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Swayback Posture and the Kinetic Chain

Part 1: Upper Body

Posture. Everyone had that one coach that was constantly on them to stand up straight and not slouch. I’ll never get my dance and gymnastics coaches’ voices out of the back of my head hollering at me to keep my shoulders back and to get the arch out of my lower back. As annoying as it was, it turns out they were actually on to something. A lot of the aches and pains our bodies endure daily are caused by strength and flexibility imbalances that naturally occur when we spend a significant amount of time in one position or the same pattern of positions. Sitting at a desk for 40 hours a week with a slouched back, crossed legs, and rounded shoulders followed by sitting in a similarly harmful “couch potato” position for the rest of the time is a common example. People who spend the majority of their time in these positions no doubt have tight hip flexors from having their hips bent (or flexed) in the seated position and tight hamstrings from having their knees bent to place their feet on the ground, tight pectoralis major and minor muscles and serratus anterior from sagging their shoulder blades to come forward, and tight abdominal muscles from bringing their chest toward their belly button as they slouch. This is accompanied by overstretched, and most likely weak, lower trapezius, posterior deltoids, latissimus dorsi, and rhomboids muscles which are responsible for pulling the shoulder blades back, and lengthened lumbar paraspinal extensors from having a constantly curved lower back during a slouch. A “short/tight” muscle is complimented by its opposing “lengthened” muscle. A couple examples are discussed later in this article, but the jist of it is this: our bodies adapt to their current situation, surroundings, and stresses, and they “choose the path of least resistance,” as Brian likes to say.

Our Bodies Adapt
Our bodies are our creation. They’re a direct representation of our priorities, what we consider important and valuable, and of our self-discipline. Athletes understand this more than anybody. The tissues of our bodies (muscle, tendon, ligament, bone) require stimulation in the form of compressive and tensile forces (weightlifting, plyometrics, stretching) to maintain optimum function, and they adapt to different conditions under the stresses to which they’re exposed. However, when we go through the same movement patterns or do the same types of activities over and over and over but don’t balance those patterns with strengthening the opposing muscle groups, or at the very least stretching the overused muscles and having an adequate active recovery plan, strength and flexibility imbalances occur. This leads to poor body alignment and posture. Swayback posture is a result, and great visual example, of how many secondary issues these imbalances can cause.

Imbalances and Compensations
As I mentioned earlier, Brian puts it best by saying our bodies “choose the path of least resistance.” Put simply, our bodies naturally adapt to the postures we spend the most time in and to the activities we spend the majority of our time doing. This chronic posture becomes our new baseline and one could pretend that the body “resets” to this new norm. Since this new position is different from the natural alignment of our body, the tissues are under different length and tension forces, and will pull on their associated bones and joints differently than they were meant to. Brian deals with numerous aches and pains caused by impaired posture that can be attributed to strength and flexibility imbalances from previous injuries that either didn’t completely heal or he has re-injured, from current overuse injuries, and from his daily activities. I’ll use some of those injuries as examples here and others in future articles, but right now let’s start at the very beginning. I say it again: POSTURE.

Swayback Posture
There are four commonly recognized types of posture: kyphosis, lordosis, swayback posture, and flat-back posture. If you look at an individual with swayback posture from the side, you’ll see that their head sits slightly more forward than their shoulder of their shoulders and their upper back looks rounded with an exaggerated curve in between their shoulder blades. This is called thoracic kyphosis, one of two spinal deformities found in swayback posture. This "humpback" can be caused by a combination of factors. Similar to the example of society’s chronic slouching “desk posture” and the imbalances that come about as a result, athletes in certain sports are prone to experience imbalances specific to their sport because of the nature of their training and competitive activities.

The rounded shoulder and upper back position (thoracic kyphosis) seen in swayback posture comes from tight and/or overdeveloped pectoralis major and minor, levator scapulae, and serratus anterior that pull the scapula, or shoulder blades, forward into a protracted position either without sufficient strength, or with too much length/flexibility in the lower trapezius, rhomboids, and latissimus dorsi to counter the force. As I mentioned before, this could be a strength OR flexibility imbalance meaning the muscles pulling the shoulder blade forward could be stronger OR less flexible (tighter) than the muscles in the back. A large enough rounded back from thoracic kyphosis can cause a person's head to naturally bend forward toward the ground making it feel like their looking down all the time. These individuals unconsciously begin to use the muscles on the back of their neck (cervical extensors) to bring their eye level back up to horizontal. Try to slouch in your chair letting your shoulders relax so that you can see them in your peripheral vision. If you alternate back and forth between this slouched position and sitting straight up, even watch yourself do it in the mirror, you’ll notice that your chin follows a natural progression of gliding forward so that it sits more over your chest than your shoulders. This upper body position is common in mixed martial artists who utilize their serratus anterior (known as the “boxer muscle”), levator scapulae, and pectoralis muscles to forcefully pull the shoulder upward and forward to throw a jab, cross, or any type of strike. These muscles are also engaged when both wrestlers and MMA fighters are in the guard position. Both athletes spend a significant amount of time in this position during practice and competition, and consequently these muscles will be stronger than the lower trapezius and rhomboids which work to pull the shoulder back to it’s natural position. Rock climbers are susceptible to this position if they spend more time hanging from holds than staying tight to the wall. Being in a position where you’re hanging from your hands resting on your back muscles like a hammock can cause the middle and lower trapezius in addition to the rhomboids to become overstretched and effectively weak.

