Postural kyphosis
Postural kyphosis is a flexible, correctable rounding of the upper back driven by muscle imbalance and habitual posture rather than vertebral wedging. It is by far the most common form we see — particularly in adolescents who spend long hours over screens, and in adults whose work involves sustained forward reach. Because the curvature is flexible, the prognosis with consistent therapy is excellent: most patients see meaningful change within 8–12 weeks. We focus on thoracic extension mobility, scapular and deep neck flexor strengthening, and rebuilding the postural endurance that allows the corrected position to feel effortless rather than held.
Scheuermann's kyphosis
Scheuermann's is a structural kyphosis with anterior wedging of three or more consecutive vertebrae, typically presenting in adolescence. PT cannot reverse the wedging itself, but it remains the cornerstone of non-surgical care: maintaining mobility above and below the rigid segment, building the postural musculature that compensates for the curve, and reducing the secondary muscle pain that drives most symptoms. We coordinate with your spine specialist when bracing or surgical evaluation is appropriate.
Hyperkyphosis of aging
After roughly age 50, kyphotic angle tends to increase — driven by a combination of disc degeneration, vertebral compression fractures, and postural muscle weakness. Hyperkyphosis is associated with falls, breathing difficulty, and reduced function. The good news: targeted exercise meaningfully reduces kyphotic angle and improves quality of life even in patients with osteoporosis. We use programs adapted from the published 'spinal proprioceptive extension exercise dynamic' (SPEED) and similar evidence-based protocols, modified for safety in osteoporotic patients.
Excessive lumbar lordosis
Hyperlordosis — excessive inward curvature of the low back — typically goes hand-in-hand with anterior pelvic tilt, weak deep abdominals and glutes, and tight hip flexors and lumbar extensors. It often presents as low back pain with prolonged standing, difficulty engaging the core, and a visibly arched lower back. Treatment is rarely about 'flattening' the spine; it is about restoring the muscular balance that lets the pelvis sit neutrally. Our program targets hip flexor mobility, gluteal and deep abdominal activation, and posterior pelvic tilt control.
Flat-back and lumbar hypolordosis
The opposite problem — too little lumbar curve — is increasingly common in patients with prolonged sitting, after certain spinal surgeries, or as part of a sagittal-plane imbalance. Flat-back posture reduces the spine's shock absorption and is strongly linked to fatigue, low back pain, and difficulty standing upright through the day. We work on segmental lumbar extension mobility, hip extension range, and the postural endurance needed to maintain a healthy lordotic curve.
Forward head and upper-crossed syndrome
Forward head posture rarely exists in isolation; it travels with rounded shoulders, an elevated and protracted scapula, weak deep neck flexors, and tight upper trapezius and pectoralis muscles. This pattern — sometimes called upper-crossed syndrome — is a major driver of cervicogenic headaches, mid-thoracic pain, and shoulder impingement symptoms. Our program addresses the full chain rather than treating the neck in isolation.
Lower-crossed syndrome
Lower-crossed syndrome pairs tight hip flexors and lumbar extensors with inhibited glutes and deep abdominals, producing the classic anterior pelvic tilt and lumbar hyperlordosis. It is one of the most common postural patterns we see and underlies a large share of mechanical low back pain. The treatment principles are well-established; what makes the difference is consistent, progressive programming and motor-control work that translates into how you actually stand, sit, and move.