1. By Joshua Mayer, Rickey Blake and Sarah Hoover

2.  Head is shifted
0.23” to the right
 Right shoulder
elevated
 Shoulders are
shifted 0.37” to
the right
 Right arm
appears longer

3. Head is shifted
1.17” forward
 Effectively making
head weigh 29.7 lb
Shoulder’s
protracted
Hips posteriorly
tilted
Knees are shifted
2.80” forward

5.  Forward head posture
 Increasing lordosis of cervical spine
 Protracted shoulder girdle (right )
 Pelvis is posteriorly rotated
Decreasing lordosis of lumbar spine

6. Upper Trapezius (right)
Levator Scapulae (right)
Pectoralis Major and Minor
(right)
Hamstrings
 Pulling pelvis posteriorly
Janda’s Muscle Imbalance
Upper Cross Syndrome

7. Neck flexors
Rhomboids
Serratus Anterior
Middle and
lower trapezius
Iliopsoas
Janda’s Muscle Imbalance
Upper Cross Syndrome

8. • Upper
Trapezius is too
tight
• Lower
Trapezius and
Serratus
Anterior are
over-stretched
• Poor upward
rotation during
shoulder
flexion
• Upper
Trapezius
stretched
• Lower
Trapezius and
Serratus
Anterior
strengthened
• Healthy
scapular ROM
restored

9. Decrease lordosis of cervical spine
Retract and depress pectoral girdle (right)
Increase lordosis of lumbar spine (not too
much!)
Restore more favorable center of gravity
 Decrease external forces

10.  To stretch levator
scapulae (and upper trap)
 Stabilize shoulder (hold
onto chair)
 Laterally flex the head
to the contralateral side
(hold here to stretch
upper trap)
 Rotation of the neck
(Look down like you are
looking in your pocket)
▪ Stretches levator
scapulae

11. This would be beneficial because:
 Stretching the upper trapezius and levator
scapulae muscles will help to depress the resting
position of the right shoulder back to normal

12.  Stand in the center of an
open doorway placing arm
next to doorjamb
 Step forward with ipsilateral
leg and rotate to the
contralateral side (in this
case to the left, stretching
the right shoulder)
 Keep your hips facing
forward while the shoulder
is rotating back to maximize
the stretch

13.  This stretch will lengthen the tight pectoralis
major and minor muscles
 This will help to get rid of forward rolled shoulder
 Retract the resting right shoulder posture
 By stretching these overly tight shoulder muscles will
help to fix and further prevent a protracted, forward
rolled shoulder

14.  Lay FLAT on foam roller –
support from head to
tailbone
 Perform chin-tuck to
flatten neck against
foam roller
 Important to stabilize
shoulder blades (retract &
depress)
 Arms OUT, palms UP

15.  Chin-tuck helps to reverse forward head
posture
 Also helps to strengthen overstretched neck
flexors
 Light isometric contraction of overstretched
rhomboids and middle trapezius to stabilize
shoulders
 Stretches tight pectoralis major and minor

16.  To strengthen serratus
anterior:
 Push up position – arms
straight and hands shoulder
width apart
 Go down until chest is a few
inches off floor
 Push back up, straighten
arms, then push upper back
toward ceiling.
 This extra movement is
minimal
Stabilize shoulders! DO NOT shrug
shoulders toward ears

17.  If unable to perform
this exercise with
good form, perform
an easier version
instead:
 INCLINE Push-
Up Plus
 WALL Push-Up
Plus (easiest)

18.  Strengthening the serratus
anterior will help to stabilize the
scapula against the thorax, which
will reduce winging of the
scapula
 The combination of stretching
the upper trapezius (look-in-
pocket stretch) and
strengthening the serratus
anterior will help restore proper
functioning of the scapular
upward rotation during shoulder
abduction and flexion

19. Keep back straight, pull elbows back while
squeezing shoulder blades down and
together
Palms facing each other,
exhale as you pull back
keeping elbows close to torso

20.  This rowing exercise mainly works the upper
back muscles, specifically the middle trapezius
and rhomboids
 Doing this and other rowing exercises will help
to strengthen those muscles to help stabilize
(retract & depress) the scapula

21. Start with arms no higher
than shoulders
Pull straight down to sides,
squeezing shoulder blades
down and together
This exercise will help to
strengthen the
overstretched middle and
lower traps

22. Hamstring stretch and
Strengthen iliopsoas
 Decrease posterior pelvic tilt
 Increasing lordosis of lumbar spine
Stretching the hamstrings will also decrease
knee flexion postural deviation
 Help to bring knees closer to COG

23.  Decrease lordosis of cervical spine
 Retract and depress pectoral girdle (right)
 Increase lordosis of lumbar spine (not too
much!)
 Restore more favorable center of gravity
 Decrease external forces

24.  Still a slight forward
head posture
 0.74” forward shift
compared to 1.17” shift
without brace
 Making head weigh
23.9 lb. Compared to
29.7 lb without brace
 Center of gravity
closer to normal

25.  Brace helps to retract
and depress right
shoulder
 Hopefully, with time,
doing these exercises
will allow him to lose
the brace and be able
to maintain proper
posture on his own

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