The torso relies on the alignment of the ribs with the pelvis maintain its shape. This keeps the diaphragm directly over the pelvic floor and the deep abdominal wall taught. The stomach area then remains contained in a cylinder shape that gently expands and contracts with each breath. This mechanism is known as Core Support.

When our posture shifts it alters the shape of our cylinder. In some cases gravity and hip flexor muscles pull the hips tilt too far forward. To keep the rest of the upper body from following, and falling face first, the low back muscles lift the ribs. This lengthens the distance between the ribs and pelvis in the front and shortens it in the back.

In this position the diaphragm tilts upward and the pelvic floor downward. The increased distance pulls the abdominal muscles forward and down in the front, causing them to bow outward and weaken. This is known as the Open Scissors position.

Conceptual image of the Open Scissors Posture, created by Claude September 2026

Regaining that ideal abdominal shape, strength and alignment for Core Support starts by reversing this arrangement. The ribs and pelvis need to move closer together in the front, and away from each other in the back. This is accomplished by bending the back and holding it in a flexed position with the abdominal muscles.

Conceptual image of the Yoga Cat Pose created by Gemini September 2026

This is a great way to start to restore abdominal strength and shape. You should feel like your stomach muscles are doing 50% or more of the work to hold your body up. Bringing the back up and ribs and hips as close together as possible increase the amount of work they are doing. Hold this position for 5 to 10 breaths, 3 or more times.

I’ve had more than enough injuries during my early life, including a reversed neck and unstable connection where my head and neck meet (C1/C2). I understand that feeling of chronic irritation, dull ache to sharp pain, depleted energy and brain fog. Year after year, specialist after therapist, treatment after treatment and still no resolution.

I finally found relief when I started practicing Postural Restoration and Dynamic Neuromuscular Stabilization.

Necks require special care. They house all the nerves as they leave the brain and enter the body, blood and lymph flow to and from the brain and secure space for the airway. Keeping these systems safe and flowing is why any time it’s threatened the neck tightens up and locks down.

This instinct to protect also makes treating the neck challenging. Sometimes going straight at it causes panic and it seizes, refusing to move. This is the exact situation I avoid and why the results in just one session are so profound.

O.S. fell two years ago, striking the back left side of her head. The fall resulted in concussion serious enough to cause some memory loss. Since then she’s experienced extreme tightness in her left side neck, pain down the left side of the head, jaw and neck down to the collar bone. Her assessment revealed a straight or reverse neck curve with tight right side muscles.

Instead of working directly on her neck I had her activate other areas of her spine, shoulders/chest and jaw. This avoided creating any sense of threat at the neck and used her own muscles to make comfortable movements that allowed her neck to adjust. This is the result after just 20 minutes of my guidance.

She contacted me that same evening to tell me that the tension and pain on her left side was greatly reduced and she was able to move her head, neck and shoulder much better.

Neck issues are not permanent. I promise. I see that with every client.

The brain is one of the most energy-expensive organs we have. It makes up only about 2% of body weight yet consumes roughly 20% of our total calories. A relatively small portion of that energy goes toward basic maintenance. The majority supports active processing and response.

The brain is organized by function. The cerebrum handles higher cognitive tasks: thinking, decision-making, and integrating sensory information from sight, hearing, smell, and touch. Deeper subcortical structures help process learning and emotion while regulating the body’s daily internal balance (homeostasis). Automatic functions such as breathing, heart rate, and digestion are largely managed by the brainstem and its connection to the spinal cord.

The cerebellum, located behind and below the cerebrum, plays the central role in balance, posture, and coordinated movement. This is where complex movement patterns are refined, organized, and stored. When the cerebrum initiates a goal (“walk,” “reach,” “lift”), the cerebellum helps create a detailed motor plan, activates the appropriate muscles, and continuously monitors the body’s position in space through feedback from joints, tendons, ligaments, cartilage, and the vestibular system.

This neuromuscular loop operates almost instantaneously. It supplies constant information so the system can make rapid corrections when something unexpected happens, like a trip, a slippery surface, or obstacle. With repetition, the cerebellum refines these sequences until they become automatic. The result is smooth, efficient movement that no longer requires conscious attention.

In practical terms, the cerebellum establishes an autopilot for action and correction. It responds to the feedback it receives from connective tissues and the inner ear. When the pelvis shifts, muscles tighten or lengthen, or joints change position, sensory receptors in the connective tissues and inner ear report the new information. The movement pattern then subtly adjusts itself.

You still recognize the overall action, walking, swinging, running, lifting, but not the nuances of the hundreds of small adaptations that occur underneath.

This is why movement and posture can change gradually over time without our awareness… until something starts to feel really wrong or performance suffers.

It’s also why correcting these shifts do not automatically translate into optimal performance. The pattern needs to adjust to the new, healthier alignment.

Beth Howzen (Kais), M.Ed., NSCA-CSCS, PRI-PRT, DNS-ET

July 29, 2026

Every health professional enters this field with the same goal: to restore the patient/client so they can progress and enjoy the life they aspire to. The system we work within, one that evolved from a trauma based model of care, asks us to focus only on the immediate concern. We dedicate specialists to treat specific body parts. We prescribe rehabilitation only to those locations. We train each muscle or joint individually. This method does not recognize that these areas are a small piece of a larger, complicated whole.

The result, too often, is a patient/client feeling frustrated, confused, depressed and sometimes more lost than when they arrived. And they are not alone. Many doctors, therapists and trainers feel exactly the same way, constrained by protocols or ideals and aware that things are being left unaddressed. This article is part of a reminder: the injury or individual joint is attached to body which requires alignment and pressurization for stability and a mind confident enough to accept the change the interventions seeks to make.

The Patient/Client as a Whole Person

The majority of patients/clients come to us already at a health crossroads. They are seeking exercise instruction. They are injured or in pain. They have tried to ignore or manage the problem themselves and reached their limit. Their bodies may have gone into a survival mode and shifted structurally in search of relief. Their minds may have internalized the struggle as an emotional experience in their amygdala and hippocampus or limbic system as a signal for early detection in hope of future prevention.

