Side-view stacking, neck turn, overhead reach, breathing, palpation and a vertical jump, each scored in a 5 to 7 minute screen
Chapter 17 of Eileen Durfee's Spinal Fitness book sets out the Spinal Curvature and Capacity Screen: 6 tests run in 5 to 7 minutes and scored Green, Yellow or Red. Green means the pattern is present and easy, Yellow means it is present but restricted or compensated, and Red means it is absent, painful or replaced by a clear compensation strategy.
Chapter 17 states that when centers of mass sit forward of the hips, 4 posterior tissues are often recruited to hold posture: the suboccipitals, upper traps, thoracolumbar extensors and hamstrings. When the trunk mass is balanced over the hips, these muscles are minimally recruited to maintain posture. The 4 results it lists are a tight posterior chain, limited hip extension, reduced stride length, and reduced ability to generate force against anterior resistance. Its 3 recurring patterns are forward head posture (cervical curve loss or reversal), a flattened lumbar curve (a posterior pelvic tilt strategy with a guarded low back), and trunk mass forward of the hips (hamstring-dominant stabilization and reduced hip hinge capacity). The Creatrix guide on forward head posture covers the first pattern.
The book's setup notes for the trainer: screen on a good day rather than during a flare-up, take shoes off if safe for a better view of hip and foot strategy, and film side-view posture for 10 seconds when possible to set a baseline for later comparison.
| Screen | Test | Green | Yellow | Red |
|---|---|---|---|---|
| 1. Side-view stacking | Stand to the side; look for ear, shoulder and greater trochanter in a vertical line | Head stacks close to the shoulders, thorax not drifting forward, pelvis centered | Mild head-forward posture, rib flare or mild lumbar flattening | Obvious turtle posture, shoulders rolled forward and down, trunk mass visibly ahead of the hips |
| 2. Neck turn | Turn the head to look to the side | Smooth turn led by the eyes, no chin-jut, shoulders quiet | Slight chin-lead, stiffness at the end of range | Rigid column rotation, obvious chin-jut, shoulders rotate with the head |
| 3. Overhead reach | Both arms overhead, palms facing | Arms straight overhead, ribs down, head not pushing forward | Mild rib flare or slight head thrust | Marked rib flare, lumbar extension compensation, or arms cannot reach overhead |
| 4. Breathing and lumbar curve | A slow deep breath, then a gentle low-back arch | Breath expands 360 degrees; lumbar curve appears with the arch | Mainly chest breathing; partial lumbar curve | No lumbar curve; chest-dominant or held-breath pattern |
| 5. Posterior palpation | Standing; observe and gently palpate the neck, low back and hamstrings | Neck and low back soft, hamstrings relaxed, spine over the hips | Mild posterior tension, muscles firmer than expected for standing | Neck and low back muscles noticeably swollen and firm, hamstrings tight, trunk forward of the hips |
| 6. Vertical jump landing | Jump straight up and land | Lands on the takeoff spot, trunk over the base | Slight forward drift or minor asymmetry | Lands noticeably forward, trunk forward of the hips throughout |
The book adds 2 notes. On palpation, an experienced trainer can sometimes move the upper trunk mass posteriorly and feel the posterior spinal muscles begin to relax as the trunk lines up over the hips. On tracking, the screens carry the most information before and after a training block, and a shift from Red to Yellow, or from Yellow to Green, on a single screen is a documented change. The book gives the reading behind 3 of the screens: a chin-leading neck turn suggests the deep cervical stabilizers are not organizing the movement; a flat, rigid low back during breathing suggests posterior muscle bracing in place of spinal curve; and with trunk mass chronically forward of the hips a jump cannot be truly vertical, which reduces jump height and adds compressive and shear forces in the knee on landing. The mechanics behind Screen 6 are covered in the book's jumping analysis.
The book runs evaluation in 5 steps: safety screen, exposure profile, posture and curvature screen, tolerance check, and track assignment with a first-week dosing plan. The safety screen lists the red flags that pause training and call for medical referral: bowel or bladder changes (new incontinence or retention), saddle anesthesia (numbness in the groin or perineal region), progressive neurological weakness such as foot drop or rapidly worsening grip strength, unrelenting night pain, unexplained loss of body weight, fever or chills with spinal pain, recent significant trauma with severe pain or inability to bear weight, and severe radiating pain with worsening numbness or tingling that does not settle with rest.
