Ideal

• Thoracic Spine is evenly and not excessively curved (convex posteriorly)
• Plumb line should halfway through chest (lateral view)

You See

• Thoracic Spine is excessively curved (convex posteriorly)
• Scapulae are protracted
• Arms are medially rotated
• Forward head posture

Likely Cause

• Scheuermann’s disease
• Short anterior chest muscles like pectoralis minor, pectoralis major, rectus abdominis (sometimes only upper fibers)
• Long (thoracic) spine sxtensors, middle trapezius, rhomboids
• Habitually having arms for long periods in front of the body in combination with improper sitting, like in computer work
• Long (thoracic)
• Kyphosis
• Flat back
• Sway back
• Lumbar lordosis
• Upper crossed syndrome
• Lower crossed syndrome