A. Causes

• Habitual Faults: Prolonged sitting or standing in a suboptimal position.
• Muscle Imbalance: Tightness in certain muscles (e.g., Pectorals, Hip Flexors) and weakness in others (e.g., Rhomboids, Gluteals).
• Ergonomic Deficits: Incorrect setup of workstation, monitor height, or chair support.
• Pain Avoidance: Shifting posture to avoid pain from an underlying injury.

B. Symptoms

• Neck/Back Pain: Chronic, low-grade pain from sustained load on joints and ligaments.
• Headache: Tension headaches often associated with forward head posture.
• Fatigue: Excessive fatigue from inefficient muscle use and overworking postural muscles.
• Restricted Mobility: Reduced range of motion due to structural shortening of muscles.

C. Diagnosis

• Visual Assessment: Observation in static positions (sitting, standing) and during movement.
• Plumb Line Test: Assessing alignment against a vertical line to identify deviation planes (e.g., forward head, rounded shoulders).
• Muscle Length Testing: Identifying tight structures (e.g., Pectoralis Minor, Hamstrings).
• Ergonomic Assessment: Detailed review of the patient’s daily physical environment (desk, car, bed).

D. Physiotherapy Treatment Plan

• Awareness/Education: Training the patient to identify and correct their own postural faults (using a mirror).
• Mobilization: Improving mobility of the thoracic spine to allow for better shoulder/scapular positioning.
• Flexibility: Stretching tight structures (e.g., Pectorals, Hip Flexors) to allow correction.
• Strengthening: Targeting weak postural muscles (e.g., Deep Neck Flexors, Rhomboids, Gluteus Maximus).
• Core Stability: Training low-level, sustained TrA activation to support the spine.
• Ergonomic Intervention: Adjusting chair, monitor, and keyboard height to maintain a neutral spine.
• Postural Endurance: Low-level, sustained holds of corrected positions to build muscle stamina.
• Micro-Breaks: Implementation of short movement breaks to interrupt prolonged static postures.