Why Alignment Matters

The foundation of Restorative Exercise is whole body alignment. When doing corrective exercises, we’re essentially trying to get our body back to its default state, or anatomical neutral, and alignment points are the fundamental tool that help us get there.

There’s A LOT of posts out there about various alignment points, but to my knowledge no round up of the benefits or reasons why we choose these points. I’m putting together this bullet list based off of my own understanding of how this works after years of studying these principles. I’m not an academic biomechanist, and I may be mistaken on some of the finer points. As I learn more, I’ll be updating this list.

Feet:  Keep the outside edges of your feet parallel and your weight balanced on your heels.

Why?

  • Keeps our tarsals and metatarsals aligned with forward movement. Notice how if you walk or stand with your feet out at an angle, your bones will be on a bias to the direction of movement. This could displace those bones in a less than ideal way, and puts uneven stress on them.
  • Similarly, our arch should be aligned with the direction of movement. When your feet are turned out, your arch would roll from one corner to the other, which eliminates a lot of the strength inherent in that structure. Oftentimes collapsed arches and turned out feet go together (though the problem is likely caused further up the body).
  • Our tibia is the strongest bone of our body and is connected at the ankle to the talus and calcaneus. Notice how much larger and heavier those bones are than the tarsals and metatarsals. Where do you think the weight should be centered?
  • Keeping your weight back on your heel allows your toes freedom of movement, allowing them to respond to uneven surfaces as they were designed to do.

Knees and Hips: Knee pits pointing directly behind you, patellas relaxed down.

Why?

  • Being unable to move your kneecaps is a sign that your quads are always turned on. This pulls the patella deeper into the joint space, reducing it’s ability to respond and rubbing on the cartilage in not happy ways.
  • Having your thighs rotated to neutral (knee pits pointing directly back) allows optimal motion when the knee is bending.
  • Neutral femurs allow you to access your deep hip rotators, creating a stronger pelvic floor.
  • Neutral femurs, paired with a neutral pelvis, allow you to access your glutes when you walk.

Pelvis: Anterior Superior Iliac Spines (sticky outy hip bones) and pubic symphysis (pubic bone) in the same plane, perpendicular to the floor.

Why?

  • The tendency in our culture is to tuck our pelvis, which places the lumbar spine in flexion. This is the weakest position for it, and a big risk factor for low back pain issues.
  • A neutral pelvis allows the greatest degree of loaded hip extension when walking, which keeps the hip joint supple and the head of the femur strong. Load bearing movement is the best way to prevent osteoporosis.
  • A neutral pelvis allows the sacrum to move at the SI joint, which benefits walking and pelvic floor health.
  • Your pelvic floor length is optimal when your pelvis is in a neutral position, allowing it the greatest chance to respond appropriately to load (and keep your pants dry when you sneeze!).

Ribs: Relaxed down, so that your sternum is vertical and your lower ribs are balanced directly over your pelvis.

Why?

  • The tendency is to thrust the ribs forward, which pull the rectus abdominus out of its channel, creating less than ideal loads. This is a significant factor in issues such as diastasis recti.
  • Keeping your ribs relaxed down allows you to access the muscles of the upper back, maintaining thoracic mobility and preventing that forward posture so many are trying to avoid.

Shoulders: Stable, flush scapula (this is an advanced alignment point) with elbow pits pointed forward.

Why?

  • Stable shoulders allows you to develop good shoulder mobility and is the ideal starting place for any rotator cuff motion.
  • Both of these points gives you the greatest joint space in the shoulder (subacromial space), which prevents shoulder dysfunction and rotator cuff injury.
  • Stable shoulders and neutral humeri allows gentle motion of the upper back during walking, which keeps it mobile as we age.

Head and Neck: Ears balanced over shoulders, chin relaxed downward.

Why?

  • Our head is heavy and our cervical vertebrae are small! A forward head is a weak position for them, and creates a lot of tension.

Whole body alignment is a fantastic tool that allows us to objectively assess how we’re performing a movement, and what our underlying tension patterns are. Achieving the alignment points without effort is not the goal, and if you can’t get there you’re not doing it wrong. I do recommend every one of my clients learn something about how they work because they are a good way to learn more about your body, and  ultimately use that information to move better and feel better.

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