Before we intervene, it is worth asking: is this person’s mind and body prepared to support the treatment we are about to provide? And if it isn’t, what is our plan for that?

Postural Shifts and the Loss of Stabilizing Pressurization

We cannot escape the fact that the human body is asymmetrical by design and this creates a constant, natural challenged to alignment. Internally, we are not the same on both sides. The liver and three lobe lung are heavier on our right side so gravity constantly draws our center of mass toward the right side pelvis.

For most of our history the daily demands of life prevented this shift. In the agricultural and industrial age we walked everywhere, reaching, climbing, forcing our bodies to shift back over to the left, preventing the right side bias from taking over. In the technology age we spend the majority of our day sitting at computers, driving and in front of screens during our free time. It’s the absence of rotation movement back to the left that allows our bodies to shift out of alignment and into compensatory breathing and alignment patterns we’re discussing today.

These postural shifts develop on their own over time. A traumatic injury accelerates and compounds them. Training with single joint exercises reinforce them.

Any successful program: surgery, therapy or physical training, must account for how the left and right sides of the body differ and what this asymmetry means to the alignment and pressurization that support optimal physical and emotional function. How we as professionals respond to this reality shapes the health outcomes of our patients and clients.

The Importance of Proper Breathing

This might feel like a strange place to start. After all, every person is breathing successfully enough to sustain life, so what could possibly need attention here? More than most people realize.

Most people have gradually adjusted to breathe in a way that no longer supports them. Not because of anything they did deliberately, but because life quietly reshaped their patterns over time. Stress, prolonged sitting, old injuries, repetitive movement patterns, the habit of holding everything in, all alter how we breathe. And how much air we bring in determines the stability and resilience of both our physical and emotional states.

The brain prioritizes oxygen intake over everything and will adjust everything to meet this need. It may begin by increasing the rate of inhalation and exhalation. Switching to this rapid breath rate activates the sympathetic nervous system and sets a long list of consequences in motion. Blood pressure and heart rate increase. Adrenaline and cortisol rise. Blood flow is diverted from the organs to the muscles while glucose leaves the muscles and enters the bloodstream for an energy boost.

The fight/flight signal is triggered. Eye focus narrows, hearing sharpens and our back extends elevating our chest into an aggressive posture as our entire system goes on high alert. This response is essential to our survival when confronted with a genuine danger. It was designed for that short-term measure. When it becomes a chronic state it burns out the hormonal and emotional system while creating lasting shifts in body position that exacerbate the excited state.

The Engine Behind Breathing and Cylinder of Posture Alignment

The diaphragm is the primary breathing muscle, contracting somewhere between 20,000 and 25,000 times every day. When it isn’t working well, the body doesn’t just struggle, it quietly reorganizes the entire posture to compensate. This is where most joint problems begin, often affecting areas that have nothing to do with breathing at all.

The diaphragm is part of a pressurized cylinder that creates intra-abdominal pressure. It sits at the top, like the lid on a can. The pelvic floor forms the supporting base. The deep abdominal wall, the innermost core muscle, connecting the ribs to the pelvis and wrapping around the torso, provides the circular side wall that binds everything together.

These three muscles are designed to move in a coordinated rhythm with every breath. On an inhale, the diaphragm descends pulling the incoming air with it. This increases the pressure against the sides and bottom of the cylinder, gently forcing the deep abdominal wall outward and downward like an inflating balloon. It is this combination of internal force created by air and muscles resisting expanding that keeps the torso and pelvis aligned for easy tasks like posture, sitting, standing, walking and picking up light objects. The ligament connection between the diaphragm and lumbar vertebrae provides additional support to spine, by pulling upward on the lumbar vertebrae.

On exhale this process reverses. As the air leaves the lungs pressure subsides. The diaphragm and pelvic floor move back upward as the deep abdominal wall draws inward, appropriately tightening around your waist, like your natural Spanx shapewear. This circular tightening continues supporting pelvis and torso alignment as the breath cycle concludes. When the system encounters resistance, like moving a heavy object, sprinting or swinging, the deep abdominal wall moderates its response and tightens appropriately. This maintains torso, spine and pelvis alignment on exertion.

Whenever air pressure decreases, whether through breath volume, gravity acting on the heavier right side organs, or both, the internal pressure necessary for posture alignment decreases. The pelvis and torso, no longer supported by the breath, shift out of alignment taking the head and neck with them. Shoulders, which rely on the position and expansion of the ribcage destabilize. Hips, which rely on a centered mass and pelvis, tighten muscles to prevent us from falling over. Knees, ankles and feet adjust and now no joint has a stable socket to move in.

The Two Primary Posture Shifts – Right and Forward Stance

The first place the body compensates, absent physical trauma, is the pelvis. When we do not forcefully shift our body weight from the right side back over the left side sufficiently, gravity pulls on the heavier liver and right lung, moving the body’s center of mass over the right hip. This creates the Right Stance or Postural Restoration Left AIC Pattern.

Right Standing or Postural Restoration Left AIC Pattern. The left side of the pelvis drops in front and tilts too far forward, rotating the waistline to the right. The right side lifts in front and tilts backward. This angles the body, belly button and pant seam to the right.

In the close-up image of the shifted pelvis above the arrows indicate the elevation of the right side pelvis well above the left, the decrease in space between the right ribs and hip, pulled downward by contracting abdominals, and the increase in space between the left ribs and hip, pulled apart by lengthening abdominal muscles.

Note also the misalignment between the center of the chest and the belly button which is also shifted off to the right (blue dots). The line of hair beneath it continues to angle further towards the right hip. These markers on the front also represent what is happening at the low back where the lower portion of the spine is also shifting and turning to the right. A shift in the pelvis has now also compromised the lumbar spine as well.

