Could your posture be causing you aches and pains?

Postural assessment Kensington and Mayfair

By Beth Lewis 

The Swiss Touch Physiotherapy 

In today’s fast paced, screen-heavy world, postural issues are one of the most common, and most overlooked, causes of musculoskeletal pain. Whether it's neck stiffness, lower back pain, or nagging knee pain, your posture could be quietly playing a major role.

At The Swiss Touch Physiotherapy, with clinics in both Mayfair and Kensington, we offer advanced biomechanical postural assessments that go beyond surface level symptoms to uncover the real sources of dysfunction. When combined with a personalised treatment programme of manual therapy, Pilates, and strength and conditioning, this approach can lead to significant, long-term relief.

10 subtle signs your posture may be to blame:

Chronic neck or shoulder tension:

Forward head posture and rounded shoulders increase strain on cervical and thoracic muscles, a known contributor to pain (Ishikawa et al., 2023). This can also lead to shortening of the pectoralis muscles which will further contribute to the shoulder rounding. 

Frequent headaches:

Tension or cervicogenic headaches can often be traced back to poor posture, especially if the upper cervical spine is compressed or muscles at the base of the skull are tight. This often accompanies poor desk ergonomics or long screen time.

Lower Back pain when sitting or standing:

Discrepancies through the lower back and pelvis, for example a forward tilt on the pelvis, and increase in the lumbar spine curve, or an uneven hip height, places uneven stress on spinal structures, commonly leading to non-specific low back pain (Mansfield et al., 2020).

Knee pain without obvious injury:

When the hips and pelvis aren’t properly aligned, the knee often has to compensate, which can lead to pain, even without any obvious injury. This is especially common in women. Anatomically, women tend to have wider hips than men, which contributes to a naturally higher Q-angle, a measurement that reflects how the thigh muscles (quadriceps) align with the knee. The Q-angle is formed by drawing two lines: one from the front of the hip to the centre of the kneecap, and another from the kneecap to the top of the shinbone (centre of the patella to the tibial tuberosity). Typical Q-angle values are around 10–14° in men and 15–17° in women. A larger Q-angle can increase the risk of knee problems such as patellofemoral pain syndrome (PFPS) and ACL injuries, particularly in women. This risk is even higher when combined with poor pelvic posture, like an anterior pelvic tilt, which can cause the thigh bone to rotate inward and the patella to track out of alignment. This will put extra strain on the joint. In both men and women, an elevated Q-angle paired with postural imbalances can lead to ongoing pain or dysfunction. As noted by Smith et al. (2017), assessing Q-angle is a valuable part of understanding knee loading issues and should be included in a full biomechanical and postural evaluation.

Uneven shoulder hight:

Asymmetry in the shoulders can be a visible sign of deeper muscular imbalance or scoliosis. A scoliosis describes a curve in the spine that doesn’t replicate the anatomical spinal curves. This can produce uneven muscle bulk and compensation and contribute to pain to the surrounding joints, such as the shoulders and hips. 

Uneven shoulder hights can also be caused by muscles imbalances in the upper trapezius. We all have a dominant hand, but consistently using one arm more than the other will contribute to muscle bulk on one side of the neck that will also affect your upper back and shoulder regions. 

Tight hip flexors or hamstrings:

Sitting for long periods shortens the hip flexors and hamstrings. Over time, this reduces your movement efficiency and contributes to poor pelvic posture, which in turn stresses the lumbar spine and knees.

Weak or poor activation of core muscles:

When posture is poor, deep core stabilisers like the transversus abdominis can become underactive, reducing your ability to stabilise the spine during movement. This can lead to poor performance, reduced balance, and increased injury risk (Kavcic et al., 2022).

Uneven shoe wear:

Do the soles of your shoes wear out more on one side? This is a subtle yet telling sign of asymmetrical gait or imbalanced load-bearing, often stemming from poor pelvic, hip, or foot alignment.

Feeling unbalanced:

Subtle misalignments in your posture can affect your sense of stability and coordination. Do you often feel clumsy or unstable, it may be due to postural imbalances interfering with your body’s proprioception (your sense of position and control).

Fatigue:

When your posture is inefficient, your muscles have to work harder just to maintain basic movements like walking or standing. This often results in early fatigue, particularly in the lower back and legs (Nunes et al., 2018).

The importance of a biomechanical postural assessment:

At The Swiss Touch Physiotherapy, our advanced assessments involve a detailed evaluation of posture, movement patterns, and muscle activation. This data forms the foundation of a personalised rehabilitation plan, focused on treating the cause, not just the symptoms.

With clinics in both Mayfair and Kensington, we make expert care easily accessible in Central London.

Your personalised treatment plan may include:

• Manual therapy to release restrictions and restore mobility

• Clinical Pilates to retrain posture and build core stability

• Strength and conditioning to support long-term resilience and performance

This integrated approach is supported by research showing the effectiveness of combining exercise and manual therapy for musculoskeletal pain (Puentedura et al., 2017).