Postural

Postural Guide

Abdominal muscles weak: quadratus lumborum

Antalgic gait: piriformis, gluteus medius, gluteus minimus, tensor fasciae latae,

pectineus, adductor group

Anterior head position: sternocleidomastoid, trapezius, levator scapulae, scalene

muscles, masseter

Arms, short upper arms: quadratus lumborum, hamstrings, scalene muscles

Atrophy of gluteal muscles: piriformis

Back

chronic low back pain: semimembranosus, semitendinosus

flattened lumbar curve with scoliosis: quadratus lumborum (on concave

side)

flexion and extension restricted: quadratus lumborum

side-bending restricted: quadratus lumborum

Bent forward at hip, can’t lean back: quadratus lumborum, tensor fasciae latae

Breasts, heavy: trapezius

Breathing:

restriction, in association with round-shouldered posture: pectoralis major,

serratus anterior, diaphragm, intercostal muscles

mouth breathing: masseter

shallow rather than abdominal: serratus anterior, scalene muscles,

sternocleidomastoid, diaphragm, intercostal, rectus abdominis,

external and internal obliques

Bursitis of biceps femoris, semimembranosus, or anserine bursa: hamstrings

Cervical flattening (loss of curve):

due to posture: sternocleidomastoid, scalene muscles, deep anterior cervical

muscles

due to whiplash: sternocleidomastoid, scalene muscles, trapezius, levator

scapulae, pectoralis major and minor, jaw muscles, deep anterior

cervical muscles, deep and superficial spinal muscles of posterior neck

and upper back

Elbows unsupported while working with arms held out in front: trapezius; while

also leaning forward over desk to read or see computer: quadratus

lumborum

Face tilted up: posterior cervical muscles

Foot:

bunion: flexor hallucis longus, peroneal muscles, Morton’s foot structure

calluses: Morton’s foot structure

dorsiflexion weak: tibialis anterior

foot drop during swing phase of step: piriformis, tibialis anterior, extensor

digitorum longus

high arch, supinated foot: flexor digitorum longus, flexor hallucis longus

hyperpronation: quadratus plantae, flexor hallucis brevis, adductor hallucis,

flexor digiti minimi brevis, interossei

muscle imbalances and articular dysfunctions may lead to problems in

the knee, hip, pelvis and spine

pronation or “flat feet:” tibialis posterior, gluteus medius, piriformis, vastus

medialis, popliteus, tibialis anterior, flexor digitorum longus, flexor

hallucis longus, Morton’s foot structure (see below, “Morton’s foot

structure”); effects in upper body: levator scapulae

reduced dorsiflexion: gastrocnemius, soleus, flexor digitorum longus, flexor

hallucis longus

toed out: iliopsoas, tibialis posterior

Gait:

ankle weakness: tibialis anterior

antalgic or awkward gait: piriformis, gluteus medius, gluteus minimus, tensor

fasciae latae, pectineus, extensor digitorum brevis, extensor hallucis

brevis, abductor hallucis, abductor digiti minimi, flexor digitorum

brevis

foot drop or dragging during swing phase of step: piriformis, tibialis anterior

foot slap, after heel strike of step: tibialis anterior, long extensors of the toes

hiking hip to clear foot from floor or ground (can’t bend knee, difficult to

climb stairs): vastus intermedius

limping: hamstrings (cause), scalenes (result)

stiff-legged, without bending one knee normally, indicating locked patella:

vastus lateralis

toed-out with possible knee buckling: vastus medialis, Morton’s foot

structure

Hamstrings excessively tight: quadriceps femoris, hamstrings

Head forward:

check for trigger points in: hamstrings

neck and head pain: sternocleidomastoid, trapezius, levator scapulae,

scalene muscles, splenius cervicis, suboccipital muscles, masseter,

temporalis, medial pterygoid, lateral pterygoid, suprahyoid group,

infrahyoid group, longus colli, longus capitis

rotation or side-bending restricted: levator scapulae, posterior cervical

muscles

stiff, lack of natural bobbing and nodding while talking: posterior cervical

muscles

strengthen: deep flexors of the neck

tilted to one side: sternocleidomastoid

with thoracic kyphosis: gluteus maximus, longissimus, iliocostalis

Imbalanced posture: “Tightness of the iliopsoas and hamstring muscles can also

seriously disrupt balanced posture.” VII P544

Knee:

bent, cannot straighten: vastus intermedius

locked (“stuck” patella): vastus lateralis

Kyphosis: gluteus maximus, gluteus medius

Lateral rotation of the leg: gluteus medius, gluteus minimus, piriformis, gemelli,

obturator quadratus

Leaning to one side: iliopsoas

Leaning over low sink or work surface: quadratus lumborum

Leg length inequality: quadratus lumborum, gluteus maximus, gluteus medius,

gluteus minimus, piriformis, pectineus, hamstrings, soleus, iliopsoas,

iliocostalis, external oblique, latissimus dorsi, trapezius, levator scapulae,

scalene muscles (“Tightness of both the iliopsoas and hamstring muscles can

also seriously disrupt balanced posture.” VII P544)

Leg “spiraling,” medially rotated, with pronation or toeing out of the foot: tibialis

posterior

Limping due to hip pain: gluteus minimus

Lumbar lordosis, excessive: tensor fasciae latae

Lying supine causes pain in hip: quadratus lumborum (if due to small hemipelvis,

small hip lift helpful)

