Learn How To:
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Evaluate postural alignment and its role in back
health.
Assess static and dynamic postural alignment.
Identify common postural imbalances and
design exercises that address common muscle
imbalances associated with postural
dysfunction.
Design and implement a 30 minute “Better
Backs” training session with little to no
equipment.
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“It is your power
foundation- a
stacked framework
from your feet
through your legs,
hips, spine and
shoulders to your
head”. Lee Parore
(Power Posture).
The neutral position
from which all
movement arises…
or the keyboard on
which your brain
orchestrates
movement.
 Alignment
that
optimizes the
spine’s natural
curves, with
each part
adding to
whole body
movement.
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Posture or position of
greatest efficiency, around
your center of gravity, with
muscles on all sides,
exerting pull.
A balanced lumbar curve–
the position in which the
lumbar spine and the pelvis
are best aligned to receive
the weight of the trunk with
minimal joint stress.
When lumbar curve is
balanced you transfer
forces between your upper
and lower body with ease.
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Powerful movements
depend on every part of the
spine being strong.
The spine coordinates
whole body power via
proper execution of
movements or exercises.
Perfect posture pays
dividends- by reducing
stress/loads which leads to
tension in the antigravity
musculature, degeneration
of weight bearing
structures, less efficient
movement, misalignment
and risk for injury.
More specifically:
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Cervical spine gives your
head freedom of
movement,
Thoracic allows rotation
of your torso,
Lumbar spines provides
stability,
Sacrum provides the base
for your spine to sit on.
Sacroiliac joints act as a
pivotal axes allowing
movement integration
between your legs, pelvis
and spine.
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Aging- your body gradually loses its capacity to absorb and
transfer forces however its not aging that influences posture
as does:
Inactivity/sedentary living/reluctance to exercise -leads to
loss of natural movement flow,
Poor postural habits -eventually becomes your structure,
Biomechanical compensation → muscle imbalance, adaptive
shortening, muscle weakness & instability within the “core”,
Body composition – increases load, stresses on spinal
structure, leads to spinal deviation,
Workspace –ergonomics,
Poor movement technique/execution/training ,
Injury -leads to reduced loading capacity or elasticity,
Others:
*Posture is the single most common cause of painful soft tissue
syndromes affecting the body!
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Your core muscles—comprised of the abdominal and back
muscles- act like that of a corset to hold everything in or
support and stabilize your lumbar spine.
The result is a slimmer shape, and more importantly, a
spine that is supported against strain, pain and injury.
The core “corset” also functions: to move the trunk in all
directions—flexion (forward and laterally/sideways),
extension and rotation/twisting.
These core muscles must remain strong throughout our
lives to allow us to continue to move the way our bodies
are meant to as well as help balance on one leg.
To build a functionally strong back—a better back for life
you must first address posture in the context of fitness
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Fitness professionals should limit their
observations and assessments to general
screenings.
Specific posture and muscle dysfunction work
is limited to addressing strength and
flexibility exercise and muscle re-education
that will help offset poor postural habits both
in sitting and while moving.
Diagnosing and prescribing corrective
exercise may be seen as outside the fitness
professional’s scope of practice.
Alignment
May be tight
May be weak
Exercises
Mid back flexion
Upper abdominals
Thoracic extensors
Mid and lower trapezius
Active & passive
thoracic extension
Protracted scapulae
Serratus anterior
Shoulder adductors
Shoulder internal
rotators
Mid & lower trapezius
Rhomboids
Stretch Serratus
Stretch Pectoralis minor
Narrowed intercostal
spaces
Intercostals
Titled scapulae
Pectoralis minor
Lower trapezius
Stretch Pectoralis major
Stretch Latissimus dorsi
Elevated scapulae
Upper trapezius
Levator scapulae
Lower trapezius
Strengthen Middle &
lower trapezius
Stretch Upper traps &
Levator
Extreme neck
extension’
(Hyperextension)
Long Cervical
Extensors
Short neck flexors
Strengthen neck flexors
Deep breathing
Multifidus
Quadratus lumborum
Alignment May be
tight
May be
weak
Exercises
Anterior tilt
Abdominals
Stretch hip flexors
Strengthen obliques
for stabilization
Avoid full sit ups
Hip extensors
Strengthen
gluteals
Hip flexors
Hip flexion
Extreme low
Low back
back extension
extensors
(hyperextension)
Stretch low back
extensors
Alignment May be
tight
Posterior Pelvic
tilt
May be
weak
Hamstrings
Exercises
Stretch
hamstrings
Low back
flexion
Back extensors
Strengthen back
extensors
Hip extension
Hip flexors
Strengthen hip
flexors
Alignment
May be tight
May be weak
Exercises
Posterior pelvic tilt
Hamstrings
Hip flexors
Stretch hamstrings
Strengthen hip flexors
Long kyphosis
Upper abdominals
External obliques
Upper back extensors
Strengthen upper back
extensors
Stretch and strengthen
abdominals
Narrowed intercostal
spaces
Intercostals
Deep breathing
Hip extension
Extreme neck extension
(Hyperextension)
Extreme knee extension
(Hyperextension)
Strengthen hip flexors
Upper trapezius
Levator scapulae
High cervical extensors
Neck flexors
Stretch upper traps &
levator, strengthen mid
& lower traps,
strengthen neck flexors
Hamstrings
Calf
Strengthen hamstrings
and calf
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Static Postural Assessment
Dynamic Postural Assessment
Gait analysis
Flexibility assessment
Muscle testing
Once postural alignment is assessed the focus
should be on teaching and training “Neutral
Spine”
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Standing on both feet: front, side and rear
views
Standing on one leg
Sitting supported and unsupported
Kneeling
Supine
Sleeping
Performing:
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A push- up
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A squat- with arms in front, lifting overhead