In this rotation, held in part by tight right abdominal muscles and weak, lengthened left abdominals, the ribcage lowers down on the right and lifts on the left. The diaphragm follows: descending and narrowing on the right and rising and flattening on the left.

This creates three separate but critical interconnected problems for breathing and alignment. Above, the head and neck follow the body rightward shift over the right hip. As the eyes attempt to reorient back to left the neck twists, reducing air flow through the trachea. Below, the right ribs, held down by the abdominals, prevent air from entering the right lung while the upward tilt of the left ribs only allow air into the upper portion of the left lung. The altered rib position also prevents the diaphragm from fully contracting, limiting both its downward pull on the lungs and upward lift on the lumbar spine. Overall air intake volume reduces as low ribcage expansion decreases.

At the pelvis, the pelvic floor moves in the opposite direction: forward on the right and backward on the left. Our intra-abdominal pressure cylinder, like a dented soda can, has collapsed down on the right side and expanded on the left.

How These Changes Affect the Hips

Below at the pelvis, the increase in mass on the right side causes it to center over the right hip and tilt backward into extension. The new location of the socket turns and shifts the right hip inward with respect to the body’s mid-line. This tightens the hamstrings, adductors and hip internal muscles as they work to prevent us from falling over to the right, settling the weight on the outer edge of the right foot.

Simultaneously, the mass shift to the right pulls the left side pelvis forward into flexion, causing the left hip to turn outward and move away from the mid-line. This opposite position tightens the hip flexors, abductors and hip external rotators as the weight settles on the inside of the left heel.

How The Forward Stance (Postural Restoration PEC Pattern) Develops

When the loss of supporting pressure continues over a longer period, the body makes further adjustments to maintain air flow and to stay upright. Senses the rightward rotation of the torso, it tries to turn the body back to the left. In doing so it sets off a new cascade of repositioning. The right pelvis, following the torso, begins to tilt forward. Hip flexor muscles to tighten on both sides, pulling the low back forward into an increased arch, shifting the center of mass forward with it. This creates the Forward Stance or Postural Restoration PEC Pattern.

Forward Standing or Postural Restoration PEC Pattern. Both sides of the pelvis move down in front, tilting too far forward.

In this closer image of the torso the arrows indicate the elevated top of the waistband in the back compared to the lower front of the pelvis with the deep curving at the low back and straight upper back.

This forward position lowers the ribs down in the back, closer to the hips and lifts them to lift up in the front and farther away. The diaphragm follows suit, slanting upward from the low back towards the chest. This altered angled position changes two critical elements in our pressure system: it distorts the diaphragm’s dome and shifts the alignment between the top and bottom of our cylinder.

The diaphragm relies on that dome shape to create space needed to pull on the lungs. When that curve flattens, the available room shrinks reducing the downward movement. Total airflow and abdominal pressure decrease as inhales become shallow and more frequent.

At the pelvis the pelvic floor again moves in the opposite direction of the diaphragm, upward in the back and downward in the front. Our dented can has now turned: collapsed in the back and bulged outward in the front.

With both side of the pelvis tilted forward, the torso to leans forward. Both hips flex forcing them away from the mid-line into abduction and external rotation and the center of mass shifts forward toward the toes.

Breathing and Alignment for Successful Outcomes

Treating a system in distress is challenging for both the practitioner and the patient/client. A posture, already altered by gravity, continuously signal the brain that the body is not functioning normally. Joint position and movement are compromised. If injured, they may resist interventions directly at the injured site: physically, from fear of increased in pain, or emotionally from the protective instinct to guard what is already hurting.

In both cases, abdominal pressure cannot maintain alignment. Reduced air intake with an extended spine keeps the nervous system on high alert. The foundational support system is in complete disarray. Attempting to build a lasting recovery on this foundation is like serving a Michelin-star meal directly on the table before the appetizer and drinks: no plates, no silverware and no mind/body context for what is being offered or why.

The best outcomes carefully put all the elements to their correct place, in the right order, one step at a time, with measurable standards along the way. The current health and wellness system rarely allows for this. But knowing it is possible changes what we can offer.

This week, let’s look at one cause that gets in the way of that rotation.

Your Spine Was Built With Curves for a Reason

Your spine’s job is to carry the weight of your head and torso all the way down your pelvis. To do that well, it relies on three curves that flow into one another. Your neck curves gently in. It’s counterbalance, the upper back, curves out, and your low back curves in again. Each one normally measures between 30 and 35 degrees.

Those curves keep enough space between each bone in your spine to protect three important things: the cushiony discs sitting between the bones, the nerves passing through on their way to the rest of your body, and the balanced tension in the muscles connecting them.

Here’s what a normal neck curve and range of motion looks like:

https://youtube.com/shorts/PJKQbjDKLbo

What Happens When the Neck Straightens

When your neck, or any part of your spine, loses its curve, your head’s weight stops spreading evenly along the bones. Instead, it presses straight down onto the discs and the base where your neck and shoulders meet.

That extra pressure stops the discs from rehydrating the way they’re supposed to, so they shrink, and the bones move closer together. That crowding is exactly what limits how far your neck can turn.

Your Muscles Also Compensate

When the bones in your neck straighten, your head shifts forward. That moves your head’s weight off-center, away from sitting over your neck and toward your collarbones and chest.

To manage that shifted weight, the muscles along the sides and front of your neck, and at the base of your skull, end up working harder. Over time, they tighten. That tightness is a big part of what makes your neck feel stiff all the time and limits how well it turns.

Try This

Turn your head as far as you comfortably can, first to the left, then to the right. Now pull your chin in toward your throat as far as it will go and try turning again. Feel the difference? Pulling your chin in forces your neck into a straighter position and why it’s suddenly harder to rotate.

Why This Isn’t a Quick Fix

Restoring the curve in your neck takes more than stretching your head up or pulling your neck back. It’s more complicated than that because your neck’s curve isn’t working alone, it’s part of a connected system that supports your entire spine. When the neck loses its curve, the rest of your spine shifts to adjust to the new load.

