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Lean Forward - Fall Down!

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Research Shows You Must Stand Taller to Keep Standing Longer

“Old Posture” is the phrase we use to communicate to patients the flexed-forward head, flexed-forward torso posture commonly associated with aging. Consequences of “Old Posture” include increased fall risk, and, especially for older individuals, the risk of a life-changing fracture goes up as well.

According to de Groot et al, (2013), motor function breaks down and fall risk goes up in those people who develop flexed forward head protrusion and an increased thoracic kyphosis with age.

de Groot’s team noted that increased thoracic kyphosis brings the body’s center of mass forward, requiring a reflexive response to maintain balance. In addition to training muscles and molding ligaments into flexed posture, this also reduces the ability to respond to unexpected changes and perturbation, further setting the stage for falls. A corresponding loss of other unused muscle patterns explains the observed higher variation in the gait pattern in flexed-posture patients.

Conclusions (from deGroot et al):

  • “Impairments in postural control during walking are a major risk factor for falling,” and
  • “These impairments may affect motor function, and consequently increase the risk of falling and fractures.”

The collapse of the kinetic box we call “Old Posture” was also previously described by Vladimir Janda as an Upper Cross syndrome model.

BOTTOM LINE: Regardless of the label, the more a body is falling forward, the likelier it is to fall down. And the likelier it becomes that the person doesn’t get up.


de Groot, M. H., van der Jagt-Willems, H. C., van Campen, J. P., Lems, W. F., Beijnen, J. H., & Lamoth, C. J. (2013). A flexed posture in elderly patients is associated with impairments in postural control during walking. Gait & Posture, 39(2), 767-72. doi:10.1016/j.gaitpost.2013.10.015. Retrieved from


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