Your Posture Isn’t Broken – It’s Just a Shape

'This muscle is tight.' 'This muscle is weak.' 'Your shoulders are rounded.' 'You have an anterior pelvic tilt.'

We've all said some version of this. I certainly have. For years, I built parts of sessions around what I saw when a client walked in - the position of their shoulders, the curve of their spine, the tilt of their pelvis.

Until I started asking a different question: what am I actually seeing?

What Are We Looking At?

When you look at someone's posture, you're looking at the outside. Shape. Position. A snapshot of how they happen to be standing in that moment.

But what's creating that shape?

The same rounded shoulders could be structural - how their ribcage developed, where their scapulae naturally sit. It could be habitual - years at a desk. It could be protective - the body guarding against pain that may or may not still be there. It could be emotional. Fatigue. What we are looking at could simply be their normal. How would you know which one you're looking at?

We're seeing the outside and guessing the inside.

And how well does that work? When forty-eight physical therapists assessed lumbar lordosis from photographs and their assessments were compared against radiographs, the accuracy was 9%. 2

Trained professionals. Nine percent accuracy. Now think about everything else we assess visually.

Think about the landmarks we rely on. ASIS, PSIS - approximately 1.5cm of surface area. Our ability to read what's underneath is influenced by glute size, tissue thickness, fat distribution - all of which vary enormously between people. And what if the shape of the ASIS and PSIS is different between people? Can we really palpate a 10mm difference through all of that?

What are we actually basing our programming decisions on?

What Happens When You Ask Them to Change It?

Here's a question I keep coming back to.

If you ask someone to stand taller and they can - if you ask them to pull their shoulders back and they do - are they actually as tight or as weak as you assumed?

If they can achieve the position, the limitation isn't structural. It's not a strength deficit. Something else is going on. Habit. Comfort. Attention. Fear.

I had a client with back pain. Surgical candidate who recovered fully - no longer had structural issues. But he was fixated on 'perfect posture'. Rigid. Fearful of any spinal flexion. His problem wasn't his posture. It was his relationship with it. The fix wasn't corrective exercise. It was gradually reintroducing variability into his movement, through graded exposure.

The industry default is familiar. Observe a posture. Label muscles as tight or weak. Prescribe stretches and strengthening accordingly. But how often do we check whether that story holds up? How do you actually know your client has tight hip flexors? And if the exercises you prescribe after the assessment were going to be the same regardless of what you found - what was the assessment for?

What If It's Not a Problem?

Lordosis and kyphosis are names of shapes. Saying someone has a kyphotic thoracic spine is an accurate description - it doesn't tell you whether that's good or bad. It's geometry, not pathology.

Every person in front of you has reasons for how they stand. Structure, habit, emotion, pain, protection. The question isn't 'what's wrong with their posture?' It's 'what's influencing it?' And then: does it actually need to change?

Your question: Next time you notice something about a client's posture, before deciding what to do about it - ask them to change it. If they can, what does that tell you about what's actually going on?