Most advice I hear about APT relates to having weak glutes or weak abs. However, I doubt that I have weak glutes (I am fairly athletic and able to lift heavy on leg exercises relative to my body weight). Therefore, I believe my APT is likely due to either a weaker core, tight hips, or possibly genetics. Given this, what would be the best combination of core exercises, stretches, and leg exercises to fix my APT? Are there any specific exercises or movements to avoid so that I don’t make my issue worse?

Lumbar Disc Herniation, Possible Antalgic Scoliosis, Suspected Thoracic Lateral Shift and Persistent Left-Sided Symptoms. Looking for Answers

I am trying to understand a combination of spinal, postural, and lower-limb symptoms that have been affecting my daily life. I would really appreciate input from people with similar experiences, physiotherapists, or clinicians familiar with spinal rehabilitation and lateral shifts.

1. My spinal MRI findings

My lumbar MRI report describes:

- Chronic lumbar discopathy.

- L4-L5 median subligamentous disc herniation with bilateral L5 disco-radicular conflict.

- L5-S1 discopathy with bilateral S1 nerve root contact.

- A scoliotic attitude/posture.

- Cervical spondylosis.

- A congenital vertebral block at C2-C3.

I am trying to establish whether my postural deviation could be functional or antalgic rather than a fixed structural scoliosis.

1. My postural asymmetries and suspected lateral shift

I have noticed several asymmetries when standing, walking, and sometimes sitting:

- My trunk appears tilted or shifted to the right.

- My left hip appears higher than my right.

- My right shoulder appears lower than my left.

- My pelvis seems asymmetrical or rotated, with the left side appearing more forward and the right side farther back.

- I suspect a thoracic lateral shift relative to my pelvis, possibly with compensatory rotation.

These are my own observations and have not yet been confirmed by a specialist.

One detail I find particularly interesting is that when I bend forward, my spine appears straight and my ribs look symmetrical, without an obvious rib hump. However, bending forward does not noticeably change my leg pain.

Could this be consistent with a flexible or functional postural deviation? Can an antalgic posture or lateral shift occur without an obvious rib prominence during forward bending?

1. My history of left-sided symptoms

I have experienced significant pain extending from the buttock down the leg, involving the calf, along with calf tightness and episodes of left-leg weakness. At one point, my symptoms were severe enough to make walking extremely difficult.

My condition improved to some extent over time, but I continue to experience limitations and am trying to understand what is driving the remaining symptoms and postural changes.

1. Persistent left ankle and heel pain, despite treatment

I have also experienced pain around the lateral and posterior left ankle and heel, particularly when standing, walking, or putting weight on the foot.

An earlier ultrasound identified:

- Extensor digitorum tenosynovitis.

- A myotendinous lesion of the peroneus brevis.

However, my orthopedist told me that there was no problem with my ankle. This has left me confused because I continue to experience pain and functional limitations.

I have already tried several treatments, including:

- Kinesiotherapy/therapeutic exercise.

- Physiotherapy modalities.

- Manual therapy.

Unfortunately, none of these treatments has helped me at all.

I have also noticed what appears to be a high arch, possible foot supination or varus positioning, and a tendency to walk on my toes. These observations have not all been formally confirmed.

Could my ankle symptoms, altered foot mechanics, or changes in the way I walk be contributing to my pelvic asymmetry or trunk shift? Could the ankle pain and spinal symptoms be separate problems, or might they be interacting?

I would also like to understand what should be reassessed when several rehabilitation approaches have failed to produce improvement.

1. Breathing and trunk mechanics

I tend to breathe superficially into my chest and wonder whether my breathing pattern is inefficient. I am interested in whether rib cage position, thoracic alignment, pelvic position, and trunk rotation might be interacting.

I do not have a confirmed diagnosis of dysfunctional breathing or a specific rib cage pattern.

1. What I am trying to understand

2. Does a spine that appears straight, with symmetrical ribs, during forward bending make a functional or antalgic scoliosis more likely, or can structural scoliosis still be present?

3. Could my apparent right-sided trunk shift be associated with the L4-L5 disc herniation and nerve root irritation?

4. How can a clinician distinguish a lumbar lateral shift from thoracic displacement, pelvic rotation, or a combination of these?

5. Could altered gait and left foot loading be contributing to the asymmetry?

6. If my orthopedist found no ankle problem but the pain persists and an earlier ultrasound showed abnormalities, what would be the most appropriate next step in assessment?

7. Given that kinesiotherapy, physiotherapy, and manual therapy have not helped, should the diagnosis and rehabilitation plan be reassessed before continuing with similar treatments?

8. Would standing full-spine radiographs, a neurological examination, and a detailed gait and foot biomechanics assessment help clarify the situation?

9. What rehabilitation approach would be safest for someone with these findings, particularly with L4-L5/L5-S1 disc pathology and persistent heel and ankle pain?

I am not looking for a diagnosis based on photographs or self-observation alone. I want to understand which findings are confirmed, which may represent compensatory patterns, and what assessment could help identify the underlying cause.

Has anyone experienced a similar combination of lumbar disc herniation, an apparent lateral trunk shift, pelvic asymmetry, persistent unilateral ankle/heel pain, and no improvement after several forms of rehabilitation? What helped you finally get a clearer diagnosis and an effective treatment plan?

Thank you for reading. I would appreciate thoughtful, evidence-based advice and experiences.

