Michael Phelps and rounded shoulders and swimmer's shoulder.

Michael Phelps’ Forward Head Posture and Swimmer’s Shoulder

Swimmer’s shoulder can include several different pathologies, including rotator cuff tendinitis, shoulder instability, and shoulder impingement.

Figure 13. The Backward Stretch on the Ladder Barrel Pilates Apparatus Exercise. Permission Simona Cipriani. The Art of Control Pilates Studio, Stamford, CT, USA.

How Pilates Can Treat Thoracic Hyperkyphosis, also known as Rounded Back

When a client presents with thoracic hyperkyphosis (rounded back), there are many approaches for how Pilates can treat thoracic hyperkyphosis. And for each of these approaches, many Pilates exercises can be utilized. Before addressing these approaches, let’s briefly review thoracic hyperkyphosis…

Upper and Lower Crossed Syndromes. Permission Joseph E. Muscolino. Artwork: Giovanni Rimasti.

Thoracic Hyperkyphosis – The Critical Component of Upper Crossed Syndrome

For most of our clients who present with the postural distortion pattern known as upper crossed syndrome, it is important, perhaps absolutely necessary, to include thoracic spinal joint mobilization technique into extension as part of the treatment plan to address the thoracic hyperkyphosis.

brain-3168269_1280 - pain neuroscience

How Can Tight Hip Flexors Give You a Headache?

Tight hip flexor musculature causes excessive anterior tilt of the pelvis… hyperlordosis of the lumbar spine… hyperkyphosis of the thoracic spine… hypolordosis of the lower neck with hyperextension of the head at the atlanto-occipital joint… forward head carriage… tight posterior neck muscles… headache.

Shoulder Impingement Syndrome. Permission Joseph E. Muscolino. Kinesiology - The Skeletal System and Muscle Function, 3ed (Elsevier, 2017).

Six Causes of Shoulder Impingement Syndrome – Part 1

Shoulder impingement syndrome is a condition in which the distal tendon of the supraspinatus and the subacromial bursa become impinged between the head of the humerus and the acromion process of the scapula. Following are the six major causes of shoulder impingement syndrome.

Forward Head Posture. Permission Joseph E. Muscolino. Manual Therapy for the Low Back and Pelvis - A Clinical Orthopedic Approach (2013).

Deep Pressure Massage to the Low Back – Forward Head Posture

The neck and head do not contribute to the generation of pressure, so head and neck posture should be whatever is most comfortable and least stressful. Forward head posture, a common postural distortion imbalance pattern that occurs is caused by a flexion of the head and neck.

How do we Treat Upper Crossed Syndrome with Manual Therapy?

Especially effective for the pectoralis musculature is to use pin and stretch technique. With the client/patient supine and positioned toward the side of the table, pin the musculature with your finger pads as you bring the client/patient’s abducted arm off the side of the table and down into horizontal extension.

Signs, Symptoms, and Assessment of Upper Crossed Syndrome

The first and most obvious sign of upper crossed syndrome (named by Vladimir Janda) is the characteristic postural dysfunction of protracted scapulae, medially (internally) rotated humeri, hyperkyphotic (overly flexed) upper thoracic spine, and a protracted (anteriorly held) head.

Suggested postures for smart phone use.

The Price of Smart Phones – Ten Conditions Caused by Smart Phone Use

Following are ten of the most common dysfunctional postural patterns and injuries that may occur with smart phone (cell/mobile phone) use.

A thorough assessment should be performed for all clients presenting with neck injury/pain, such as after a whiplash accident pictured here

Assessment and Treatment of Specific Musculoskeletal Conditions of the Neck

This blog post introduces and explains how the manual therapist can perform assessment and treatment for specific musculoskeletal conditions of the neck.

tight neck extensor musculature can cause tension headaches

Tension Headaches

A tension headache is caused by excessive pulling force of tight muscles in the back of the neck that exert tension on their attachments on the head.

extension mobilization stretch for the thoracic spine on an exercise ball

The Thoracic Spine… The Silent Saboteur

There is an old saying that no posture is bad unless you get stuck in it. The problem is that the thoracic spine often does get stuck in bad posture.

Locked short muscles / locked long muscles in upper crossed syndrome and lower crossed syndrome

Locked Short Muscles – Locked Long Muscles

Two opposing muscle groups, the “facilitated” muscles that are locked short and the “inhibited” muscles that are locked long.