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I have read your information and want to be able to take it to my primary care MD for reference. However, I am not willing to take the article full of advertising.
If you will give me access to the printable version, I can give you a small donation. I am a retired senior female and noticing changes in posture that were never present before.
Unfortunately – I do not currently have an ad-free version of the blog posts. However, if you are a laptop computer, you can try copy/paste the blog post into a word document.
I believe that should automatically remove the ads.
Hi Mark, can we book a 30 min session over FaceTime so I can show you my routine for forward head posture? I want to make sure I’m doing everything I can. Best, Miranda
Hi Mark
I am 65 years old and have many issues. I have S-curve scoliosis with convexities on the thoracic spine (left, mild) and lumbar spine (right, more acute). As a teen I was told I had scoliosis. I think the lumbar curve is degenerative and secondary to severe R hip osteoarthritis. Sagittal and hip alignment are maintained. Rib spaces are maintained.
I had a total right hip arthroplasty (lateral approach) in Oct. ’25. I also have multilevel DDD, facet joint OA, mild top severe spinal and foraminal stenosis on several levels, etc. I do not have back pain. though, except when I walk after my hip replacement. It never bothered me before.
My main concern is that I still can’t walk 6 months after the hip replacement. The hip is very stable and I have no pain from it, but I think my back doesn’t like this new artificial hip. I have severe Trendelenburg gait and back pain after walking only about 50 metres without an aid like a crutch or trekking pole. My left knee (arthroscopic bucket handle tear repair 20026) also starts hurting. My left leg seems to sway inwards when I walk. I had no issues with that knee for 20 years. I really don’t want to aggravate it. I have high arches and feel off-balance, but have never fallen.
Apparently, I had mild dysplasia in the right hip, so the surgeon put in a bigger cup that protrudes on the front and side and a longer stem to prevent dislocation. That hip now sits at a slightly different angle as a result, and I think that is a problem. I can ride on an exercise bike without issues, and have no problem with exercises while lying down or sitting. I am working very hard on my glutes and core. I can do a 1 minute plank with good form.
I never limped before surgery. The surgeon is a friend and he did not even notice anything wrong. He was shocked at my X-rays. I had severe hip pain, but my body compensated and found a way for me to walk. I have ballet training where you learn how to ignore pain and still move well.
I am so glad I found your website. I will start working on the scoliosis exercises. I hope I get it right with two curves. My entire body feel out of whack. I will try to sleep on my back. Currently, I sleep mostly on my left side with a pillow between my knees.
I am working with a physiotherapist, but it mostly for the hip, and I have so many other issues. I don’t know which to address first!
Thanks for the detailed comment. It helps me understand your situation a bit better.
Here are some thoughts/comments/questions:
– The spine and pelvis will often compensate for a painful and/or tight and/or weak right hip. This may explain why you may have an exaggeration of the pre-existing scoliosis presentation you mentioned and why you get back pain when you walk.
– With your right hip, do you know if you have adequate INTERNAL ROTATION. This movement is important to help the body shift into that right side which is part of a normal walking pattern. You mentioned that the surgeon placed a bigger cup which extends to the front of the joint, this may be changing the orientation of the hip joint and/or possible physically blocking some internal rotation movement. (Check with your surgeon.) If it is physically blocking, this would be consider a structural limitation.
If you are lacking internal rotation, check out this post: Hip Internal Rotation Exercises. Please work closely with your therapist if you are going to perform any of the exercises on this blog post. Not all exercises will be suitable/appropriate for you.
– It is good to hear that you are working hard on your glutes and cores. Both very important! Make sure you don’t forget to strengthen the other muscles around your hip (Hip Flexors, Hip adductors, Hip Internal rotators) as they all help to stabilize the hip joint. I suspect your internal rotation strength will be compromised.
– Another thing to check is your leg length. Sometimes one leg may feel a bit longer/shorter after a hip replacement surgery. This can make walking a bit more challenging and can result in a trendelenburg sign. (you can get your physical therapist to check this for you) It’s important to work on gluteus medius strengthening exercises for this.
– Following a hip replacement on the right hip, the body will tend to place more pressure through the left leg to avoid pain. This will naturally place more pressure through your left knee and may have resulted in your said left knee issue. You will likely benefit from gradually loading this left knee with progressive weight bearing exercises as guided by your therapist. As your right hip is still problematic, this left knee will be working harder for the time being. Ultimately – if you fix the right hip, the left knee won’t need to do most of the work anymore.
– In terms of the scoliosis, it is fine to do the exercises for it. But I suspect you’ll need to figure out the hip first for best results.