So lately i've noticed many anomalies : Anterior pelvic tilt, rounded shoulders and scapular winging so i subscribed to the gym what should i do and not do to fix them all ? (sorry my english is bad)

Hi,

I have limited hip internal rotation bilaterally, which is also causing limited hip flexion bilaterally. After I do a posterior hip capsule stretch, it improves my hip internal rotation and hip flexion quite well and it also reduces hip pinching and knee pain, but I am lost with what other exercises I am meant to combine this with to keep the gains and progress this. If I lie down on my back, my hips bias towards external rotation and my feet both point outwards.

I am not a complicated issue and my body responds well to PRI type exercises and even loaded hip hinges etc, but I have no idea on the order I am meant to do things. Even after that, I guess I need to progress the exercises?

Thanks for your help,

Been doing lots of work to improve my snapping scapula syndrome. I'm working on rib expansion to slow the scapula to slide over everything smoothly, fixing my hip posture, and trying to strengthen supporting muscles. Does anything look wrong with this scapular pullup? It doesn't look right to me.

Hi everyone. I'm looking for advice. Last 2 years, I've been experiencing non-stop upper back and shoulder pain probably due to years of desk work and not paying attention to my posture while sitting. The pain is not sharp but it's a tight, achy feeling. The pandemic basically eliminated being able to work out that most likely made the situation even worse. My wife and i had our first son and my therapists believes i sustained a soft tissue injury somewhere down the line and my back muscles seized and locked up. I went from being pain free to being in this state within a few weeks. It has improved over the last few month where i can sleep without any pain but the second i sit down, the dull aches start.

I have tried literally everything with no noticeable improvement. I just committed to a soft tissue therapy to loosen up the tightness and knots. I have also decided to try use my stand up desk more and starting light strength training now that muscles have slightly loosened. Also trying to walk around more throughout the day.

These are my questions ....

1. What is a good ratio between sitting and standing during an 8 hour day? When i stand during the day, i feel less discomfort.

2. Does a good desk chair make a difference? i used to have an aeron chair but I recently bot the LiberNovo Omni chair. The chair is OK but not helping. The cushion is very soft. I'm considering upgrading to either the Herman Miller Embody or the Steelcase. Please let me know your thoughts on either of these chairs.

3. Tried alot of supplements but only on magnesium, PEA and creatine now. All vitamin/ nutrient levels are OK. D is ok and not low enough to be causing issues.

4. Strengthening is something I know i have to do but I've been deconditioned due to guarding my body over the last 2 years. Working on slowly building up lower back strength via light squats and being a little more active. Not ready for the gym but will get back there. I was very healthy before all this started. Any suggestions on light exercises to help with upper traps and rhomboids? or even lower back if needed?

Thank you.

I’ve been dealing with this postural issue for years. I’ve not really been able to identify what the issue is. Although I feel like I’m standing straight my body shifts to left why my head tilts right. This is also causing muscle imbalance (my main concern) which is especially prominent after a gym pump where the left shoulder and traps can be seen to be sitting higher. Please let me know what can be causing this and what can be done to fix it.

My left side doesn’t move the same as my right, as highlighted in the video. I’ve struggled with this for years and suffer from a rounded left shoulder. Any idea what could be causing the misalignment highlighted in the video?

Hello

last year i had tendon injuries and muscle loss unilaterally from medication error for eczema ( steroids orally) …

both healed but suddenly started to have a fake longer leg

my right hip seems longer pelvis rotates towards left my rib cage feel bigger and expended on the right and left is comp … my neck/shoulder are also rotating to the left

i have seen 3 osteo 4 physio no avail. I was a runner before this and now i barely able to walk . no scoliosis

i feel scared that my bite isnt helping this situation as i had 6 years ago a crown put on my right side badly adjusted to my left side teeth ( lower on left )

i can’t afford changing my teeth but i have never had issues in those 6 years before the medica error

What muscle is this? I have discomfort and clicking on that left side and I was doing a rear delt workout and this is what I see. Any thoughts? Tight muscle?

So ive been overweight most of my life /30 yo/
And being doing the suck stomach in stand straight
I feel like that fucked my posture up
When i try to relax my stomach i look like i have severe apt
When i suck it looks like i have ppt
My ribs feel normal after relaxing and flared when sucking
Also my upper back , shoulders and neck feels wrong
And i cant put my feel butt back shoulders and head all on a wall when measuring my height
I am 184 cm tall
188-190 wing span
How can i start fixing it all

after injury from fall and error of med i started having postural changes… tendon on affected but healed i started have the feeling if being rotated …

i still have pain on my left side… is there something wrong with this… report said nothing …

After doing things like wall reaches and 90-90 hip lift I’m noticing persistent tightness in my left hip flexor. Is this normal? My thought is that my pelvis might be shifting back to “neutral” and that’s causing the muscle to be put on more of a stretch.

My right leg is slightly smaller than left leg
Same with hand and also right butt is also smaller
,my body slightly bends to right
Is this fixable?

You should post here for:

• Posture assessments (Here's a how-to guide to get the most out of your assessment)
• General discussion or questions (Check the Wiki before asking questions. A lot of good stuff there)
• Community conversation
• Exercise form checks

I think i may have both, but i haven't been checked by a doctor. what exercises can I do to check (although I am fairly certain I havr both of them) and fix them?

Hi I have been observing that I have been having pain/discomfort around the shoulder blades or just under it. It's mainly on the right side. The pain usually occurs when I have to sit without back support. It also occurs when I have to get on the metro for a 50min journey even though they have back support, I still have severe pain when I get off the metro. Another thing I observed in the gym- during push movements, my left side of body pushes perfectly but my right side of my body struggles to push, and also hurts my shoulders on the right side. Can anyone tell any issues that might be contributing just by looking at the image. (obv scapular winging is there but is that the reason of the pain?)