Integrating successful corrective exercise strategies into client programs to alleviate their aches and pains is easy if you have a good understanding of posture. This article provides a brief explanation the most common postural imbalances and exercises you can use to correct them.
The downward pull of gravity places a tremendous amount of stress on your feet. If your feet are deconditioned (and most people’s are), they tend to flatten in response to this pressure (i.e., overpronate). When your foot overpronates, your ankle rotates inwardly over your foot toward the middle of your body. Your leg follows your ankle, causing both your lower and upper leg to rotate inward. These imbalances of the foot and leg cause the knee to shift inward also (i.e., medial knee displacement). Over time, these compensations can lead to excessive pressure on the knee and ankle joints, causing discomfort and dysfunction in these areas (see Image 1).
Image 1: How Overpronation Affects the Knees
Malalignment of the feet, ankles, knees and legs can also cause stress in your hips and lower back. The top of your leg attaches to your pelvis via the hip joint, so when your leg rotates inward, your pelvis must shift to accommodate this movement of the leg in your hip socket. It does this by tilting down at the front (i.e., an anterior pelvic tilt). This forward-tipping of your pelvis causes your lower back to arch excessively (i.e., excessive lumbar lordosis – see Image 2). This displacement of your hips and pelvis can lead to muscle tension and back and hip pain.
Image 2: How the Feet and Legs Affect the Hips and Lower Back
These lower back and pelvis imbalances can also produce counterbalance compensations in your upper back and shoulders. These upper torso structures must round forward to enable your body to remain balanced and upright (see Image 3). (If they didn’t round forward you would topple over backward!) This forward rounding of your shoulders and upper back (i.e., excessive thoracic kyphosis) can cause the muscles in these areas to become overworked and restricted. It can also affect the positioning of your neck and head. In order to keep your head balanced, you must arch your neck excessively (i.e., excessive cervical lordosis) to keep your eyes level with what you are viewing (e.g., computer screen, landscape, etc.). These compensations can cause upper back, shoulder, and neck pain.
Image 3: How the Lower Back and Pelvis Affects the Upper Back and Shoulders
Postural compensation patterns can originate anywhere in the body from the bottom up (i.e., from toes to head) and/or from the top down (i.e., from head to toe). In any event, integrating the following corrective exercises into client programs can help reduce compensation patterns and alleviate resultant pains.
Recommended Corrective Exercises
Exercise #1: The Golf Ball Roll
This exercise helps rejuvenate and regenerate the soft tissue structures (i.e., plantar fascia) on the underside of the foot to eliminate some of the adverse effects of overpronation.
Roll a golf ball back and forth on the underside of your foot on any sore spots for at least 30 seconds to one minute once per day.
Exercise #2: Tennis Ball Around Shoulder Blade
This self-massage exercise reconditions the muscles of the mid-upper back and shoulders to help alleviate back, neck and shoulder pain associated with excessive thoracic kyphosis.
Lay on the floor with your knees bent and head on a pillow. Pull one arm across your chest and place a tennis ball under the shoulder blade of that arm. Find a sore spot and hold to the release tension. Then move the ball gently to another sore spot. Hold for 20-30 seconds on each sore spot. Perform at least once per day.
Note: Do not roll around vigorously when performing this exercise.
Exercise #3: Hip Flexor Stretch
Tight hip flexors can cause the lumbar spine to be pulled toward the top of the leg and the pelvis to drop down and forward (i.e., excessive lumbar lordosis and an anterior pelvic tilt). Stretching the hip flexors enables those structures to move into better alignment, reducing hip and back pain.
Kneel down on one knee and place your other foot in front of you. Lift your torso upright, tuck your pelvis under, and contract your gluteal muscles. You should feel the stretch in the front of your hip and leg of the kneeling side. Perform at least once a day for 30 seconds to one minute on both sides.
Improving your musculoskeletal assessment skills will enable you to develop a keen eye for detecting a client’s most prominent compensation patterns and imbalances. You can then focus your corrective exercise strategies on those areas where a client needs them most to swiftly and effectively alleviate their pain.
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