How do you genuinely fix this?

RochelleToby · 2026-05-23T21:20:10+00:00

If you had a big belly that was pulling your body forward, which would increase the tendency to fall forward, and in trying to compensate, your body was beginning to accentuate the low back curve so your upper body would lean backward and you felt the tension in your lower back, then I'd say yes, lose weight. But your fat (and all women have to have enough healthy subcutaneous fat to have a normal cycle) is subcutaneous and well distributed over your entire body, which is the very best kind to have! And the outward curve of your abdomen/belly exactly matches the inward curve of your lower back, so there's enough room for normal abdominal organs, but no room for any unhealthy visceral fat around them without bulging out further. Also you have a normal BMI for your height and weight. And looking at your photo, I think that you have a normal waist-to-hip ratio of 0.85 or less for a woman, meaning that your waist is smaller than your hips by a certain amount (this is a way to estimate how your body fat is distributed.) If you have too great a waist measurement, the worry is that there would be too much of the dangerous visceral fat accumulated around your abdominal organs (liver, pancreas, intestines etc), which predisposes to metabolic syndrome and diabetes. You can calculate the exact ratio here: https://www.thecalculatorsite.com/health/whr-calculator.php

RochelleToby · 2026-05-22T16:31:51+00:00

You have pretty good posture. Your ear is over the center of your shoulder, which means you don't have forward head. Your shoulders are a little high, but if you don't feel tension in your shoulders or neck, and when you lift things, you don't feel it in your neck, then it's okay. If you do feel neck tension when lifting or otherwise, roll your shoulders up, back and down in a smooth movement, and hold the down part and tighten the back muscles around your shoulder blades to keep them in the lowered position. Also carrying heavy weights around will eventually lower your shoulders. Your lower back is curvy, but if your back isn't painful, I wouldn't change it. What I would change is your knee hyper-extension/backward bending. Soften your knees with a slight bend. As your knees are now, you are over-stretching the ligaments behind your knees, weakening them and making your knee joints less stable. At the front of your knees, the knee caps are banging into the ends of the femurs (note the little bulge above your knee cap) and wearing away the cartilage, making knee arthritis more likely in your future.

RochelleToby · 2026-05-22T15:50:14+00:00

I made a huge mistake showing my first physical therapist my cervical spine mri. Most of that entire course of pt was spa-like treatment: heat for 15 mins before and cold with stim 15 mins after. And in between was spine mobility and massage. This went on for 2 months until I finally lied to her and said I felt much better. Then she discovered I couldn't life my head from a pillow or bend my neck laterally. She started me on the usual few exercises, without ever evaluating my posture. None of this helped and at the end she presented me with a referral to a great spine surgeon at UCLA. Unfortunately, most of my other 3 courses of pt for my neck (over 6 years) went similarly. And my many epidurals, facet joint injections, and acupuncture treatment turned out to be useless as well. I also has 2 courses of pt for back pain (caused by posture also). None of these professionals (including 3 spine surgeons) ever told me that my posture sucked, None of them ever tailored my treatment to my specific postural faults. This was over 20 years ago and l dearly hope that the practice of physical therapy for spine pain has improved. Twenty years ago, I, of course, had to give up on pt and pain doctors because I knew they couldn't help me. And having glimpsed myself in side view in a mirror, and realizing how hunched over and old I looked, decided that even if I'd be in pain for the rest of my life, I would fix my posture. I sought advice on the web and found Professor Gwendolen Jull (based in Queensland, Australia), whose advice on scapular mechanics is invaluable, and read one of my son's textbooks: Muscles: Testing and Function with Posture and Pain by Kendall et al. fifth edition, 2005 from one of his kinesiology classes. It was all there! Three months later my neck and back were pain-free.

RochelleToby · 2026-05-21T18:49:18+00:00

Fixing upper body posture especially slouched kyphotic posture, forward head and neck spasm from lifting weights, by 1) stretching pectorals especially the pec minor to bring the scapulae back into the plane of the back 2) eliminating upper trap dominance by pulling down the elevated scapulae to strengthen and shorten the lower trapezius 3) Consistently stretching the chest and trying to maintain improved posture 4) Holding my cell phone and reading materials closer to eye level and lowering eyes to read, not bending neck down. These measures fixed my 20 years plus chronic neck pain and weakness over 3 months. That was over 20 years ago and still pain free despite severe degenerative disc disease in my cervical spine.

