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Postural Imperatives: Uncompensated Imbalance = Weak Posture

A new European Spine Journal study by Italian orthopedic surgeons looked at spinal compensation and noted two important purposes of normal sagittal alignment:

  1. Allowing the individual to maintain a horizontal gaze.
  2. Keeping the body balanced.

While they didn’t use our terminology, they described the PostureZone© concept and stressed the importance of a centered body-gravity line, with head over torso over pelvis over the support area, or the feet.  They noted that “this makes it possible to maintain the standing position without external support and with minimum muscular effort.”

They also had some interesting observations about posture for all clinicians, including:

  • Sagittal balance is an independent predictor of clinical outcomes in spinal care.
  • Aging trends toward loss of sagittal alignment.

The paper described a new concept, “uncompensated imbalance,” defining it as “increasing deformity or inadequate muscle strength or endurance in the individual [which makes]…compensatory mechanisms…fail in achieving horizontal gaze and gravity line alignment.”

We call this weak posture.  I am a chiropractor, and my perspective is functional.  My goal is empower professionals to help people to help themselves, which is precisely why we promote strengthening posture with regular StrongPosture® exercise.

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Lamartina, C., & Berjano, P. (2014).  Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms.  European Spine Journal.  Retrieved from


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