How Can Physiotherapy Aid Postural Alignment?

What is good posture?

  • Postural alignment is the composite of the positions of all the joints and limbs of the body at any given moment. Optimal postural alignment is a prerequisite for optimal movement function. It allows postural stability – the ability to maintain the position of the body, and specifically the centre of body mass within specific boundaries of space.

What is Optimal Posture alignment?

  • Places minimum stress and strain on the supporting structures of the body while maximizing body efficiency.
  • Is a state of muscular and skeletal balance which protects the body against injury or progressive deformity
  • Is one that allows optimal movement

An Optimal Standing Posture may look like:

  • Tongue on the roof of the mouth, neutral bite, no clenched teeth
  • Plumbline from earlobe bisects neck and drops just behind collarbone
  • Slight convex curve of the neck with no tilt & rotation to one side, chin poke or retraction
  • No Shoulder blade drooping, elevation, movement forward or winging
  • Level collar bones
  • Slight concave curve of the middle back, no big ‘hunch’
  • Slight convex curve of the lower back, no big hollow
  • Minimal muscular effort
  • Even heights of the pelvic crests
  • No big forward or backward tilt of the pelvis
  • Plumbline slightly behind hip joint and in front of the knee joint
  • Front of the hips relaxed
  • Knees slightly bent, not hyperextended
  • Even weight on both feet with weight going down through the arches
  • Relaxed toes, well-maintained arches and feet slightly turned

The Causes of Postural Alteration:

Postural alignment is the end result of the way the body has been used over a prolonged period of time. Abnormal muscle tension and alignment stress alter the compressive loads through bone, discs, ligaments and joints.

Serious Causes

  • Injury, intense pain, fracture

General Causes

  • Poor eyesight – use of bifocals
  • Compensation for an injury
  • Muscular imbalance – weakness and tightness
  • Boney deformity – leg length difference

Emotional and physical tension

Emotional and physical tension can often manifest as muscles being held tightly, teeth clenching, raised shoulders

General Health

  • Obesity
  • Pregnancy
  • Post-surgical, de-conditioning


  • Prolonged periods of sitting in front of a computer, in a car and standing.
  • Repetitive movements: i.e. Factory or line workers.


  • Poor support from a pillow and/or bed

Recreational Activities

  • Do you do a lot of a particular sport e.g. sailing, chess

How a physio can help

  • Awareness of poor postural habits
  • Inhibit poor postural habits
  • Develop conscious control to replace old habits
  • Ensure integration into daily activities and movements

A Physiotherapy Assessment of Postural Alignment may include:

  • Static Plumb line alignment in sitting and standing
  • Muscle length and strength
  • Joint stiffness
  • Posture in recreational and work situations eg. on a bike or at a desk

A Physiotherapist may Facilitate Optimal Alignment with:

  • Verbal Instruction & Education
  • Optimal postures in lying, sitting, standing, work situations
  • Tactile Input and Handling
  • Correction and Connection
  • The Position of the head and neck influences the control of posture. By focusing ahead instead of down, will give the body an extra lift
  • Ergonomic Assessment & Correction: Advice on the best office furniture and set up, bed and pillow for you
  • Advice about when and how to change postures during your day
  • An individual exercise program that addresses your weak and tight muscles that support your trunk, and exercises to mobilise stiff joints.
  • Visualisation & Relaxation Training will help you understand the factors that precipitate poor posture, the response your body has to this stressor, and to then enable you to take action.

If you need help with postural alignment, call PCA today on 0813 208 0496!

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