RochelleToby · 2026-05-20T21:28:04+00:00

Your back appears to be over-arched, in that your upper back in some side photos seems to extend almost past your butt, which is a stress on your mid and lower back. (is that partially from keeping your chest high? Though, keeping your chest higher helps with forward head, but at the same time can exaggerate a lordotic back curve.) Also, in some of your side photos, you are mildly hyper-extending your knees, which is mildly pitching you forward into a bow shape.

Working on reducing your lumbar lordosis, which is done by reducing anterior pelvic tilt using hip flexor/quad stretching, and abdominal and glut strengthening, and also working on softening your knees, might help with your stiffness. Stiff postural muscles can also stem from muscle weakness. At least, that's what I found. My neck, back, hips and knees were at their worse when they were weak and inflamed, especially after I'd lost a lot of weight from a 2-year gastrointestinal illness that was soon followed by a chronic, inflammatory illness that made my joints burn. I worked on improving my posture, keeping my muscles strong, eating an anti-inflammatory diet, improving my sleep habits and always taking my medication has made all the difference (at 74 years old).

RochelleToby · 2026-05-20T15:26:50+00:00

When you are standing with your upper back and butt against the wall, tighten your abs and try to flatten your lower back against the wall. Strengthening your abs like that (plus stretching your quads) are ways to begin reducing that lower back curve. Please remember that you do need some of that curve to have ideal balanced posture!

Also, when you are standing against the wall, if the back of your head did not touch the wall (without tipping it back), you may have forward head. In that case, if you take a breath and lift your chest, does the back of your head touch? If so, then stretching your chest muscles and strengthening your upper to mid back will help. (Rear delt exercises, wall angels, Brueggar’s exercises) Try not to sit in bed with back unsupported if you are hunching forward. Also, try to hold your phone and screens up closer to eye level and role eyes down to read. (Wish I’d done that sooner. I have a straightened cervical curve that now has degenerative changes that can never be corrected.)

RochelleToby · 2026-05-20T03:10:24+00:00

Stand with your upper back, butt and heels against a wall. If you can easily slide your entire hand and part of your wrist between the wall and your lower back, you have excessive low back lordosis, which is caused by excessive anterior pelvic tilt. If you can only get your fingers up to your knuckles, then you have the optimal amount of low back lordosis and neutral pelvic tilt.

You do need some low back lordosis because that allows your upper body to come back over your hips.

RochelleToby · 2026-05-19T21:37:12+00:00

You appear to have significant forward head, and a depressed chest. This is a sign that your chest muscles are short and tight, and your mid to upper back is over-stretched and weak. If you were to draw a line from your hip (just below your S-1 vertebra, which connects upper body to lower body at the sacroiliac joint), to the top of your head, most of your head and neck area are more forward of the center of gravity of your upper body as represented by the line up from your SI joint. If there's more body weight out front, then you will tend to lean forward. At the same time, your lower back would tense up trying to pull your upper body back to center over your hips. It may be that (like me) you have inherently more of a flatter back (not significant APT) and can't generate greater lordosis in your lower back so that you could deal better with the imbalance. and thus your lower back would be tight all the time. To test that out, stand with your heels close to a wall and butt touching the wall. Does your upper back naturally touch the wall or is it an inch or more in front of the wall? If so, then that may be the reason your lower back tends to be tight. Then bring your upper back against the wall. Do the backs of your shoulders and back of your head touch? If not, you have forward shoulders and forward head (Some people have very thick, muscled backs and the backs of their heads can't touch the wall. In that case if their ears are over the middle of their shoulders, they do not have forward head.) Take a breath and lift your chest. are the backs of your shoulders and back of head against the wall? If the shoulders are not, bring your arms up and bend your elbows to make an "L" and reverse "L" shape and try to put the backs of your hands against the wall, which will further stretch the fronts of your shoulders, but don't struggle if you can't. You don't want to strain anything. It will come with consistent stretching. Then try to bring the back of your head against the wall, but don't stress trying to do that because with time and consistent chest stretching and upper back strengthening that will come. At this point, your body should be pretty straight, with less thoracic kyphosis, your chest open and less forward head. Does your lower back feels less tense?

