have you seen our amazing Olympic athletes? Truly inspiring seeing people who just seem to make motions look flawless and effortless! It’s a bit of a satisfied “ahhh” feeling for us. So why do we spend so much time assessing how people move both inside and outside the clinic?

The answer is pain. The body is always looking for ways to maintain balance between muscle groups. Once something is out of whack it will compensate, however after moving incorrectly for so long injuries can come about. This often is accompanied by muscular pain but can eventually lead to tendonitis, bulging discs, rotator cuff repairs, and chronic injuries. Let’s give you some common examples.

Neck/upper back pain. This is a huge factor these days with people always on their phones looking down, working at desks, or perhaps moving heavy objects without proper form repetitively. This is also referred to as “upper crossed syndrome” if it’s happening at the neck and shoulder level. The neck flexes and the muscles shorten to look down the upper back also slouches over and stretches to accommodate. After doing this every day for minutes to hours at a time it’s common to feel burning and sore spots in the muscles, cramping, even headaches. It’s important to note muscles can become “locked” in both a lengthened or shortened state. For example the green boxes from below represent the shortened muscles and the red represent lengthened muscles, but both lead to decreased mobility and pain!

Physiologically, a muscle has a very hard time contracting once fully lengthened OR fully shortened, therefore your mobility quickly goes downhill and other muscles are used to “help” but they are not qualified for that motion. An example is someone with very tight/overactive neck extensors and chest muscles who also has lengthened/weak scapular muscles and neck flexors. For this person watching a plane overhead can be near impossible without help from the shoulders shrugging up, and they may experience pain in the back of the neck. Doesn’t sound very functional does it?

This syndrome also translates to the lower spine as well, eg, “lower crossed syndrome” and can lead to low back pain and issues even further down the chain. The more slouched we sit—whether you’re a student in class all day, someone who works at a desk, or perhaps have to endure a long commute—the deep core no longer receives the signal to turn on in a slouched position. The muscles “atrophy” or get smaller and weaker over time. Therefore when you are required to use them they quickly fatigue and no longer support the spine, making it resemble a wet noodle—recipe for disaster! And since you don’t have stability in the torso any more from the muscles on the side of the spine, the lower chain may have to compensate as well, which can even lead to knee and foot pain. See the figure to the right. Notice the line through the kneecap isn’t straight? This could mean patellar tendonitis, hip bursitis, or even plantar-fasciitis due to decreased trunk stability.

By increasing mobility in the tight structures and increasing stability in the weak ones we improve function and decrease pain! Bottom line. It’s important to maintain balance from top to bottom and bottom to top. And knowing where to start is hard—is it my collapsed arches below causing imbalances above or visa versa? Good thing you know some experts on the subject! We will help get you straightened out. As therapists we are the first line of defense when it comes to preventing injuries and we are always ready to help. We are here to empower you on your way to your healthiest self! Let us at Bader PT educate you in you on your way to better function, health, wellness, and fitness so you can live a more productive life!

Petersen W, Rembitzki I, Liebau C. “Patellofemoral pain in athletes.” Journal of Sports Medicine. 2017;8:143-154.