2. If Your Body’s Alignment is a Problem, How Will You Know?

This is the second article in a series about body alignment. Today’s article addresses controversial topics such as the relationship between posture and pain and whether alignment matters.

It concludes with an idea that may be overwhelmingly at first glance, but is actually liberating in it’s simplicity. Scroll down for the start of the article.

[thrive_text_block color=”green” headline=”Background”]I went from enjoying an active lifestyle to being unable to take a quick, short walk without significant pain and discomfort.

I wrote this series in hopes of helping other people avoid this fate or overcome similar problems. Don’t mistake this for professional advice – I’m not a physical therapist.

The culprit in my body’s misalignment is a left leg half an inch shorter than the right. Even if your legs are the same length, you could still be suffering from alignment problems and benefit from what I’ve learned. [/thrive_text_block]

[thrive_text_block color=”blue” headline=”Articles in the Alignment Series”]

  1. Is your balance worse on one side? Could alignment be the problem? Describes the progressive deterioration I experienced over the course of decades, slowly at first, then rapidly. My right leg mysteriously twisted inward and I lost my balance on that side. Figuring out what was happening was a long, frustrating and expensive process.
  2. If your body’s alignment is a problem, how will you know? [YOU ARE HERE] In this article I tackle several topics, like does alignment even matter? The biggest message I hope you take away is that when we take a reductionist view of our injuries and pain points we miss the chance to make long lasting changes to our bodies.
  3. Surprising Signs of Misalignment: Assess Yourself Learn ways to get a sense of your skeletal alignment.
  4. Exercising for Alignment Remember, I am not a strength trainer. I’m not even pretending to be one on the internet. I’ve done many, many exercises and programs to try to improve my chronic problems, as prescribed by professionals. Nothing has been as effective at re-shaping my body as the way I exercise now.
  5. 12 Random Tips, Insights and Admonitions About Alignment A mash up of things I’ve learned and things that have helped during this process.


Debating the importance of alignment

There’s endless debate about the importance of alignment and posture, likely because several issues get tangled up together.

The first is that “aligned” implies symmetrical, which are related but not equivalent concepts.

We are all structurally asymmetrical, partly because we are born that way and partly because of our habits.

  • Internal organs are asymmetrical
  • Most everyone is right or left-handed
  • Much of the work we do is one-sided and repetitive
  • Long bones may grow to different lengths
  • Joints may be shaped differently from side to the other
  • Other congenital asymmetries
  • Traumas and surgeries that alter our skeletons

Can an asymmetrical body be aligned? Can it be organized and balanced for easy posture? I think it’s more difficult when the skeletal structure is more asymmetrical.

Unfortunately, science hasn’t added much clarity to this subject. Alignment and good posture carry the promise of comfort, ease and lack of pain, but research hasn’t established much of a connection between pain and posture.

Usually I prefer evidence-based discussion, but there are too many limitations to the research in this field. In my opinion…

1. There aren’t affordable, reliable and meaningful ways to quantify alignment or measure various body parts and positions.

2. It’s hard to ask the right questions. For example, studies show no association between lower back pain and leg length discrepancies (LLDs). I have a LLD and no lower back pain, but my longer leg twisted and bent inward. Does that mean LLDs matter, or don’t matter? Scientists have to ask the right questions. Think of all the survey questions you’ve answered that miss the mark.

3. Scientists need to ask the right questions at the right time. When we’re talking about the potential negative outcomes of misalignment we’re talking about a timescale that lasts a lifetime. That’s pretty hard for scientists to work with.

Does alignment matter?

In the context of biophysics, the answer is unequivocally, “yes, alignment matters.”

Gravitational forces have an enormous affect on our bodies. These forces shape our physical shape and determine the balance of our development. Not only does alignment affect muscle strain and movement efficiency, as I already described, the position of bones and joint angles influence how muscles develop.

The activity doesn’t matter – lifting weights in the gym, skiing 30 km, running for the bus or working at a desk – poor alignment causes muscle imbalances to develop both front to back, and right to left.

And it’s not just a few muscles in localized areas, like tight hip flexors and weak glutes. Imbalances riddle the entire musculoskeletal system. In my case, even the tiny muscles on the back of my skull were imbalanced and tight on one side.

Strength imbalances in our muscles then feed back and affect joint positioning, which affects how our joints wear over time.

None of this is theoretical speculation. This is fact. I think what people really mean when they debate “does alignment matter?” is:

Will the average member of the general population experience negative consequences, such as pain, discomfort, injury or loss of function because of skeletal misalignment?

This is where things get murky because there are so many factors at play. I can think of 5 pieces to this puzzle:

  1. Age
  2. Activity
  3. Individuality
  4. The extent of your misalignment and structural asymmetry
  5. Performance demands

Imbalances stemming from misalignment are accelerated by age and activity level. In the same way that more repetition and heavier loads in the gym make you stronger, more work done with poor alignment strengthens and reinforces the misalignment.

Every year spent living with poor alignment and every exercise done while out alignment has the potential to compound upon itself. Misaligned movements become deeply ingrained and muscle imbalances grow more pronounced with time.