The exposure profile asks 6 questions: total hours sitting per day; hours driving per day; how often the person lifts, carries, pushes, pulls or handles awkward loads; any vibration exposure from forklifts, delivery trucks or heavy equipment; what posture the person collapses into late in the shift; and what has flared up in the past 30 days and what helps it settle. The tolerance check sorts irritability into 3 levels: low, with infrequent symptoms that do not linger; moderate, with symptoms during moderate activity that take time to settle; and high, with symptoms during minimal activity that linger. The book's action for each of the 3 levels: low can progress more quickly; moderate progresses slowly with close monitoring; high starts with the gentlest inputs and prioritizes decompression over loading. Irritability level determines starting dose.
The standard sequence begins with Back Trac rolling (Step 1), because most bodies arrive with accumulated guarding, stiffness and postural compensation. The book sets 3 exceptions when the screen results are clear and the safety screen has been passed:
The principle for all 3 is that the correct starting step is the one the body can currently accept without guarding, bracing or pain. The progression rule: progress reps, range or density only when the current dose no longer produces the intended strain, or when form is cleaner with less compensation than in the previous session. "Enthusiasm is not a progression criterion."
The SFAI scores 5 categories, each from 0 to 5:
| SFAI score | Meaning in the book |
|---|---|
| 0 | Optimal alignment and control |
| 1 | Good control with minor inefficiencies |
| 2 | Functional but compensating |
| 3 | Moderate limitation or poor control |
| 4 | Major compensation or instability |
| 5 | Severe dysfunction, pain, or unable to perform |
The book closes the chapter with 4 validation questions for any training program: what anatomical structure and physiological function it aims for (for Spinal Fitness, the adult S-shaped neutral spine with curves that allow efficient force management in gravity), how it determines that the person lacks them, what the rationale for its intervention is, and how results will be measured. Its 6 measurable outcomes are better movement, improved screen scores, reduced guarding, increased tolerance, fewer flare-ups and improved work capacity.
This is a screening and coaching tool, not a diagnosis, and it is not used to declare pathology or to push range of motion or loading through pain. Refer progressive neurologic symptoms, bowel or bladder changes, or severe unrelenting pain to a medical provider immediately. When in doubt: stop the session, document what you observed, and refer.
A mostly cervical screen starts with Step 4, Neck Flexion, which begins with bare hands; the Neck Shaper takes over once the pattern is established. The standard start is Step 1 on the Back Trac.
Practitioner Eileen Durfee, NBS (Nutritional Balancing Science), NASM-CPT — wellness educator, inventor, author, and a Nationally Certified Spinal Fitness Specialist.
I write my own symptoms down, because symptoms that have disappeared are easy to forget. My book carries a photo caption of Leigh Steinberg, the real-life inspiration for Jerry Maguire, during his first Back Trac rolling session: "Results after one session: measurable restoration of cervical lordosis."
Our Facebook group is free to join for questions about any of the 5 steps in the Spinal Fitness system.
The book gives 5 to 7 minutes for all 6 screens, scored Green, Yellow or Red.
Green: the pattern is present and easy. Yellow: present but restricted or compensated. Red: absent, painful, or replaced by a clear compensation strategy.
No. The book calls it a screening and coaching tool and sends red-flag symptoms to a medical provider before any training.
Most do. The book's exceptions start a cervical pattern with Step 4, a mostly Green screen with Step 2, and a highly irritable back with Step 5 only.
Structural alignment, segmental control, load tolerance, compensation patterns and pain interpretation, each scored from 0 (optimal) to 5 (severe dysfunction).
Published October 19, 2026 • Updated October 19, 2026
By Eileen Durfee, Nationally Certified Spinal Fitness Specialist, NASM-CPT, and author of the Spinal Fitness book.
More from Eileen Durfee
Eileen's free guide, Is Your Posture Aging You?, on EileenDurfee.com
This article is for educational purposes only. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. Nuco Enterprise Solutions LLC.