Your neck also helps preserve the space your body needs to bring oxygen into your lungs. When that space shrinks, less air gets in. Your nervous system responds by pushing your head even further forward, trying to get back a little more room to breathe. Correcting the neck means addressing the entire spine and air flow.

Next up: Now that you know why a straight neck limits rotation, next week we’ll get into another cause: neck shift, how it reduces rotation, and why your body can do to prevent it from happening.

Don't stop your efforts in making an impact.

We’re wired through evolution to trust our sense of sight more than any other. Of all our senses, vision gives us the most information about the world around us, helping us detect threats, navigate our environment, and stay safe.

When we look straight ahead, each eye gives us roughly 100 degrees of vision to the left and right. Add the neck’s ability to rotate up to 90 degrees on each side, and we gain a full 360-degree awareness of our surroundings. This extra range lets us see what’s (potentially lurking) behind us to spot danger early, whether we’re walking down the street, driving, or playing sports.

When our functional visual field shrinks, our nervous system notices immediately. We become more cautious about where we move. Our finely tuned motion detection suffers and timing gets off. We may stumble, bump into things, or feel uneasy without fully understanding why. Performance drops in everything from athletics to everyday tasks.

Here’s the important part: a limited visual field is often not just an eye issue, it’s frequently a neck mobility issue. When neck rotation is restricted, we lose that critical peripheral awareness, especially in the far sides and behind us. We miss objects coming toward us, react too late or inappropriately, even feel constantly on edge.

Preserving good neck movement isn’t just about avoiding a pain in the neck. It’s about keeping our sense of safety, confidence, and performance intact.

Next week: What causes the neck to lose its ability to rotate the way it should?

Our experiences play a different but equally important survival function. They participate in a give and take of information essential to surviving current conditions. Changing circumstances alter the messages received. We adjust and then share that information with others. This contribution to evolution, referred to as epigenetics, acts more like a program update: a little tweak to the software to make it operate better given the environment. Unlike DNA, this input is determined by us.

Our Brains Are Designed for Input

While we do not have the largest brain by total volume we don’t need it. Our amazingly efficient design has instead given us the largest area responsible for processing information. The construction: two eyes, ears and nostrils on either side of the head, is designed to take in the vast quantities of data provided by the left and right sides of the head. Our task is to provide that input, and that’s where movement comes in.

There’s a difference between learning and experiencing, and we seemed to have lost the distinction between the two. Learning can be accomplished without having to interact physically with the world around you. Experience, with its deeper neurological and emotional imprint, cannot. Learning provides one half of the equation, experience the other, and together they give us knowledge.

Gathering Information requires physical activity – this is where the importance of movement starts.

Let’s broaden your horizons. See you next Sunday.

This desire produced remarkable results. It moved us away from relying primarily on brute strength and toward the power of our intellect. Even jobs that once demanded heavy physical labor are now supported by machines that lift, carry, and move for us. All of these advances reserve more energy to pursue play.

Here’s the catch: while our conscious thinking minds have adapted beautifully to this new way of being, our bodies are still running on ten-thousand-year-old hardware. And that operating system still requires lots of movement to function optimally.

Why?

At our core, we are engines — fueled by the rich input of our five senses: sight, sound, smell, taste, and most importantly, touch. When we limit how much we move, we reduce that vital sensory input, and the system becomes malnourished. Over time, we wither and not just physically, but intellectually and emotionally as well.

Work and play aren’t competing forces. They are partners that sustain us. Movement is the essential bridge that keeps us both healthy.

In the weeks ahead, we’ll explore how our bodies were truly designed to function, why physical activity is fundamental to both surviving and thriving, and practical ways to bring more intelligent movement back into our daily lives.

So why is it so widespread — and why does it so often return even after treatment?

The answer isn’t usually in the low back itself. It’s in the entire system above and below it.

The Low Back Was Never Designed to Carry the Load Alone

Your lumbar spine is meant to work as part of a team — sharing the weight of your head and torso with the neck and mid-back above, and supported by a stable pelvis below. When this system is balanced, load is distributed evenly and movement stays easy.

But modern life throws that balance off.

From Above: The Forward Head Cascade

When breathing becomes restricted, the head often drifts forward to help pull in more air. This straightens the neck and shifts extra weight downward onto the mid-back, which stiffens in response. The low back is left bearing far more load than it was built for.

From Below: Loss of Pelvic Support

The pelvis should act as a stable foundation. When it’s properly positioned, the deep core muscles (diaphragm, pelvic floor, deep abs, and back muscles) create internal pressure — your true “core strength” — that supports the spine from within.

When the pelvis shifts or tilts out of position, this pressure system weakens. The low back loses its internal brace and is left to fend for itself.

The Hidden Asymmetry That Starts It All

The human body is naturally asymmetrical. The liver (on the right) is significantly heavier than the spleen (on the left). The right lung is larger than the left to make room for the heart. These normal differences create a slight rightward weight bias.

In active people who move well, the body handles this asymmetry. But with prolonged sitting and repetitive patterns, the body slowly drifts rightward. The pelvis follows. The spine compensates. And the low back takes the hit.

What Happens Next

Over time, the low back compensates by tightening, tilting, sliding, and rotating. This uneven loading leads to the most common problems we see:

· Bulging or herniated discs

· Joint irritation and arthritis

· Spinal stenosis

· Vertebral slippage (spondylolisthesis)

These aren’t random injuries. They’re the end result of a system that’s been out of balance for a long time.

The Takeaway Low back pain is rarely just a “low back problem.” It’s a whole-body system failure. That’s why treatments that only focus on the painful spot so often fall short. Lasting relief usually requires restoring balance from the head down through the pelvis and ribs.

The good news? Once you understand the real pattern and fix it, real and lasting improvement becomes possible.

Leave a comment or question on how.