Shoulder Impingement

Brian was a wrestler in high school and Muay Thai kickboxer following that. He’s developed swayback posture and it creates a lot of characteristic secondary issues; one of the most chronic being a shoulder impingement. We just discussed how tight pectoralis major and minor, levator scapulae, and serratus anterior pull the scapulae, or shoulder blades, forward in relation to the chest. The altered position of the scapulae, or shoulder blades, causes abnormal and harmful stresses on the surrounding muscles and poor biomechanics in the shoulder joint. An athlete might notice that he can’t move his arm from the side of his body up to his ear or perform an upright row without pain or without using some other movement compensation such as shrugging his shoulder to get his arm up. Remember, our bodies always find the path of least resistance. In early stages, he might also notice a dull ache or clicking sensation while trying to move his arm up and down, and it might cause some difficulty falling asleep and staying asleep. The characteristic sign of a shoulder impingement is a sharp pain when one tries to reach into his back pocket. This is caused by either the supraspinatus tendon or subacromial bursa (a fluid filled sac designed to decrease friction between a bone and muscle or tendon to prevent fraying) becoming pinched against the top and anterior structures of the shoulder when the arm is moved in certain directions. If an athlete experiences these, it’s crucial to see a physical therapist or orthopedic specialist as soon as possible. If left untreated, the condition will only worsen, bringing with it increased joint stiffness, pain, and muscle weakness, and can the issue could possibly end up as a completely torn supraspinatus tendon.

Swayback Posture and the Abdominal Muscles
When you speak with any movement or rehabilitation specialist, you’ll likely hear them discuss how everything in the body is connected through the “kinetic chain.” Simply put, segments of our bodies that are connected to each other impact one another (“the thigh bone’s connected to the hip bone, the hip bone’s connected to the back bone,” you know the song). Dysfunction in one area will inevitably cause some degree of dysfunction in another. Swayback posture is no exception to this rule. Try alternating back and forth between slouching and sitting up straight again. You might notice that when you do this your chest gets closer to your belly button and the curve in your lumbar spine reverses, almost like you’re doing a modified crunch. Through the kinetic chain, thoracic kyphosis (the "humpback")
in the upper body that causes rounded shoulders and a forward head also puts the lumbar portion of the spine in a more flexed and flat position as opposed to the arched “lordotic” position that we consider typical. The upper obliques, upper rectus abdominis, and muscles between the ribs (the intercostals) become shortened (tight) which can negatively impact an athlete’s breathing efficiency and, by the same principle, can cause one’s pelvis to be tilted slightly backward compared to what we consider neutral. No specific injuries are caused solely by our abdominal section being too tight (shortened), however, certain injuries can arise as a result of the lumbar spine and pelvis resting in a chronic unnatural alignment. Soccer players, wrestlers, and mixed martial artists who rely heavily on abdominal and hip strength are susceptible to these types of muscle imbalances.

What To Do

M&B Wellness Solutions offers multiple services to assist you in correcting these strength and flexiblity imbalances, and will help you manage the aches and pains that we may encounter during the process. Whether it’s cold laser therapy, traditional, insurance-based physical therapy, or our PT Squared Program where our physical therapist works together with the highly experienced trainers at iThinkFit to design the perfect plan that will help athletes train through the recovery process, we have what it takes to help athletes recovery quickly and stay at the top of their game.

The best way to start your road to recovery is to see a healthcare professional specializing in movement and rehabilitation who can assess your range of motion, strength, and quality of movement to determine if your pain is due to chronic overuse, from strength and flexibility imbalances, or poor biomechanics. Stop by M&B Wellness Solutions located inside iThinkFit Gym for an evaluation with a licensed physical therapist so we can get you on your way to moving the best you possibly can.

- Michaela Cantral, PT, DPT