What Posture Says About Your Pain

Most people think of posture as simply “standing up straight,” but in the world of physical therapy, posture is a window into how your body is managing stress, movement, and often pain. Whether you’re dealing with nagging low-back tension, neck stiffness after long workdays, or recurring shoulder issues, your posture may be telling an important story.

Posture Is a Symptom, Not a Character Flaw

First, let’s clear something up: poor posture doesn’t mean you’re lazy or doing something wrong. Posture is your body’s best strategy in the moment to keep you upright with the least effort. When pain or weakness shows up, your posture often changes to compensate. This is why physical therapists evaluate posture, not to judge alignment, but to understand how your body is adapting.

How Posture Reflects Pain Patterns

1. Forward Head & Rounded Shoulders

This is one of the most common patterns today, especially with increased screen time. What it may tell us:

• The muscles in the front of your chest may be tight

• Your upper-back muscles may be underactive

• Your neck is working overtime to hold your head forward.

  Common symptoms: headaches, neck pain, shoulder impingement

  
  

2. Excessive Low-Back Arch (Anterior Pelvic Tilt)

This posture creates a deeper curve in the lower back. What it may tell us:

• Your hip flexors (front of the hips) might be tight

• Your glutes and core might be weaker or less engaged

• Stress is being placed on the lumbar joints

  Common symptoms: low-back pain, hip pinching, hamstring tightness

  
  

3. “Swaying” or Leaning Into One Hip

You might notice yourself standing with weight shifted to one side. What it may tell us:

• One hip may be working harder than the other

• Ankle or knee discomfort may be causing you to offload weight

• Pelvic asymmetry or glute weakness could be present

  Common symptoms: SI joint pain, hip bursitis, knee irritation

  
  

4. Rounded Upper Back (Kyphotic Posture)

This is common in both older adults and younger individuals who sit frequently. What it may tell us:

• The spine is adapting to long periods of sitting or lifting

• Upper-back mobility may be limited

• Breathing mechanics may be affected

  Common symptoms: upper-back stiffness, shoulder pain, shallow breathing

  
  

Pain Causes Posture Changes, Not Just the Other Way Around

Many people think “bad posture causes pain,” but it’s more accurate to say posture and pain influence one another. For example:

• If your back hurts, you might shift weight forward to avoid pressure.

• If your shoulder aches, you might elevate or round it to decrease tension.

• If you’re stressed, you may tense your neck or shrug your shoulders.

These compensations become habitual over time, reinforcing the posture we see.

What We as PTs Look For

When assessing posture, we do not aim for a “perfect” position. Instead, we evaluate:

• Movement quality: How your posture changes when you walk or reach

• Muscle balance: Which muscles are tight, weak, or overworked

• Load tolerance: What positions increase or decrease pain

• Functional habits: Workplace setup, sleep position, daily activities

Posture is just one piece of the puzzle, but it provides valuable clues.

Can Fixing Posture Reduce Pain?

Often, yes, but not because of the posture itself. Improving posture works because it:

• Reduces stress on irritated tissues

• Helps muscles coordinate more efficiently

• Increases mobility and strength

• Improves breathing and core stability

• Encourages better movement patterns

It's not about achieving military-perfect alignment. It’s about finding a posture that supports your body and reduces unnecessary strain.

Simple Ways to Improve Posture (Without Overthinking It)

• Move every 30–60 minutes. Movement matters more than perfect form

• Strengthen your upper back and core

• Stretch your chest and hip flexors

• Adjust your workstation so your screen meets your eye line

• Breathe deeply. Good posture starts with rib and diaphragm mechanics

  
  

Physical therapy isn’t about telling you to stand up straighter. It’s about finding the root cause of your discomfort and teaching your body to move well in every posture. Here at RTC, our goal is to help your body adapt to all the postures life requires, not to avoid certain movements out of fear.

—Need to come in for an evaluation? Reach out or schedule a visit — we’d love to support you.

Thank you for reading,

Your friends at RT