Photo courtesy: <a href=/__u/bethkais.substack.com/&#8221;https://www.vecteezy.com/free-photos/shoulder&#8221;%3EShoulder Stock photos by Vecteezy</a>

You’ve reset your pelvis. Your breathing is improving. But that right shoulder still feels tight, restricted, or “off.”

If this sounds familiar, there’s a good reason.

When the body shifts to the right (a common pattern), the right waist muscles tighten and pull the lower ribs down. To still get air into the upper right lung, the body recruits small muscles in the neck and a tiny but important muscle called the subclavius (which sits between your collarbone and first rib). Over time, this muscle gets tight and “glues” the collarbone and rib in a lifted, stuck position.

This is known in Postural Restoration as Superior T4 Syndrome. It limits shoulder movement and can eventually compress nerves heading down the arm, leading to tingling, numbness, or weakness (Thoracic Outlet Syndrome).

What It Really Takes to Free the Right Shoulder

Freeing this pattern requires working through several layers — in the right order:

1. Gentle nerve gliding (if nerves are irritated)

2. Releasing the tight subclavius (usually needs hands-on work)

3. Restoring proper rib and collarbone movement

4. Directing breath into the upper right chest to help the ribs rotate back down from the inside

5. Re-rotating the mid-back using the serratus anterior and reaching movements

Each step creates the conditions for the next one. This is why jumping straight to shoulder exercises often doesn’t work — the foundation isn’t free yet.

The Good News
If your right shoulder has been stubborn, it’s not that something is permanently broken. It just needs this specific, layered approach. Working with a trained Postural Restoration practitioner can make a big difference here.

The right shoulder is often the last piece to resolve — but when it does, everything feels lighter and moves better.

Most people are told the pain is from “wear and tear,” rotator cuff issues, or poor posture from sitting at a computer. Many traditional treatments focus exclusively on the shoulder joint itself — strengthening, stretching, or injecting the painful area. This localized strategy frequently delivers only temporary relief.

But what if that approach is missing the bigger picture?

The Shoulder Is Part of a Kinetic Chain

The shoulder does not operate in isolation. It sits on your ribcage, which connects to your upper back, which connects to your lower back and pelvis. For optimal shoulder mechanics, this entire chain must maintain proper alignment and mobility. Breathing plays a critical role in this system, as the diaphragm and ribcage directly influence shoulder blade position and stability.

How Breathing Impacts the Shoulder

For everything to move well, this entire chain needs to be balanced — and it all depends heavily on how you breathe.

When breathing becomes restricted or the pelvis shifts out of neutral, the ribcage compensates — sometimes lifting up on one or both sides. These changes in breath volume and ribcage position take away the shoulder’s stable base. Without a reliable foundation, the position and function of the shoulder become compromised, limiting range of motion and often leading to pain.

The Role of Natural Asymmetry

One of the most significant — yet often overlooked — contributors to shoulder dysfunction is the body’s natural internal asymmetry:

· The liver, located on the right side, is substantially larger and heavier than the spleen on the left.

· The right lung is larger than the left to accommodate the heart’s position slightly to the left of center.

Over years of modern living — with prolonged sitting, driving, and uneven weight distribution — gravity gradually pulls the body toward the heavier right side. This creates a common right-dominant shift: the pelvis tilts, the spine rotates, the ribcage adjusts, and the shoulder is forced into a less optimal position.

These subtle shifts accumulate slowly, which is why many people develop shoulder pain without any obvious injury or trauma.

A More Effective Path Forward

True shoulder recovery goes beyond strengthening or stretching the shoulder alone. The most effective approach is to restore balance to the entire system — starting with the pelvis and breathing — so the shoulder can finally sit and move in its natural, pain-free position by:

· Restoring neutral pelvis position

· Re-establishing full 360° diaphragmatic breathing, and then

· Rebuilding coordinated stability through the ribcage and core

Lasting improvement requires understanding that the shoulder functions as part of a larger, interconnected system. When the foundation is stable and breathing is optimal, the shoulder often regains pain-free mobility and strength naturally, without aggressive isolated exercises that may reinforce existing compensations.

By understanding and correcting these systemic patterns — rather than treating the shoulder in isolation — many individuals experience significant and lasting improvement in shoulder function and overall posture.

Ask me how.

The Superman (or prone back extension) is a classic exercise that’s been around since the early days of fitness. Lie face down, lift your arms and legs off the ground, and hold. It looks like it should strengthen your back and improve posture.

But it usually doesn’t.

How the Superman is Done

You lie on your stomach, arms extended overhead or hands by your ears. On the exhale, you lift your upper body and legs while keeping your pelvis on the floor. The goal is to strengthen the muscles along the spine (erector spinae), upper back, shoulders, and glutes.

It seems logical — a rounded upper back must mean those muscles are weak, right?

Not quite.

Why This Exercise Often Backfires

1. It strengthens the wrong muscles In most people with poor posture, the muscles along the spine are already overworked and tight. The Superman makes them even tighter, which can compress the discs and increase pain.

2. It flattens the wrong part of the back The upper back doesn’t round evenly. Usually only the top portion (near the neck) is too rounded, while the lower upper back is already too flat. The Superman extends the entire spine, making the already flat area even straighter.

3. It makes breathing worse A stiffer, straighter upper back restricts airflow into the lower lungs. Your body then compensates by rounding the upper back and pushing the head forward again — the exact posture you’re trying to fix.

4. It’s not functional Real life doesn’t involve lifting your arms and legs while lying face down. The upper back is designed to bend, rotate, and side-bend all at the same time — especially during walking, swinging, or reaching.

A Better Approach

Instead of isolating the back, we need to restore movement the way your body was designed to work.

The most effective exercises train the upper back to rotate, bend, and stabilize in coordination with the rest of the body. Moves like the Wood Chop and Reverse Wood Chop (which mimic a golf or tennis swing) do this naturally.

Postural Restoration (PRI) and Dynamic Neuromuscular Stabilization (DNS) take this further. They focus on fixing the root causes — poor breathing, ribcage position, and pelvic alignment — so the upper back can return to its natural curve without being forced.