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A lunge
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Walking
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Lifting
5 Stage Program:
 1. Develop corrective patterns; build basic
patterns through to complex activity specific
patterns
 2. Build whole body and joint stability
 3. Increase endurance
 4. Build strength and stamina
 5. Develop speed, power and agility.
Do
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Encourage daily exercise for spinal stability and mobility
even with individuals who have a healthy back,
Include cardiovascular training into back exercise
programs—they are ideal for preventing and managing
back pain,
Carefully evaluate and select exercise dosage—light
weight/load and greater repetition for enhancing
endurance strength,
Focus and encourage quality of movement versus quantity
and,
Increase range of motion to achieve and maintain neutral
spine or ideal posture.
“Brace” vs. “Hollowing” technique.
Don’t
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Impose high loads (of resistance) in an attempt to gain strength
Avoid traditional curl ups that encourage flattening the lower
spine (lumbar region) into the floor by modifying the exercise as
described below or selecting alternative ways to target
abdominals,
Exercise into positions or with loads that produce or increase
pain (even in programs that advocate benefits ie yoga, Pilates),
Perform range of motion exercises early morning if you suffer
low back pain because disk hydration is at its greatest and
compressive forces on the disks will be increased,
Exceed the capacity or tolerance of the individual: reduce the
number of sessions to 2-3 brief sessions per day vs longer
sessions at a time,
Stop exercising altogether but instead modify activity and,
Diagnose or prescribe therapeutic or rehabilitative exercise.
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STANDING WITH STAB BALL AT THORACIC SPINE- CHIN GLIDES AND
SCAPULAR RETRACTIONS
SQUATS with progression (WALL SQUAT WITH STABILITY BALL, FRONT
BODY SQUATS)
SEATED ROW/LAT PULLS/SUPINE PULLOVERS/PRONE SHOULDER
FLEXION (neutral spine)
DEADLIFTS
4 POINT KNEELING OR PRONE ALTERNATE ARM AND LEG LIFT
V-SIT with variations
SIDE LYING DOUBLE LEG LIFT/STANDING HIP ABDUCTION (with
variations)
SIDE LYING/SITTING LATERAL TRUNCK FLEXION
PRONE PLANK/HOVER (with scapular stability)
HIP BRIDGE (SUPINE, SIDE) with variations
MODIFIED ABDOMINAL CURL UP with focus on maintaining neutral
spine (balloon) and progressions (SUPINE CROSS CRAWL/AB CYCLE)
PRONE BACK EXTENSION (both lumbar and thoracic regions)
PRONE EXT PRESS UP
SEATED/STANDING SHOULDER PRESS
*Emphasis is on leveling and stabilizing the scapulae & pelvis.
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SUPINE/STANDING STRAIGHT LEG HAMSTRING stretch- with
neutral spine
PRONE QUADRICEP stretch (with hip extension and
adduction)
LOW LUNGE with lateral body opposing stretch(psoas
muscle)
PRONE EXTENSION PRESS UP
SUPINE SPINAL ROTATION with alternate upper body rotation
SUPINE INNER THIGH STRETCH (at the wall)
FIGURE 4 STRETCH (standing or floor)
SEATED OR STANDING ANTERIOR SHOULDER/CHEST (WITH
EXTERNAL ROTATION) stretch
CALF stretch
SITTING LATERAL FLEXION (against wall with hands behind
head)
STANDING ITB/QUADRATUS LUMBORUM
FIGURE 8 STRETCH (upper body)
Stretch big to small, breathe and maintain for 30-60 seconds
Bend and Lift Power-bend your knees, pull navel in,
maintain your lumbar curve, hold your breath and push with
your legs to initiate lifting.
Twisting-
allow your hips to steer, rotate through your
hips, engage your abdominals, twist between your shoulder
blades and move your eyes.
Leg Power-
push the ground with your feet, keep your
knees aligned and engage your abdominals and your butt.
Pushing Power-
keep your elbows in front of your
shoulders, your tongue on the roof of your mouth, engage
your abdominals and push with legs.
Learn correct movement in a slow and meaningful manner,
then add rhythm and speed.
Train specifically for movement that you wish to become more
powerful in performing (increase by 20%).
Integration “Push Test”
It’s all about Whole Body
Integration/Movement
springing and flowing from
your power center.
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Eisenman, Rachel, MS “Posture 101”. ACE Certified News,
February-March, 2007
Hagan, Maureen, “FIT-iology- the Study of Fitness In
Action”, Volumes I (Lessons 9 & 10) & I (Lesson 24)
Volumes Publishing. Go to www.mohagan.com
Florence Peterson Kendall “Muscle Testing and Function”
4th Edition- Williams & Wilkins 1993
McGill, Stuart, “Low Back Disorders-Evidence Based
Prevention and Rehabilitation, Human Kinetics
McGill, Stuart, “Ultimate Back Fitness and Performance”,
3rd Edition, Human Kinetics
Parore, Lee, “Power Posture- The Foundation of Strength”,
Apple Publishing
www.nasm.org for BodyMap to assist postural/body
assessments