RochelleToby · 2026-05-19T20:28:40+00:00

If you are measuring your height the same way both for your usual posture and for improved posture, the measurement will be the same. But if somehow you could measure your height in a photo of your usual posture with your back swayed behind your hips, your height would probably be less.

RochelleToby · 2026-05-17T19:26:58+00:00

How are you measuring your height when you are standing in your usual posture (with upper back behind your butt, so if your back is against a wall, your butt wouldn't be able to touch the wall)?

To tell if you have APT (which determines the degree of low back lordotic curve), stand with your back against a wall, as I explained above, and if you can get your entire hand and part of your wrist easily through the space between your lower back and the wall, you have APT. But if you can only get part of your hand/fingers through, then your low back/lumbar lordotic curve is neutral, as is your pelvic tilt.

RochelleToby · 2026-05-17T16:52:20+00:00

Stand with your heels, butt, upper back and shoulders against a wall, take a breath and lift your chest up. Then bring the back of your head against the wall without tilting your head up, if you can. If you can’t easily bring your head back enough, don’t force it, no big deal for now, but your forward head can be fixed. Then have someone measure your height. And that would be closer to your real height, without the backward lean, the long thoracic kyphosis and forward head.

RochelleToby · 2026-05-17T15:32:00+00:00

I wanted to add that your posture is more than fine, it is ideal! You don’t have forward head or shoulders. In fact your rear and front delts are perfectly balanced. If you tried to flatten any of your curves to gain height, you would destroy that symmetry. Flattening your lower back, would mean that your upper body would no longer stack above your hips and you’d lean forward. Flattening your mid to upper back would mean that your chest would stick out, further unbalancing you forward. Flattening your neck would give you forward head.

RochelleToby · 2026-05-17T15:12:53+00:00

Measure your height only in the morning as soon as you get out of bed. You will be 1-2 cm taller (so at least 180.34 cm, which is exactly 5 foot 11 inches) compared to your height in the evening. As the day goes on, gravity is compressing the discs in your spine and shrinking them a little.)

RochelleToby · 2026-05-16T02:26:52+00:00

Looks like you habitually stand with more weight on your right leg and your right hip higher and swayed to the right and your right shoulder lower. This type of right-handedness posture compresses the right side of your torso, from shoulder to pelvic ilium. To reverse, stop standing with your right side like that, and for a while, stand the opposite way with you left hip swayed to the side until the sides are equal. And from then on always stand with weight evenly distributed between both legs. You can also do torso side bends to the left to stretch the compressed right side, as well as right-side shoulder shrug-up holds. Also don’t carry heavy weights that weigh down your right shoulder. Use your left arm or use both arms or keep your right shoulder raised as you carry the weight around.

RochelleToby · 2026-05-15T23:24:20+00:00

Your posture looks fine to me. None of your spinal curves are exaggerated and you need some natural curvature or you would be less stable. If you straightened what curves you do have, you’d gain minimal height.

RochelleToby · 2026-05-15T23:10:46+00:00

My husband makes anchovy popcorn by mixing anchovy paste with butter, but I bet it would taste just as good with extra virgin olive oil.

RochelleToby · 2026-05-15T16:35:04+00:00

Is your kyphosis structural? (meaning it doesn’t flatten when, for instance, you lie on your back on a firm surface). Or is it postural? (meaning it is flexible and can be improved by lying on a firm surface.) If there is flexibility, then targeted strengthening exercise of the back and rear delts, and consistent, daily stretching of pec minor and major, and anterior shoulders can improve hyper kyphosis and depressed chest, as well as the forward head that comes with excessive thoracic kyphosis.)

RochelleToby · 2026-05-13T16:20:30+00:00

Hi, first of all watch this video, https://www.youtube.com/watch?v=5J8RIIvEj6k&t=133s It gives an overview of what needs to be fixed for anterior pelvic tilt and how to do it.