– check to see if your pelvis is neutral as well. Main one to check for is anterior pelvic tilt and sway back posture. These pelvic postures may affect hip movement.
I hope you are doing well. I have been dealing with several postural issues, including forward head posture, uneven shoulders (my left shoulder is slightly higher than my right), anterior pelvic tilt, lateral pelvic tilt with a right hip hike, left hip drop, valgus knee, and partially flat feet. These problems are mostly caused by tight and weak muscles. Although it may sound complicated, the issues are minor and not noticeable unless someone looks closely. I have tried sleeping (14’’ hybrid mattress)on my left side with a rolled towel under my left hip, a pillow between my knees, a thick pillow to hug, and another rolled towel under my head. However, I feel tightness in my left shoulder when I sleep this way. I also have a deep bite that needs correction, and I feel this sleeping position might be making my jaw smaller or worsening my deep bite.
I have been following your exercises, and my posture has improved a lot. My main concern now is that I am having trouble with bowel movements, even though I have healthy habits and good digestion. I have tried laxatives, but nothing seems to help.
I use a stool while on the toilet seat, but I still find it difficult to defecate.
I would be grateful if you could suggest some exercises for my pelvis to help with constipation. Also, clarify when there are multiple issues. Should we exercise from the top down or the bottom up? I mean foot first or pelvis.
– Has there been any dietary changes that may have lead to the constipation? Increased caffeine in take? Fasting? Perhaps any new medications?
– Do you have any lower back issues? Any scans to check for cauda equina compression?
– Any issues with your pelvic floor?
– Have you tried magnesium citrate supplements?
– It is good that you are using a stool whilst on the toilet. That places the pelvis in more ideal position where you do not need to strain.
– You can try going for a walk or increase general movement to see if that helps.
In regards to multiple postural issues (which is often the case). you can address any body part to begin with. Although that being said, you might find that you if you address one area, it may have a positive effect on another area. For example, if you correct a foot posture, it can sometimes help to improve the orientation of the pelvis. In this case, you would probably be better off focussing on the foot first.
I have read your information and want to be able to take it to my primary care MD for reference. However, I am not willing to take the article full of advertising.
If you will give me access to the printable version, I can give you a small donation. I am a retired senior female and noticing changes in posture that were never present before.
Thank You,
B. Ginett
Hi Bonney,
Unfortunately – I do not currently have an ad-free version of the blog posts. However, if you are a laptop computer, you can try copy/paste the blog post into a word document.
I believe that should automatically remove the ads.
Hope this helps.
Mark
Hi Mark, can we book a 30 min session over FaceTime so I can show you my routine for forward head posture? I want to make sure I’m doing everything I can. Best, Miranda
Hi Miranda,
I don’t offer online consultations but feel free to send me some videos.
Mark
Hi Mark
I am 65 years old and have many issues. I have S-curve scoliosis with convexities on the thoracic spine (left, mild) and lumbar spine (right, more acute). As a teen I was told I had scoliosis. I think the lumbar curve is degenerative and secondary to severe R hip osteoarthritis. Sagittal and hip alignment are maintained. Rib spaces are maintained.
I had a total right hip arthroplasty (lateral approach) in Oct. ’25. I also have multilevel DDD, facet joint OA, mild top severe spinal and foraminal stenosis on several levels, etc. I do not have back pain. though, except when I walk after my hip replacement. It never bothered me before.
My main concern is that I still can’t walk 6 months after the hip replacement. The hip is very stable and I have no pain from it, but I think my back doesn’t like this new artificial hip. I have severe Trendelenburg gait and back pain after walking only about 50 metres without an aid like a crutch or trekking pole. My left knee (arthroscopic bucket handle tear repair 20026) also starts hurting. My left leg seems to sway inwards when I walk. I had no issues with that knee for 20 years. I really don’t want to aggravate it. I have high arches and feel off-balance, but have never fallen.
Apparently, I had mild dysplasia in the right hip, so the surgeon put in a bigger cup that protrudes on the front and side and a longer stem to prevent dislocation. That hip now sits at a slightly different angle as a result, and I think that is a problem. I can ride on an exercise bike without issues, and have no problem with exercises while lying down or sitting. I am working very hard on my glutes and core. I can do a 1 minute plank with good form.
I never limped before surgery. The surgeon is a friend and he did not even notice anything wrong. He was shocked at my X-rays. I had severe hip pain, but my body compensated and found a way for me to walk. I have ballet training where you learn how to ignore pain and still move well.
