Postural alignment is the composite of the positions of all the joints and limbs of the body at any given moment

What is good posture?

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
  • Plumb line from earlobe bisects neck and drops just behind collar bone
  • 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
  • Plumb line slightly behind hip joint and in front of the knee joint
  • Front of the hips relaxed
  • Knees slightly bent, not hyper extended
  • 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 Eye sight – 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


  • Poor support from a pillow and/or bed

Recreational Activities

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

“A body is said to be in a position of equilibrium when there is a balanced distribution of weight and a stable position at each joint. Here the body can suspend ‘easily and freely’- with the best alignment and muscle calibration – therefore minimal effort” (Tobias).

What Typical Poor Postures may look like

Using “classical” postural types as indicators of postural alignment faults can help illustrate the stresses that are applied to the body as a result of changes in muscle strength and length. The following pictures describe the different “classical” static postural positions or types.

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 mobilize stiff joints.
  • Visualization & 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.

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