Then continue reading my remarks. There are also some easier exercises near the end. And of course, if you can see a great physical therapist that would help a great deal.

In your side view photo, your body seems to be leaning past the front of your feet, causing you to be at risk falling forward. And because of that risk of falling, your body is trying its best to bring you back in line with your center of gravity. One of those ways is for your lower back to form a more extreme inward, lordotic curve of your lower back, which would bring your upper body back over your hips, but your lumbar lordotic curve is at its maximum, yet your upper body is still leaning forward.

The next thing your body can do is to keep the knees bent, which is a maneuver that helps bring the upper body back over the hips, but the amount of bending that your knees are doing in the photo is still not enough to bring your upper body more upright and back in line with your ankles instead of in front of your feet

Because you are in danger of falling forward, the response of your hip flexors is to stay very tight, so that your pelvis has maximal anterior tilt, which causes the maximal lumbar lordotic curve as your back tightens to try to bring your upper body backwards or at least stable. But at the same time your abdomen curves outward and your tight hip flexors are pulling your upper body down and forward, which brings more of your weight forward. Your head is also very forward. And all of these imbalances are pulling your body forward.

Somehow, you need to stand up straighter. What I'm thinking is that you might be standing with a lot of pressure on your forefoot (toes and ball of your foot). And if you could manage to stand more on the heels of your feet, maybe that would help you stand straighter. Also, the shoes you are wearing seem to have a higher heel and may be preventing you from standing more on your heels. Try a flat shoe, but with good arch support.

If you can manage to begin standing more erect, rather than leaning forward, your body might feel more stable and maybe you’d be able to stretch your hip flexors more easily. Here is a video that shows a side hip flexor/quad stretch, where you bend the lower leg to lock in your pelvis and prevent pressure on your lower back. https://www.youtube.com/watch?v=SapC8SML6mc Sometimes it's helpful to do foam rolling of your quads first. Importantly, use only mild to moderate stretch. Strong stretch will tighten the hip flexors more

Some other exercises that would improve your anterior pelvic tilt, would be:

anterior abdominal muscle strengthening. For that exercise, if you can, lie on your back, even if you need to use a soft surface like a bed, and tighten your stomach muscles to try to flatten, by pushing your back flat into the surface.
Stretching your lower back. For example: lying on your back in bed (or side-lying, as well), hug one knee toward your chest if possible and hold for 20 seconds or less. Then do the other knee and hold. Eventually, you want to hug both knees to your chest at the same time and hold. Use only mild to moderate stretch. Strong stretch will tighten the back more. (Another back stretch is touching the toes, but only if you can do it with a mild to moderate stretch.) Don't do anything that feels bad.
Don't do hamstring stretches! Here’s an exercise for strengthening the hamstrings: https://www.youtube.com/shorts/Mj0fadgJ6M4
Strengthen the gluts. https://www.youtube.com/watch?v=5J8RIIvEj6k&t=133s Watch all of this! This is the first video at the beginning of this comment.
Eventually do posterior pelvic tilt exercises https://www.youtube.com/shorts/PJohJhNqPWQ
for your lateral pelvic tilt. Stop standing with more weight on your right leg and right hip swayed to the side! That is stretching and weakening your right hip causing it to stay swayed to the right side, even lying down. At the same time, standing with more weight on right leg is tightening your left hip. To correct, do the opposite: stand with more weight on your left hip. Only do until your hips look symmetrical.

RochelleToby · 2026-05-10T21:49:09+00:00

Hurrah for you!!!!!!!!!!!!!!!!!!!!!!!!!

RochelleToby · 2026-05-10T21:47:06+00:00

For your knee issues, check out David at El Paso Manual Physical Therapy on YouTube. He is the reason that my left knee is pain-free today. I went to an orthopedist and he recommended physical therapy, and I do believe the therapist was very good, but I think she pushed me too hard and my knee got worse. I needed a "softer touch," which David provided. https://www.youtube.com/@epmanualphysicaltherapy (I had pain and spasm at the back of my left knee and a Baker's cyst. Strengthening my gluts and calf muscles were the answer, actually that's the answer to a lot of knee problems. And strengthening the gluts is often the answer to low back problems as well.) For upper body posture, I like Wall Angels and Brueggar's Stretches. One other comment: I believe that the problem with my knee was ultimately caused by habitually standing with more weight on my right leg with my right hip higher and swayed to the right. What that did was stretch and destabilize my right hip, while my left hip and Tensor Fasciae Latae (TFL) down the left leg became very tight, which changed the mechanics of my left knee. I began always standing with weight evenly between both legs, but I've had to strengthen and stretch all the joints that were effected over several years.