I am so glad I found your website. I will start working on the scoliosis exercises. I hope I get it right with two curves. My entire body feel out of whack. I will try to sleep on my back. Currently, I sleep mostly on my left side with a pillow between my knees.
I am working with a physiotherapist, but it mostly for the hip, and I have so many other issues. I don’t know which to address first!
Thank you in advance for any suggestions,
Ann
Hello Ann,
Thanks for the detailed comment. It helps me understand your situation a bit better.
Here are some thoughts/comments/questions:
– The spine and pelvis will often compensate for a painful and/or tight and/or weak right hip. This may explain why you may have an exaggeration of the pre-existing scoliosis presentation you mentioned and why you get back pain when you walk.
– With your right hip, do you know if you have adequate INTERNAL ROTATION. This movement is important to help the body shift into that right side which is part of a normal walking pattern. You mentioned that the surgeon placed a bigger cup which extends to the front of the joint, this may be changing the orientation of the hip joint and/or possible physically blocking some internal rotation movement. (Check with your surgeon.) If it is physically blocking, this would be consider a structural limitation.
If you are lacking internal rotation, check out this post: Hip Internal Rotation Exercises. Please work closely with your therapist if you are going to perform any of the exercises on this blog post. Not all exercises will be suitable/appropriate for you.
– It is good to hear that you are working hard on your glutes and cores. Both very important! Make sure you don’t forget to strengthen the other muscles around your hip (Hip Flexors, Hip adductors, Hip Internal rotators) as they all help to stabilize the hip joint. I suspect your internal rotation strength will be compromised.
– Another thing to check is your leg length. Sometimes one leg may feel a bit longer/shorter after a hip replacement surgery. This can make walking a bit more challenging and can result in a trendelenburg sign. (you can get your physical therapist to check this for you) It’s important to work on gluteus medius strengthening exercises for this.
– Following a hip replacement on the right hip, the body will tend to place more pressure through the left leg to avoid pain. This will naturally place more pressure through your left knee and may have resulted in your said left knee issue. You will likely benefit from gradually loading this left knee with progressive weight bearing exercises as guided by your therapist. As your right hip is still problematic, this left knee will be working harder for the time being. Ultimately – if you fix the right hip, the left knee won’t need to do most of the work anymore.
– In terms of the scoliosis, it is fine to do the exercises for it. But I suspect you’ll need to figure out the hip first for best results.
– check to see if your pelvis is neutral as well. Main one to check for is anterior pelvic tilt and sway back posture. These pelvic postures may affect hip movement.
Hope this points you towards the right direction.
Mark
Hello Mark,
I hope you are doing well. I have been dealing with several postural issues, including forward head posture, uneven shoulders (my left shoulder is slightly higher than my right), anterior pelvic tilt, lateral pelvic tilt with a right hip hike, left hip drop, valgus knee, and partially flat feet. These problems are mostly caused by tight and weak muscles. Although it may sound complicated, the issues are minor and not noticeable unless someone looks closely. I have tried sleeping (14’’ hybrid mattress)on my left side with a rolled towel under my left hip, a pillow between my knees, a thick pillow to hug, and another rolled towel under my head. However, I feel tightness in my left shoulder when I sleep this way. I also have a deep bite that needs correction, and I feel this sleeping position might be making my jaw smaller or worsening my deep bite.
I have been following your exercises, and my posture has improved a lot. My main concern now is that I am having trouble with bowel movements, even though I have healthy habits and good digestion. I have tried laxatives, but nothing seems to help.
I use a stool while on the toilet seat, but I still find it difficult to defecate.
I would be grateful if you could suggest some exercises for my pelvis to help with constipation. Also, clarify when there are multiple issues. Should we exercise from the top down or the bottom up? I mean foot first or pelvis.
Thanks and Regards
Diksha
Hi there,
In terms of your constipation:
– Has there been any dietary changes that may have lead to the constipation? Increased caffeine in take? Fasting? Perhaps any new medications?
– Do you have any lower back issues? Any scans to check for cauda equina compression?
– Any issues with your pelvic floor?
– Have you tried magnesium citrate supplements?
– It is good that you are using a stool whilst on the toilet. That places the pelvis in more ideal position where you do not need to strain.
– You can try going for a walk or increase general movement to see if that helps.
In regards to multiple postural issues (which is often the case). you can address any body part to begin with. Although that being said, you might find that you if you address one area, it may have a positive effect on another area. For example, if you correct a foot posture, it can sometimes help to improve the orientation of the pelvis. In this case, you would probably be better off focussing on the foot first.
Mark