Military posture: rhomboid muscles

Morton foot structure: peroneus longus, peroneus brevis, abductor hallucis,

adductor hallucis, flexor hallucis brevis, abductor digiti minimi, tibialis

posterior, flexor digitorum longus, flexor hallucis longus, vastus medialis,

sartorius, tensor fasciae latae, piriformis, gluteus medius, trapezius, scalene

muscles, sternocleidomastoid, masseter

Overweight:

sore feet: flexor digiti minimi brevis

waddling: gluteus medius

Pelvis:

anterior tilt (exaggerated curve in low back): psoas, tensor fasciae latae

posterior tilt (flattened curve in low back): piriformis, hamstrings, iliopsoas

small hemipelvis: quadratus lumborum, pectineus, hamstrings, scalene

muscles – must be others

twisted: deep and superficial spinal muscles

Pregnancy:

low back ache: gluteus medius

sore feet: flexor digiti minimi brevis

Rounded shoulders: pectoralis major and minor, serratus anterior, supraspinatus,

infraspinatus, teres minor, subscapularis, sternocleidomastoid, scalene

muscles, trapezius, diaphragm, intercostals, abdominals, rhomboid muscles

Sacroiliac joint:

pain: rectus abdominis

joint displacement: gluteus minimus, piriformis

Scoliosis:

lateral curvature of the spine: quadratus lumborum, gluteus medius,

gluteus minimus, iliopsoas, iliocostalis, external oblique, latissimus

dorsi, sternocleidomastoid

lumbar fixed scoliosis: quadratus lumborum

spiral twist in spine right or left: sternocleidomastoid, levator scapulae

Short arms tend to cause trigger points in: quadratus lumborum, trapezius

Short leg tends to cause trigger points in: quadratus lumborum, piriformis, tensor

fasciae latae, peroneus longus, peroneus brevis, sternocleidomastoid

Shoulder blades “winging,” sticking out in back: trapezius (point 3), pectoralis

minor

Shoulders:

difficulty pulling shoulders back: serratus anterior

high: trapezius, levator scapulae, rhomboid muscles, posterior cervical muscles

low: latissimus dorsi, lower pectoralis major

rounded and forward: lower trapezius, pectoralis major, pectoralis minor,

rhomboid muscles, supraspinatus, infraspinatus, teres minor, subscapularis,

scalene muscles, sternocleidomastoid, diaphragm, intercostals,

abdominals

scapula sticking out: trapezius (point 3), pectoralis minor

Sitting:

armrests too high or too low: trapezius, levator scapulae

excessively: abdominals, iliopsoas, gluteus maximus, gluteus medius, gluteus

minimus, piriformis, rectus femoris, pectineus, biceps femoris,

semitendinosus, semimembranosus

in recliner or with foot stool (compresses back of legs): gastrocnemius,

soleus

knee extended for prolonged period (as on an ottoman): vastus lateralis

knees up (jackknife position, as in a bucket seat): sartorius, gluteus medius

legs crossed: pectineus, peroneus longus, peroneus brevis

head thrust forward: sternocleidomastoid, trapezius, levator scapulae,

scalene muscles

sitting causes pain in hip: quadratus lumborum (due to small hemipelvis)

painful to stand after sitting: gluteus minimus, gluteus medius

pressure from chair against backs of thighs: semimembranosus,

semitendinosus, gastrocnemius

slouching (sitting back on tail bone): sternocleidomastoid, trapezius, levator

scapulae, scalene muscles, intrapelvic muscles, gluteus maximus,

gluteus medius, levator ani

stiffness from sitting after overuse walking, running or climbing: tensor

fasciae latae

twisted to work on computer: sternocleidomastoid, levator scapulae

uncomfortable: intrapelvic muscles, gluteus maximus, gluteus medius,

piriformis

wallet in back pocket: gluteus minimus

Sleeping:

knees up: tensor fasciae latae, sartorius

on side: levator scapulae

on stomach: sternocleidomastoid

toes pointed: peroneus longus, peroneus brevis, gastrocnemius

Slouching in chair (sitting back on tail bone): sternocleidomastoid, trapezius, levator

scapulae, scalene muscles, intrapelvic muscles,

Slouching, slumping, or lazy standing posture:

upper torso: lower trapezius, pectoralis major, pectoralis minor, intercostals,

abdominals, diaphragm, supraspinatus, infraspinatus, teres minor,

subscapularis, rhomboid muscles, scalene muscles, sternocleidomastoid,

levator scapulae, splenius cervicis, masseter, pterygoids, occipitals

lower body: iliocostalis, longissimus, quadratus lumborum, gluteus maximus,

gluteus medius

Spinal disk problems, nerve compression in association with round-shouldered

posture: pectoralis major, iliopsoas

Splay-footed (toes turned outward): iliopsoas, Morton’s foot structure

Standing:

all weight on one foot (likely short leg): quadratus lumborum, gluteus medius

difficult: iliopsoas

difficulty pulling shoulder back to stand straight: serratus anterior

Stiff neck (turns body to look around): upper trapezius, levator scapulae

Stooped posture (bent forward): iliopsoas

Temporomandibular joint disorder: masseter, medial pterygoid, temporalis

Whiplash, hyperextension-flexion strain or injury, or acceleration-deceleration injury: sternocleidomastoid, scalene muscles, trapezius, levator scapulae, splenius capitis, splenius cervicis, pectoralis minor, pectoralis major, masseter, temporalis, suprahyoid group, infrahyoid group, longus colli, longus capitis, semispinalis capitis, deep and superficial spinal muscles of posterior neck and upper back, abdominal muscles