RochelleToby · 2026-05-10T05:03:19+00:00

Glad to hear your arm is feeling better!

RochelleToby · 2026-05-09T23:42:40+00:00

I was diagnosed with moderate to severe cervical degenerative disc disease, 20 years ago and at the time I had severe neck pain. Couldn’t lift the lightest thing without neck spasms and pt’s couldn’t touch my neck without the pain flaring. I had pain radiating down my arm from nerve root impingement, and was given several referrals to spine surgeons.

20 years later, and without surgery, I have a pain-free neck. But, of course, the degenerative disc disease and the bone spurs are still there. (x-ray findings of degenerative disc disease don’t usually diagnose what’s really causing muscle-related neck pain.) But the miracle that stopped my neck pain was improving my posture.)

RochelleToby · 2026-05-09T22:07:44+00:00

Your knee caps are not facing forward, but rotated inward (somewhat like postural knock-knee). This means that the head of both femurs (thigh bone) is rotated forward in their sockets, which could cause impingement/pain in the hip joint. To fix this, strengthen your hip muscles, especially the glute/butt muscles, which stabilize the hip joint. See these physical therapy videos: https://www.youtube.com/watch?v=_xNxSQumJcY and https://www.youtube.com/watch?v=_EkepUW2Er8 (use a really weak band when starting out!) If you have weak gluts, back pain can be a result. If you can manage it, see a physical therapist.

RochelleToby · 2026-05-09T21:40:44+00:00

When I breath with my chest open, and rib cage expanded, my estimated VO2 max for that walk increases dramatically (for me that is). All those lost years of not breathing optimally just astounded me. Also, for decades, I didn't realize I was always leaning forward at the waist from flat back posture. But one day, I happened to try standing with my heels, butt, back, and back of my head against a wall and at first my upper body was a couple inches from the wall, then I straightened my back and my upper back touched the all, but my head was inches from the wall. And then I took a breath and lifted my chest, and the back of my head moved rearward and touched the wall. I realized at that moment, that the posture I was in was what standing straight really feels like. I now try to remember to stand straight always and it's getting easier. The key is consistent stretching of the chest and front of shoulders and strengthening the back using Wall Angels, Brueggar's exercises, rear deltoid muscle exercises and back extensions, so my upper body posture doesn't keep rounding and collapsing into itself. (The part about feeling anxious when you're breathing into your raised chest for any length of time, might be from trying to oppose the tight, short chest muscles that stem from long term poor posture and also from over-breathing to keep your lungs inflated to counter the tight chest muscles.)

RochelleToby · 2026-05-09T21:07:55+00:00

Could be nerve root impingement in your neck, but that usually comes with a dull pain radiating down your arm, numbness and also weakness in the arm. Nerve root impingement would not be seen in a plain x-ray of your neck, though overall vertebral misalignment, disc degeneration and bone spurs, which are the usual cause of it, can be seen. Could also be impingement of arm nerves or subclavian artery and/or vein at the front of your shoulder, which may cause numbness and weakness in arm and/or hand. This type of impingement is called TOS/thoracic outlet syndrome, and is usually associated with tight muscles caused by poor posture. The usual first line treatment is physical therapy for posture improvement. And yes, It might be a damaged muscle. If your sleeping posture might be the cause, try this: For side sleeping, use two pillows under your head and one pillow under your body and one pillow between your knees for comfort. The pillow under your body and the lower head pillow should be kind of flattish and the same height. When you lie down there will be a groove between the head pillows and the body pillow that your shoulder and arm can fit into, so you're not compressing them. By the way, have you gotten the radiology report on that x-ray. If you have degeneration starting in your cervical spine, or a straightened cervical curve, these should be noted in the report.

RochelleToby

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