When the foundation (pelvis and breathing) is stable, good posture becomes effortless instead of a constant battle.

Resources:

https://www.sciencedirect.com/science/article/abs/pii/S1934148214014397

https://ojassmartpt.com/2016/02/27/do-this-not-that/

We’ve all heard “use it or lose it.” And yes, muscle loss (sarcopenia) does happen with age if we become inactive. But the real story behind declining strength and function is far more interesting — and involves much more than just muscle size.

Fun Fact #1: The “Micro-Tear” Muscle Building Theory Was Never Proven

The idea that muscles must break down with tiny tears and then rebuild stronger became popular in the 1970s and 80s. While muscle biopsies showed tissue growth, they couldn’t distinguish between muscle fibers, connective tissue, or other changes. The actual mechanisms behind strength and performance gains are significantly more complex than that simple model.

The Nervous System: The Real Director of Movement

Movement isn’t just about muscle power. It’s a sophisticated conversation between your brain, nervous system, muscles, and connective tissue.

When you decide to stand up from a chair, your brain consciously initiates the action. But behind the scenes, your nervous system automatically recruits and coordinates dozens of muscles — some to produce the lift, others to control speed, stabilize joints, and maintain balance. This seamless teamwork is what makes the movement feel easy and effortless.

When this coordination breaks down, even simple tasks like sitting or standing become labored and unsteady.

Why “Getting Your Steps In” Is More Important Than Most People Realize

Purposeful walking — the natural opposite arm and leg swing with torso rotation — does something critical: it repeatedly shifts your body’s center of mass from right to left.

Here’s why that matters. The organs on the right side of your body (liver, right lung, etc.) are heavier than those on the left. Without regular leftward shifting through gait, these organs gradually pull your body into a right-dominant stance. Over time, you carry more weight over your right hip.

This chronic shift causes:

· Certain muscles to stay tight and overworked

· Others to become long and weak

· Your nervous system to “turn down” the signal to those underused muscles

The end result? Your brain stops effectively recruiting them, and movements that once felt automatic now require conscious effort.

Why Breathing Is One of the Most Powerful Factors

Deep, diaphragmatic breathing is your body’s natural internal core-strength system. When your ribs, diaphragm, pelvic floor, and deep abdominal muscles are properly stacked and aligned, they create intra-abdominal pressure that stabilizes your entire torso, spine, and pelvis.

Once you shift chronically to the right, these key muscles lose their optimal cylinder alignment. They can no longer generate that stabilizing pressure efficiently. The result is a loss of automatic core support, forcing your outer muscles and joints to work much harder during everyday tasks.

Test It Yourself

Sit in a relatively low chair.

First, do it normally: Notice how you lower yourself — is it a quick drop with a thud? When standing up, do you need a few tries? Do your knees cave inward? Do your legs feel like they’re working overtime?

Now add proper breathing:

1. To sit down: Inhale deeply as you lower. The internal air pressure helps keep your joints aligned for a slow, controlled descent.

2. To stand up: Lean slightly forward so your ribs are stacked over your hips. Take a full inhale, then exhale while gently drawing your belly button toward your spine and pressing through your feet.

Most people notice an immediate difference — the movement feels smoother, stronger, and more controlled.

It may take several practice repetitions for the inhale-on-the-way-down and exhale-on-the-way-up pattern to feel natural, but each repetition becomes a powerful, functional training tool for your nervous system, breathing muscles, and coordination.

Resources

https://www.stronger.melbourne/blog/micro-tears-and-hypertrophy-separating-fact-from-fiction

https://pmc.ncbi.nlm.nih.gov/articles/PMC6441901/

Posture to Performance

The Diaphragm and Pelvis Position

Beth Kais The “Core” Series…

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2 years ago · Beth Howzen (Kais)

How Do We Get So Lopsided? The Curious Case of the Lifted Right Shoulder

One of the most common posture quirks people notice is a higher right shoulder and uneven ribs. It’s not random — it’s largely caused by the natural weight difference between the organs on our right and left sides.

The Ribcage “Ring” Effect

Your ribs form a ring around your chest — attached to your breastbone in front and your spine in back. Like a hula hoop, movement on one part affects the whole circle.

When your body drifts slightly to the right (due to heavier organs on that side), the muscles on the right tighten to hold you upright. This pulls the right ribs down in front, which forces them up in the back. The shoulder blade rides those rising ribs and lifts toward your ear — creating that classic “lopsided” or hunchback look on the right side.

This pattern is common enough that Postural Restoration specialists call it the Right Brachial Chain (RBC) pattern.

What It Looks Like

• Right side: Ribs down in front, up in back → lifted shoulder, tighter waist

• Left side: Ribs up in front, down in back → lengthened waist, unsteady feeling

The result? Uneven breathing, tighter muscles on one side, and that visibly uneven posture many of us develop over time.

How to Restore Balance

The fix isn’t forcing your shoulder down. It’s gently reversing the pattern by shortening the left side and lengthening the right side.

Key Restoration Steps:

1. Shorten the left waist (bring left ribs and hip closer together)

2. Lengthen the right waist (allow right ribs and hip to move apart)

3. Breathe deeply into the newly opened spaces — especially the right front and left back ribs

Simple Positions That Work

• Left side-lying over pillows or a bolster (best passive option)

• Yoga Cat pose with right arm forward and right knee back

• Left lunge (left leg forward, right leg back) while holding a door jamb with your right hand

• Add 5–10 slow, deep nasal breaths in each position, directing air into the tight right side

Hold each position for several breaths, a few times per day. Over time, these gentle shifts help the right shoulder drop naturally, balance the ribs, and improve both posture and breathing.

🌊🚩

If you’ve ever been in a car accident or had a hard jolt to your head or neck, you might still be dealing with problems years later—even if you thought you’d “gotten over it.” Many people come to me with mysterious symptoms that all started after a whiplash-type injury. They’re surprised when I connect the dots: dizziness, bad headaches, sensitivity to light, blurry vision, jaw clenching, weird blood pressure swings, trouble swallowing, nausea, and even stomach issues can all trace back to that one old neck trauma.

