Gait, posture, and movement screening

Posture before exercise selection

Before prescribing exercises, see how the body holds itself. Postural deviations predict where movement will break down under load.

Standard postural deviations

Forward head posture — head sits in front of the shoulders. Common in desk workers. Loads cervical extensors, weakens deep neck flexors. Affects overhead pressing. Rounded shoulders / upper-crossed syndrome — tight chest and upper traps, weak rhomboids and lower traps. Shoulders sit forward and high. Limits overhead reach. Anterior pelvic tilt — pelvis tipped forward, lumbar lordosis exaggerated. Tight hip flexors, weak glutes and abs. Affects squat depth and deadlift setup. Posterior pelvic tilt — pelvis tipped back, lumbar flattened. Tight hamstrings, weak hip flexors. Less common; often seen in long-distance runners. Knee valgus / varus — knees track inside or outside the toes. Affects every leg exercise.

Basic movement screen (5 minutes, no equipment)

1. Overhead squat — feet shoulder-width, hands overhead, squat to depth. Watch for: arms falling forward (thoracic mobility), knees caving (glute medius/ankle), heels rising (ankle), excessive lean (hip mobility).

2. Single-leg balance — 30 seconds each side, eyes open then closed. Tests proprioception and ankle/hip stability.

3. Shoulder reach (one hand up, one hand down behind back) — tests shoulder ROM and thoracic mobility. Hands should come within 2-3 inches of each other.

4. Toe touch / forward bend — tests hamstring and posterior chain mobility. Watch where the back rounds — if it rounds early, hamstrings are tight.

5. Walking observation — watch the client walk 20 feet. Look for asymmetries, foot pronation/supination, hip drop, shoulder roll.

Gait phases

Stance phase (~60% of cycle): foot is on the ground.

Heel strike → loading → mid-stance → toe-off

Swing phase (~40%): foot is in the air.

Initial swing → mid-swing → terminal swing

Asymmetries between sides (one leg's stance phase longer than the other's) usually indicate weakness, pain, or fear of loading that limb.

Translating findings to programming

You don't fix posture by telling someone to "stand up straight." You fix it by:

Strengthening the weak side of the imbalance
Mobilizing the tight side
Drilling the new pattern with low-load reps

Anterior pelvic tilt example: stretch hip flexors (couch stretch), strengthen glutes (hip thrusts) and abs (dead bug), drill hip hinge mechanics.

The screen is a starting point, not a diagnosis

A movement screen tells you where to dig deeper. It doesn't replace medical assessment. If you find pain or red flags (numbness, tingling, weakness pattern, sudden ROM loss), refer to a PT or MD.

TL;DR

Postural assessment predicts where movement will break. Run a basic screen (overhead squat, single-leg balance, shoulder reach, toe touch, gait). Use findings to choose corrective work — don't ignore them, don't pretend to be a physical therapist.