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Analyzing Bad Posture and The Increased Likelihood of Falls in Older Adults

According to the Center for Disease Control and Prevention (CDC), an older adult falls every second of every day in the United States. Falls are the leading cause of death and injury among older adults. In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and an estimated cost of $31 billion dollars in medical costs. 1

What is “Ideal Posture?”

Ideal Posture is based on alignment of various anatomical landmarks. The head should be aligned properly over the shoulders, hips, knees and ankles. By maintaining proper posture, your body is in its “natural” position with optimal force distribution through the various joints and muscles. 

Why is “Ideal Posture” important?

Proper alignment with ideal posture allows the joints and supporting structures to absorb force as they are designed to do so and muscles to function at their optimal length and position. With postural deficits, such as forward head and/or rounded shoulder posture, compression through the spine is altered and muscular imbalances develop. Both are commonly seen in older adults, which affect spine health and bone integrity leading to increased risk of osteoporotic changes and possible fracture. The design of your spine is based around specific curvature and when changed increases risk of injury. 

Not only does it affect the anatomical structures but also how we function.  Forward head and rounded shoulder posture alters the eye gaze from horizontal, requiring increased extension of the neck to maintain the natural horizontal position in order to prevent a loss of visual field. Decreased visual field limits one’s ability to see upcoming objects at distance which decreases reaction time.

Bad Posture also alters one’s Center of Gravity. Your Center of Gravity is a hypothetical point at which all of your mass centralizes and gravity acts. This changes from static to dynamic positions based on movement of body parts. With postural changes, the Center of Gravity often becomes displaced. This displacement is commonly to a position in front of our body and outside of one’s Base of Support due to the forward trunk lean and spinal curvature changes. Your Base of Support is the area around which your feet occupy with standing. As you can expect, the body becomes naturally “imbalanced” and requires compensation to address and prevent falls from this impairment alone. 

This compensation is through increasing and lowering one’s Base of Support through widening stance width and squatting or hunching down to assume a position lower to the ground. As a result of widening one’s base, step length is shortened and cadence (the number of steps taken per minute) increases. Research has shown that a decreased step length and increased cadence is associated with increased fall risk in older adults.

Improve your posture and increase longevity with Physical Therapy

As you can see, posture plays a major factor in one’s function and even small impairments can lead to significant changes. Our Doctors of Physical Therapy are experts in analyzing and correcting these impairments with appropriate education, stretching and/or therapeutic exercise using an individualized approach. 

If you have a history of falls, experience fear of falling, or would like to have your posture analyzed contact our office at 305-279-7677 to schedule an appointment with one of our Doctors of Physical Therapy today.


  1. Falls are leading cause of injury and death in older Americans. Centers for Disease Control and Prevention. Published September 22, 2016. Accessed January 3, 2020.

Author: Heath Bailey DPT 

Doctor of Physical Therapy 

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