In addition to age and activity level, the extent of misalignment and a person’s perception probably make a difference. Pain and physical discomfort are famously complex topics and vary from one person to the next.

And finally, what you ask of your body makes a difference. The greater the strain you place on your body, the greater the need for better alignment.

I think of postural alignment as a linear gradient. It starts with perfect alignment, which is perhaps only theoretical. From there, misalignments are minor and of no consequence, but as you move along the gradient they get progressively more severe and have greater potential to be of consequence.

Where we sit on the gradient changes with time. The degree of physical discomfort varies from person to person. Is there a tipping point? There was a cliff for me, but my bigger problem was that I didn’t even understand what was happening.

The Right Question

I think “does alignment matter?” is the wrong question. The complexity of the underlying factors render it meaningless.

Based on my experience, the right question is:

If your alignment is a problem, if it’s the root cause of your chronic pain, discomfort or recurring injury, how will you know?

I spent years chasing solutions to various pain problems, all the while my body continually deteriorated and became more dysfunctional.

I tried pretty much every manual therapy you can think of and diligently did prescribed stretching and strengthening exercises to targeted weak or tight areas in my body.

When I finally understood my problem as total body alignment, I knew I needed a different solution. I stopped focussing on localized problems and instead developed a more global, whole body approach.

Redefining my issue as “alignment” has made all the difference; I’ve made more progress in the last 6 months than the previous decade and in large part I credit my changed perspective.

Words matter. How we define our problems matters. Linking pain, injury or other issues to a diagnosis has a powerful effect. It suggests possible solutions.

But be careful! As much as it opens doors to potential solutions, it closes doors as well. It’s possible to close the door on the right solution. By always zeroing in on various areas of pain, dysfunction, weakness, tightness etc I missed the real issue. And by “I”, I mean myself and almost every professional I consulted for help.

I know the goal of improving total body alignment seems overwhelmingly complex, but difficult and impossible are not the same thing. If we’re not dead, our bodies can change. In fact, our bodies will change, whether we take an active role in the process or not.

Once you understand the overall goal, you just have to apply the same age old principles that people have used to transform their bodies since the dawn of time.

Are you in pain? Chronically injured?

Don’t mistake this for medical advice and I’m not suggesting you don’t seek professional help – if you experience pain or strange sensations, you should!

But if you suffer from mysterious pain or recurring injury without explanation, perhaps it’s time to consider your whole body alignment as a possible culprit. This might seem counterintuitive, but taking a big picture perspective is incredibly liberating.

All your pain and problems will still be there, at least for awhile, but they become background noise, little signals not to worry about too much because you have a bigger, long term goal.

So long as you believe that you can change your body (which you can) and you accept that it’s a process that will include stalls and set backs, you will continue to move forward.

The Perfect Body Project

I know this sounds crazy, but once I named my problem “alignment”, I decided I would build a perfect body. I say “perfect body”, not because I’m vain (which I am) and not even because I believe I can build a perfect body. I know I can’t.

I set “perfect body” as my goal because the goal defines the process, and that’s what I really care about.

I would love to untwist my leg, but if that was my goal, I would miss all the other opportunities to improve my body, which may also be related. As I build my “perfect body” not only will my current issues will resolve, I’ll prevent future problems as well.

Well, that’s the dream, anyway. Will it work? It’s too early to say, but I can hope.

As for what I mean by “perfect body”. I mean my muscles will be developed and balanced from right to left, front to back and between my upper and lower body. I will be able to do all basic movements pain free and with perfectly symmetrical form. Plus, I’ll have all the physical hallmarks of good posture.

The only way I will achieve these external outcomes is by taking steps to help my internal framework, my skeleton, become optimally aligned.

I find it helpful to publicly state my goals like this. It helps me commit to the objective because I don’t want to embarrass myself by not following through.

If you’re like me and want to commit to improving your posture/alignment, feel free to state your intentions in the comments section below.

In the next article, we’ll get started with self-assessment.

Next Article: Surprising Signs of Misalignment: Assess Yourself

5 thoughts on “2. If Your Body’s Alignment is a Problem, How Will You Know?”

  1. I got punched in jaw and I have been in physical therapy since October and still going. She tells me my body is out of alignment and is treating me with intense therapy, any suggestions here.

  2. hi
    i just came from seeing my chiro this morning. i have terrible pain in calve muscles. surprised to know my body is out of alignment and blood flow and signals are minimal to calves.

    thanks i read your whole article. it makes lot of sense. I am from a country where physio are prominent with less chiro. loved your article.
    keep up

  3. I have one leg shorter than the other by a cm as a result of tib/fib fracture. I have suddenly developed back pain in the fifth month after the injury. Could the back pain be attributed to the loss of a cm?

    • In my opinion, this is the most obvious place for a therapist to start their investigation. Honestly, I can believe how complacent most therapists are about leg length discrepancies. If you suddenly lost 1 cm off a leg, you’d hope that someone would maybe suggest correcting that.

Leave a Comment