My Own Story

I learned this the hard way. In 1990 I was in a car crash. For years afterward I suffered with many of the symptoms above. Regular physical therapy made things worse—neck exercises locked my jaw and made me nauseous. If someone moved my head, I had to close my eyes shut to keep from getting dizzy or feeling like I’d faint. Massage helped a little, but I was still clenching my teeth so badly that I cracked two molars.

That experience taught me two important lessons:

• After a big neck injury, the muscles and tissues around it go into “protective lockdown” mode. They stay tight until your nervous system finally feels safe enough to relax.

• Trying to push, stretch, or manipulate the neck directly often backfires. It triggers a survival reflex that makes your body guard the area and even more.

The smarter way is to leave the neck alone and work indirectly through other parts of the body that aren’t triggering those alarms.

Three Keys to Real Recovery from Whiplash

1. Build a strong foundation first Your neck doesn’t work in isolation. Start by getting your pelvis balanced, your ribcage sitting properly, and the natural curves in your upper and lower back restored. When the whole spine is aligned and stable, the neck feels a solid base to heal on.

2. Reposition the neck without touching it Work through the shoulders, jaw, and eyes instead. Because your brain doesn’t link these areas to the original injury, it doesn’t freak out and tighten up. Gentle movements here can slowly and safely guide the neck back into better alignment from a distance.

3. Give the neck a feeling of safety A simple rolled towel placed under your neck (thick enough to support it gently) can make a big difference. That little bit of support tells your nervous system, “It’s okay now—you can let go.” Once the protective tension eases, real healing can finally begin.

Bottom Line

Whiplash isn’t just a “stiff neck” that goes away on its own for everyone. For many people it creates a chain reaction of symptoms that can last for decades—unless you address the root cause in a nervous-system-friendly way.

If this sounds familiar, don’t keep pushing through the pain with treatments that make you feel worse. Look for approaches that respect your body’s protective reflexes and work with them instead of against them.

Helpful Resources

• Vertebrobasilar Insufficiency & Upper Cervical Issues

• Cervical Oculopathy (Neck-Related Eye & Vision Problems)

If you’ve been struggling with any of these symptoms after an old injury, feel free to share your experience in the comments. You’re not alone—and there is real relief. 🌊🚩

If you’ve ever dealt with neck pain, you’ve probably been told to do the usual stretches: tilt your ear toward your shoulder, pull your head gently with your hand, or slowly turn your head side to side.

These moves are the most common recommendations in physical therapy. They make sense on the surface — your neck feels tight, so stretch it.

But here’s the problem: They rarely deliver lasting relief.

Why Neck Stretches Usually Fall Short

Your neck doesn’t get tight for no reason. It tightens because it’s compensating for something happening lower in your body — typically shallow breathing, a torso that’s rotated one way, and a pelvis that’s shifted the other.

When you stretch the neck directly, you’re only treating the symptom. The muscles you’re stretching are often working overtime to help you breathe by lifting your upper ribs. As soon as you take your next breath, those same muscles tighten right back up again.

Another issue? Neck rotation isn’t just about turning your head. Your torso also needs to rotate underneath your neck. If your body isn’t turning properly (for example, during walking), your neck will keep compensating no matter how much you stretch it.

Result?

• At best: Temporary relief

• At worst: More irritation or no real change

A Better Way: Restore from the Foundation

Instead of forcing the neck to move on a misaligned body, the most effective approach is to restore proper breathing and torso position first.

Posture to Performance

Assessment Confirmation - Pelvis Corrections

The easiest pattern correction to understand is both hips tilted forward (second pattern) because both sides activate the same muscles to restore the pelvis and torso position. In many cases this lying exercise in combination with a breathing exercise and standing exercise put you well on your way to posture correction…

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2 years ago · 2 likes · 2 comments · Beth Howzen (Kais)

When you do this:

• Your lower ribs down and even with your hips. They will expand better, so the neck and shoulder muscles can finally relax

• Your body recenters, allowing the head to sit more evenly on the neck

• Tightness on the right side of the neck eases as the weight of your head returns to center

The Simplest Fix You Can Do Today

Then go for a walk.

Walking is one of the best natural ways to improve neck mobility without forcing anything. As you walk, your body naturally rotates:

• Right arm swings forward with your left leg

• Left arm swings forward with your right leg

This gentle, rhythmic torso rotation turns your body under your head. Over time, it helps restore smooth, even neck rotation — something most stretches never achieve.

Your body has a very reliable way of telling you something is off with your alignment and core stability:

Mouth breathing.

When you catch yourself breathing through your mouth during the day — or wake up with a dry mouth and sore throat — it’s rarely just a “habit.” It’s often your body signaling that your airway is narrowed because your posture has shifted.

Why Nasal Breathing Matters So Much

Your nose isn’t just a passageway. It’s a smart air-processing system that:

• Produces nitric oxide to improve oxygen delivery throughout your body

• Filters dust, bacteria, and viruses before they reach your lungs

• Warms and humidifies the air so your airways stay comfortable

• Helps maintain proper oxygen/CO₂ balance, keeping your muscles relaxed instead of tight

Mouth breathing skips all of these benefits and often leads to:

• Shallower breathing and less oxygen efficiency

• Increased muscle tension (especially in the neck and shoulders)

• Poorer sleep and more snoring

• Reduced core stability

Most importantly: Mouth breathing usually means your diaphragm isn’t working well, which weakens the natural “cylinder” of pressure that stabilizes your spine, ribcage, and pelvis.

The Real Signal Behind Mouth Breathing

Here’s what’s actually happening:

When your pelvis drifts forward and your low back loses its healthy curve, your neck often follows — straightening and shifting to the right. This narrows the airway at the throat level. Your body’s smart response? It pushes your head forward and opens your mouth to pull in more air.

