Poor Posture

Pain is a common complaint of all people no matter what the age; joint pain, muscle pain, and headaches tend to be the most commonly reported.  Your posture and biomechanics are the keystones for building a pain-free lifestyle.  Imagine building a house on an unstable foundation, no matter how strong the material you use to construct the home it will all be useless without a proper base of support.  Your body works the same way.

What kind of effect does bad posture cause?

Upper body and neck:  Improper positioning of the head is often the root cause of neck and upper back pain.  Forward head posture or ‘anterior head carriage’ is a visual description of the skull when compared to the shoulders. 

The ideal position for humans is to have your ear canal lined up with the middle of your shoulder when viewed from the side.  This causes the weight of your head to be properly distributed down your spine and surrounding muscles.  The average human head weighs between 8-12 pounds and is much larger and heavier than the neck, picture a bowling ball placed on top of a thin stick.  Every degree your head tilts forward from midline applies additional pressure on the neck and shoulder muscles.  The longer you keep your head in this position the more added strain is put on the muscles and bones to hold it in place. 

Over time eventually the muscles in the back are stretched out and become tighter, while the muscles in the front of the neck become shortened and weaker.  A muscle does not function properly if it is too long or too short, it must be at its proper length to perform its action effectively.  The direct consequence of this type of abnormal posture is muscles pain, headaches, and overall tightness of the neck.  This compromised position can also contribute to degeneration of the bones and joints of the neck, and increase chance of disc herniation. 

If you do not keep in mind the position of your head throughout the day, no amount of massage, PT, or chiropractic adjustments are ever going to solve your neck pain. 

The common situations that you should be keenly aware of head posture are:

• In front of the computer - Your monitor position while working in front of a computer should be no closer than 14” and no further than 30”.  When you sit upright in your chair and look straight ahead your eyes should ideally pass through the middle of your computer screen.  If you have a lab-top stack a few books underneath to reach the optimal height in combination with a wireless mouse and keyboard.  Sit upright with relaxed shoulders; place your hands on the keyboard in a typing position.  Now adjust your seat height until your elbows are bent at 90° and your feet are flat on the floor.  Keep your chin tucked and head facing forward at all times, anything you read while typing should be seen visually by moving the eyes NOT the head. 
• In the car – When driving a car it is easy to lose track of where your head is especially when stuck in traffic or after a long day of activity.  The easiest way to keep proper posture is to ensure the back of your head maintains contact with the headrest.  This will also decrease whiplash if you happen to be in a car accident
• In front of the TV – The average American watches 2-6 hours of television daily.  When you are seated on the couch be sure to be looking straight ahead with your neck properly aligned with the shoulders. 

If you maintain proper posture during the times described above this will impact 50% or more of the day for most people.  Those people with jobs that have them sitting in front of the computer the whole workday will need to be even more vigilant. 

Low back and hips: About 31 million Americans will experience low back pain at some point in they’re lives.  The majority of this population has this pain due to repetitive stress on the muscles and joints from improper posture and de-conditioning of the postural stabilizing muscles of the low back. 

The postural muscles of the low back are those muscles closest to the spine that keep us upright all day long.  When you sit for long periods of time (i.e. in a chair at a desk) the muscles in your low back relax because they are not being used.  Over time they start to lose strength and balance because of this inactivity, add to this improper lifting technique and your body is set up for injury. 

The best way to ensure proper posture in the low back is to strengthen the muscles that support it.  Along with maintaining the strength of the low back muscles you must also add proper biomechanics while performing daily activities and exercise.  The hips (pelvis) can move with or independently from the low back and must be taken into consideration during activity such as standing and walking.  This pelvic motion can have a strong back protecting influence or it can also be the culprit of increased strain on the low back. 

Flexibility is a major concern in the low back and lower extremities.  People who consistently sit for long periods of time generally suffer from a condition known as ‘Lower Crossed Syndrome.’  Tight hamstring and hip flexor muscles; and also having weak abdominal and gluteal muscles characterize this syndrome.  This imbalance of muscular strength and muscle lengths causes added stress and eventually leads to a variety of body pains, most commonly low back pain.  This syndrome is not only found in sedentary people but very active people that do not stretch or workout properly.  A good doctor, trainer, or therapist can help you overcome this common problem. 

Important considerations:

• Know how to use and exercise your ‘core’ – The core muscles of the back surround the low back and help stabilize your body during movement.  These muscles include your pelvic floor, diaphragm, transaverse abdominus, abdominal obliques, and multifidus muscles (the little muscles that surround the lumbar vertebrae).  If you these muscles are strong you will have better posture, balance, endurance, strength, and power.  Refer to the exercise section for specific core strengthening maneuvers.
• Use a lumbar support – A lumbar support should be utilized if you are sitting for long periods of time at work or in the car.  If you do not want to buy one a rolled up towel placed in the small of your back will dot he trick.  Always try to get up and move around after being seated for longer than 30 minutes, this will help keep your back loose and help proper blood flow.
• Watch your biomechanics – Use correct lifting technique by relying on your butt and legs to lift and not your back.  The easiest way to achieve this is to keep a wider stance and bend your knees.  When getting out of the car swing both your feet out at the same time to stand up, do not place one foot out and twist your body while pushing yourself out of your seat.  When it comes to avoiding low back pain this
• Stay flexible! – Stretch out daily, holding each stretch for a minimum of 30 seconds.  DO NOT bounce while stretching, this is called ballistic stretching and can cause muscle strains and even tears.  Adding a weekly Yoga or Pilates class is a good way to stay on top of your preventative care.  The muscles that should be stretch consistently are: Hamstring, Calves, Piriformis, Hip flexors, Quadratus Lumborum, and Tensor Fascia Lata (IT band).  Remember to enlist the help of a professional to ensure you are performing the stretches and exercises correctly.

Are there any tools that can help me evaluate my posture?

A great way to see where you stand in regard to posture is to use a digital posture measurement device.  The Posture Pro is a computer program that measures bony landmarks on a human body and compares these findings to calculated anatomical norms.  For example, this program can measure how many degrees your head is tilted forward or to one side, if one hip is higher than the other, if one shoulder is lower compared to the other, and whether your knees are in proper alignment compared to your hips. 

These are only a few of many measurements a digital posture scan can provide a healthcare professional.  Along with this digital analysis you can combine static and dynamic gait scanning (using a TOG gait scan) to determine your walking patterns to give you a full picture of your biomechanics.  Please refer to the gait analysis section to learn more about the TOG gait scan.  Armed with this information a professional can build a custom treatment and exercise program to counteract any negative postural or movement aberrations.   

If you suffer from any of the signs or symptoms below you could benefit from a full, digital body evaluation:

• Low back, neck, shoulder, hip, leg, and foot pain
• Neurologic pain – Numbness, tingling, loss of sensation or hyper-sensitivity to touch, pins and needles (sciatica and cervico-brachial syndrome)
• Disc bulges, herniations, stenosis, and compression issues
• Degenerative joint and disc disease, bone spurs, and bunyons
• Headaches – Migraine, tension, cluster, or other forms of headaches
• Tightness, knots, or trigger points in your muscles
• Past history of trauma or motor vehicle accidents
• Congenital problems – Scoliosis, flat feet, etc…

If you think you may be suffering from pain as a result of poor posture submit a consultation request and someone will contact you shortly to arrange for an in depth evaluation.

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