PT on the Net Research

Postural Deviations


Question:

If a person has postural deviations, how would one structure a safe and effective exercise program for that person? What do you suggest if that person has scoliosis? My mother is 52 years old, has a severely curved spine and wants to work out in the gym using weights. What would be a safe starting point?

Answer:

Postural deviations and exercise: The definition of posture can be easy or complex, depending on one's background. Generally, the more someone studies posture, the more complex the definition becomes. A great starting point is to purchase the book Muscle Testing and Function by Florance Kendall (1993, Williams & Wilkins). This book will show and describe deviations, along with possible exercises to help correct the misalignments.

Professional Tip: Posture analysis is an ideal screening test. It can give an initial impression on various key muscle imbalances that can later be confirmed with specific tests. As you study and practice, your ability to assess will grow! Never look for black and white answers, always use text books as guidelines that can be manipulated based on your client's goals, wants, needs and functional abilities.

As for your mom, as well as other clients, here are some pointers to get you started while waiting for your study material:

  1. Find neutral! This is the position in which the spine is best equipped to deal with intrinsic and extrinsic forces. First strengthen neutral! Note: Every person has an individual neutral; it is the position between the extremes.
  2. Teach your clients to maintain proper posture in front of a mirror. This will help them to identify their ideal position. Then, remind your clients to perform posture checks throughout the day. Have them watch others, this may remind them to maintain good posture.
  3. To counter the damaging effects of constant sitting, vary from sitting to standing as much as possible. Standing places less stress on passive structures (bones, joints, ligaments) compared to sitting.
  4. Weakness or inflexibility of hip muscles that attach to the pelvis may alter the alignment of the lumbo-pelvis hip complex. Seek an exercise program that includes flexibility training for the hip musculature. Note: There are many length-tension assessments in the book Muscle Testing and Function. Relaxing the right muscles is key!
  5. Utilize the right abdominal exercises! Refer to Paul Chek's article on The Inner Unit. This article will be EXTREMELY useful. At first, stay away from traditional trunk curls and apply active stabilization training.
  6. Teach your client to concentrate on posture and moving in perfect alignment while walking.
  7. Design exercises that train the natural coordination and rhythm between the shoulder and shoulder girdle - while the core is in control.
  8. Teach your client to correctly perform back extension exercises. Too many positions in life are flexion related - just look at the average computer posture!
  9. Consider alternative exercise programs and bodywork: Pilates, yoga, massage and neuromuscular therapy.
  10. When in doubt, refer out!