Posture the Silent Killer

Why Physios Are Nags!
No doubt about it, physio’s are great naggers. And when it comes to nagging, our number one is posture. We don’t necessarily want to be such nags, it’s just that we see so many posture related problems and the overall standard of the general population’s posture is pretty bad.

Posture correction is the most common corrective exercise that we give patients the first time we see them. There are also several treatment disciplines that are entirely related to correcting posture in static positions and with movement (dynamic posture). Posture is the silent killer causing many aches, pains and injuries.

What is posture?
Static posture is best defined as the way you maintain set positions you commonly adopt in your daily life. Sitting and standing are the two most common positions, but it could also include kneeling or some other variation. If you look at people around you, you will notice great variation in their static posture, for example the way they sit in a chair, the way they lean their weight in standing and how much they fatigue and slump. Postural stability muscles located throughout the body are responsible for maintaining good static posture.

Dynamic posture refers to how you maintain efficient, stable posture when you are moving or doing activities. This is more complicated because there are so many more variables to movement, such as how you co-ordinate muscle action. Dynamic posture requires a background of postural stability muscle use combined with appropriate mobilising muscle use.

Of course there are some fixed, structural postural deformities which may be genetic and which you have little or no control over. Scoliosis (lateral or rotational spinal curvature) is an example. But for the majority of us, poor posture is a result of lack of knowledge, understanding and discipline in application.

What are the consequences of poor posture?
If we regularly slump, abnormal stresses are applied to many joints, muscles and ligaments which will eventually result in pain and injury. The spine will gradually stiffen into a sub-optimal shape which does not distribute weight evenly and joint degeneration and pain may result.

The muscles are forced to work in a sub-optimal range (either lengthened or shortened) and may be asked to perform roles that they normally wouldn’t. This causes muscle imbalances, strains and spasms to develop. Unfortunately these changes occur slowly and most people aren’t aware that they are happening or don’t realise they are due to their everyday posture.

When you suddenly injure your back or neck it is natural for you to blame the activity you were doing at the time. It is important to realise, though, that poor posture is likely to have weakened or stiffened the affected or nearby areas to the point where they were susceptible to injury.

Of course some people do get ‘postural aches’ in muscles and spinal joints with normal tasks. Sometimes the joints and muscles gradually start to ache when the stiffness, strains or imbalances reach a certain point despite not having had an acute injury. They will usually be more aware of the importance of good posture because they can feel the direct link between poor posture and pain.

What’s the best way to correct my posture?
Here’s our posture correction exercises for sitting and standing:

Exercise 1:

Sit as tall as you can
Tilt your pelvis forward, pulling your low back in
Lift your chest up and forward
Keep your chin tucked in
Gently pull your shoulders down and back
Let your arms rest comfortably in your lap
Take a deep breath, relax and let yourself sink down a little, to the point where you don’t have to hold yourself up
Exercise 2:

Stand as tall as you can
Lift your chest up and forward
Keep your chin tucked in
Gently pull your shoulders down and back
Tilt your pelvis to neutral (mid position)
Share your weight evenly between your feet, avoid locking your knees back
Take a deep breath, relax and let yourself sink down a little, to the point where you don’t have to hold yourself up
In both cases your final position should be a better posture than you were in originally. We suggest you repeat this simple exercise every 15-30 minutes through the day to break the gradual deterioration in posture that occurs with fatigue.

Your corrected postural position may feel unnatural or awkward at first because your body has become used to a certain position and you may not have been using the postural muscles correctly. The muscles will fatigue quickly at first and you may notice muscle pain after the first few days, just as if you had started any new exercise regime. You must persist with the exercises despite this, and soon you will notice the improvements.

Physiotherapists use a special strapping tape applied to your back to make you aware of how much you are slumping through the day. It has a low-allergy adhesive and remains in place for two days at a time. Many people benefit from two to three applications of this tape!

What else can I do?
As well as postural correction exercises we usually recommend posture reversal exercises. Because you are most likely to stiffen into the position(s) you most commonly adopt, regularly moving or stretching into the opposite direction will help maintain joint mobility and appropriate muscle use.

For example, if you spend most of your day in standing bending forwards, put your hands on your low back and arch backwards to stretch for 10 seconds or rock forward and back. If you mostly sit leaning forwards over a desk or at a computer, stretch your arms overhead and arch your trunk backwards to stretch for 10 seconds.

Finally it is important to remember that the human body prefers to be moving rather than staying still for long periods. Try to move regularly through the day, even if only for a minute or two. For example if you are in a sitting position for most of the day, get up and go for a short walk or stand up whenever you can!

The Take Home Message
The postures we adopt every day determine whether we suffer from many spinal pains. If you can do these simple exercises every 15-30 minutes you will notice a big difference in how you feel by the end of the day - and we won’t have to nag you anymore!