That’s why nasal strips, mouth tape, or dilators usually only give short-term relief. They treat the symptom (mouth open) but ignore the deeper alignment issue that caused the airway to narrow in the first place.

The Better Way to Fix It

Start at the foundation.

When you reposition your pelvis back toward center and restore a normal curve in your low back, your neck naturally recenters and regains its curve. An aligned neck creates a more open airway — making nasal breathing feel easy and natural again.

Quick Self-Check: Notice how often you breathe through your mouth during the day or first thing in the morning. That’s valuable information from your body.

In the next article, we’ll cover simple techniques (including a surprising balloon exercise) to help retrain nasal breathing and restore better alignment from the ground up.

Try This Technique to Restore Better Posture and Nasal Breathing

What You’ll Need:

• A balloon

• Something soft to squeeze between your knees (pillow, ball, or rolled towel)

• A low step, stool, or chair

How to Set Up:

1. Sit comfortably on a low stool or chair.

2. Place the pillow or ball between your knees and gently squeeze it.

3. Hold the balloon in your left hand.

4. Extend your right arm straight out in front of you, slightly higher than your chest.

5. Slouch forward as much as you comfortably can (yes, really slouch!).

How to Do the Exercise:

1. Inhale deeply through your nose.

2. Exhale fully into the balloon — pucker your lips like you’re whistling or blowing a kiss. Keep your cheeks tight to your jaw

3. After exhaling, pinch the balloon closed using your tongue pressed against the roof of your mouth (this stops the air from escaping).

4. While still pinching the balloon with your tongue, inhale again through your nose.

5. Exhale into the balloon again.

6. Repeat steps 1–5 until the balloon is full (usually 3 to 5 breaths).

7. Fully deflate the balloon and repeat the entire sequence 3 times.

If you’ve been dealing with neck pain, tension headaches, tight shoulders, or jaw issues, chances are a doctor or therapist told you to do chin tucks.

Pull your chin back. Hold. Repeat.

It sounds logical — your head is forward, so pull it back. But for many people, this popular exercise delivers little relief… or actually makes things worse.

Here’s why.

The Real Problem Isn’t Just “Forward Head”

Forward head posture is rarely just a head problem. It’s usually a breathing and whole-body compensation issue.

When you breathe shallowly through your upper chest (very common with stress and screen time), your body moves your head forward to open your airway so you can get more air. This is a survival strategy, not bad posture.

Chin tucks don’t address this root cause.

5 Reasons Chin Tucks Often Fail (or Backfire)

1. They don’t fix the breathing pattern driving the forward head.

2. They move the head backward on the neck but don’t restore proper head-on-neck alignment.

3. They can increase tension on the already tight right side of the neck.

4. They strengthen the wrong muscles (extensors instead of deep flexors).

5. They can worsen jaw bracing and TMJ symptoms.

In short: Chin tucks treat the symptom while ignoring the system.

A Better Approach: Re-Center from the Foundation

Instead of forcing your head back, start by re-centering your pelvis and improving breathing. When the body is better aligned below, the neck often naturally follows.

Simple Reset Exercise: Wall Pelvis Re-Centering (Do this daily — especially as a Reset Sunday practice)

What you need:

· A wall

· A small pillow, towel, or ball (to place between your knees)

· Optional: small pillow under your head

How to do it:

1. Lie on your back with hips and knees bent, feet flat on the wall (aligned with hips).

2. Gently flatten your lower back by bringing your ribs slightly down.

3. Place the ball/pillow between your knees and give a light squeeze (20–30% effort).

4. The Shift:

o Pull your left heel down into the wall

o Gently lift your tailbone slightly

o Press your right knee upward (keep both feet flat on the wall)

5. Breathe slowly: Inhale through your nose for 6–8 seconds, exhale for 8–10 seconds while gently drawing your belly in.

6. Hold for 5 slow breaths, then rest 15 seconds. Repeat 3 times.

The position looks like this

Now you can gently open your jaw wide and move it to the left, relieving right side tension and relocating the jaw back to center.

Note: If you have TMJ or jaw clicking, open and move your jaw to the right in a way that does not cause pain or trigger clicking.

1. Forward head posture isn’t mainly a “head” problem It’s usually a breathing problem. When you breathe shallowly through your upper chest, your body moves your head forward to open the airway so you can get more air. It’s a survival strategy, not a bad habit.

2. Pulling your chin back doesn’t fix the real issue Chin tucks move the head backward on the neck, but they don’t restore the natural downward curve (flexion) the neck needs. In many cases, they actually increase tension and compression.

3. Your neck isn’t symmetrical Most people have a slight rightward drift (we’re naturally heavier on the right side). Pulling the head straight back on a neck that’s already shifted right can:

   • Tighten the already stressed right-side neck muscles even more

   • Increase jaw clenching and TMJ discomfort

   • Reduce blood flow through the right vertebral artery

   • Reinforce the very extension pattern you’re trying to correct

4. It trains the wrong muscles Chin tucks strengthen the muscles that straighten the neck (extensors), not the deep flexors that create a healthy curve. You end up reinforcing the same poor pattern.

5. It makes the jaw-neck relationship worse When the upper neck is unstable, the jaw often braces backward to protect it. Chin tucks can increase that bracing, leading to more tightness, clenching, and pain.

Bottom line: Chin tucks treat the symptom while often making the root cause (breathing + whole-body alignment) worse.

What Should You Do Instead?

Instead of forcing the head backward, the smarter approach focuses on:

• Restoring proper breathing mechanics (especially low ribcage expansion)

• Releasing compensatory jaw and neck tension

• Gently repositioning the head on the neck (not just pulling it back)

• Addressing the entire spinal chain — especially the low back and pelvis

If this article resonated and you’re ready to move beyond generic exercises that aren’t working, I’d be happy to help.

Feel free to reach out at posturetoperformance@gmail.com for a personalized assessment and guidance tailored to your unique pattern.

I reply to every email.

Warmly,

Beth Kais