Postural deviations commonly begin in childhood but can also be brought on by an imbalance in the strength of opposing muscle groups. If they are left undetected, they will generally lead to bigger problems. Head tilt, shoulder tilt, hip tilt and forward head are common signals of postural deviation in adults. These can lead to shoulder humps and a hunched-over posture in older adults. The underlying concern of posture can be a lad of balance, muscle pain and skeletal stress.

Some studies have shown that over 97% of adults have some type of postural deviation that should be corrected.

Postural deviations, including forward head, forward shoulders (scapular protraction), humeral internal rotation, and increased thoracic kyphosis, have been implicated in the development of shoulder pain.

There is a relationship between postural deviations and many shoulder, neck and back pain syndromes. This is due to the theory that prolonged postural changes will cause the adaptation of soft tissues. This means that muscle tissue will lengthen or shorten inappropriately and can lead to pain.

The three most common types of postural deviations are “Forward Head,” “Protracted Shoulder Girdle,” and “Anterior Pelvic Tilt.”

Forward Head Posture

Forward head posture (FHP) is shown by a curve in the neck which causes the head to thrust forward to the shoulder, rather than the vertical ideal. The ideal posture is known as the “plumb line posture” where the head is more in line with the shoulder. The forward head posture can be in a slight, moderate or marked degree. Some studies debate as to whether this is a pathological condition or simply a variation found in the normal population. However, through supervised stretching and strengthening exercises, it can be corrected. One should exercise great causing though, as the neck can be very delicate and prone to injury and muscle spasm.

Protracted Shoulder Girdle

In time, this condition causes inflammation, nerve compression, lack of nutrient delivery, and if left untreated can even cause severe problems. An extreme example is nerve and vessel compression in the shoulder joint, which has been known to cause Brachial Amyotrophic Diplegia. This can eventually result in respiratory failure. Though uncommon, it is an example of how a simple posture problem can spread to other systems of your body. An internally rotated humerus can lead to inflammation and even node compression and immune dysfunction.

Anterior Pelvic Tilt

This is commonly indicated when the butt is arched high, causing a misalignment at the pelvis. Your chest position effects your pelvic position. The Thoracic Cage is roughly the area from your shoulders to the bottom of your ribs, and movement here causes a muscular chain reaction all the way down to your pelvis. The stability of this area is governed by many muscles, including the internal/external obliques, the lats, the transversus abdominus, and the deep muscles on the spine.

A pelvic tilt will cause the muscles of the lower limb to compensate and the knee starts to turn inward during standing, walking and squatting.

Excessive anterior pelvic tilt can be caused by seated jobs, faulty abdominal training or poor muscle balance. It can cause dysfunction in the lower extremities, lower back pain, incontinence, and abdominal distention.It is caused by weak glutes, hamstrings and abs along with tight hip flexors and quads.

All of the postural deviations can be alleviated through stretching and targeted muscle strength training.  A qualified pilates instructor can help correct, strengthen and balance these postural deviations utilizing pilates exercises similar to physical therapy to address the postural deviations in all ages.