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Proper Posture
Proper Posture Is Important

Physical therapist Patrick Magee discusses posture with his patients more than just about anything else. "Especially people with back, neck and shoulder pain, which are some of the most common problems we see because posture is what you do all day," said Magee.  "If you exercise or do other things, that doesn't necessarily counteract the cumulative stress your body deals with if you sit with poor positioning, particularly people with desk jobs."

Defining posture
A healthy posture is when all the joints are stacked up in optimal alignment, which allows for normal curves of the spine: 
  • The cervical spine (neck) has an anterior (frontward) curve.
  • The thoracic (chest) has posterior (toward the back of the body) curve.
  • The lumbar (lower back) spine has anterior curve.

Try to feel whether you're in good alignment. Check through the body's landmarks: The ear should line up over the shoulder, which lines up over the hip; when you stand, those points should align over the ankle.

When a body is in alignment, gravity is distributed evenly and with the least amount of strain on the body.

Poor posture problems
Repetitive sitting, standing and moving when you're out of alignment can result in pain and injury.

"If you are going to build a house, you'd never build your house on an uneven foundation. The entire structure of the house can't support that. Things wear, tear, leak," Magee said.  The same concept applies to the human body.

People whose heads protrude forward or whose shoulders slump forward often end up with some sort of pain.

Rounding forward at the shoulders makes chest muscles shorten and back muscles lengthen, resulting in a weak back. A person who has this problem needs to stretch the muscles in the front and strengthen the muscles in the back to counteract it.

Because we're upright and everything we do is in front of us, we tend to lean and reach forward, throwing everything out of alignment. That can lead to neck problems, shoulder injuries, low back problems. When you're out of alignment over time, your entire system can fail.

Subsequent problems run the gamut. A person who continually reaches and lifts with poor posture might develop shoulder bursitis. With continual wear and tear, that might result in a rotator cuff tear.

Similar breakdowns happen in the neck, hips and knees. Muscles are what hold good postural position and they have to be trained to hold that position. This means practicing.

When people slump, they are relaxing the muscles and relying on the ligaments. That's why the slump feels good ? the muscles can relax. But using the ligaments like that can damage them over time.

Physical therapists suggest ways to keep that from happening:

Sitting
For those who spend considerable time at a desk, says magee, "Lift the chest up a little as though you were trying to show off a necklace. It's just one thing to think about but it makes the shoulders go back and the head back, and what's were tying to accomplish."

Don't sit back on the tailbone. Rather, allow a little curve of the back, just like when you're standing. A soft chair or sofa will encourage you to sink in and bend your spine the wrong direction.

Find a good chair that helps hold you in position, to take pressure off the ligaments and allow the muscles to relax a little, too. Many chairs need adjustments. Magee recommends a chair with some lumbar support. When he works on ergonomic positioning in the workplace, he will often take rolled-up hand towels and tuck them into the small of the back, he said.

Also, in the workplace, people should get up frequently to interrupt the cycle of slouching, Magee said. Lacking time to walk down the hall, just standing up and sitting back down will make a person more conscious of how she is sitting. Or, from the desk, just stretch the arms up and resettle with some awareness of posture.

Holding a static posture, even so-called perfect posture, is not the goal.  Shift foot and leg positions frequently. Change the location of the computer screen, the keyboard. Sit on a therapy ball sometimes.

"Movement is best," he said. "Change positions while you're sitting at the desk. It will improve your posture. Bend the spine, rotate, change positions."  That, he said, will help people avoid low-back pain.

Standing
Standing requires more muscle activation to maintain posture than does sitting . A common tendency when standing is to lock the knees, rest on the ligaments of the hips and let the abdominal muscles relax. It's better to slightly bend the knees, engage stomach muscles slightly and tuck the tailbone imperceptibly between the legs to activate the gluteal and abdominal muscles, Magee said.

"By activating the muscles, you get in the neutral position, which is helpful for joints," he said.
Good posture allows the joints to be neutral. It's a midrange of motion, not extreme or strained. Ligaments are slack. There's no compression.

One guideline when correcting posture is to try to find a "perfect" position, then back off just a little. Or when correcting from habitual posture to ideal posture, start small. "Your muscles will complain if you make a big change," Magee said.

Moving
Any movement, walking, gardening, carrying groceries should initiate from an optimal posture of the spine.  Sports and athletic endeavours place great demands on the musculoskeletal system and move it out of alignment. In that case, the body has to be strong enough to decrease forces on the spine and hips. Especially in sports such as gymnastics or golf, when the body gets pretty far out of optimal postures, a body needs to be strong to support the movements and avoid injury.
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North Stuart Physical Therapy & Rehabilitation
3397 NW Federal Highway
Jensen Beach, FL 34957
Phone: 772-692-6994

Email: info@northstuartpt.com



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