Does Your Posture Need Retraining?
Physical Therapy for Posture Training
Is Your Posture Good or Bad?
When you view a human from the side profile you can evaluate their skeletal alignment using an imaginary plumb line. Starting at the ear, you should be able to drop an imaginary line down through the top of the shoulder, straight through the hip bone, down the middle of the knee joint and to the lateral ankle bone. In reality, few adults will fit this perfect plumb line because posture, like the rest of the body, adapts and changes over time. If you notice that your posture does not align so perfectly when viewed from the side, you might wonder whether you need to fix it and whether it is even possible.
When you think about good posture what comes to mind? Most likely you picture someone sitting on a chair, spine straight, shoulders back, head held high. This certainly is one form of good posture, but is it the ideal posture? If you’ve never been told to “sit up straight and stop slouching” you have probably never been a teenager. We are taught from a young age that “good” posture fits the image described above and the goal is to maintain that posture at all times. Physical therapists followed this dogma for some time but like with all science, with new evidence, our opinions on posture have evolved.
WHAT IS “GOOD” POSTURE?
Posture can be thought of as the position or alignment of the body. We can attain and sustain many different postures–sitting postures, standing postures and postures lying down. Here are two ways we can think about “good” posture.
Straight as an arrow: We can agree that a straight posture aligns your ear over your shoulder, over your hip and so forth. This certainly is one version of good posture and ideally, you could achieve this alignment if you wanted to, but being unable to sit or stand up perfectly straight all the time does not mean you have bad posture.
We have options: More than ever physical therapists have moved away from encouraging their patients to maintain that straight-backed posture at all times and encourage them to change positions throughout the day. Our bodies are meant to move. Changing positions frequently, even into positions that appear slouched or asymmetrical can be comfortable and good for our bodies. Have you ever tried to sit up perfectly straight in a plane seat without reclining it for hours? Not comfortable right? Instead, we might consider having good posture as the ability to move in and out of a straight-backed position through a variety of other comfortable postures.
WHAT IS “BAD” POSTURE?
Let’s agree that expecting anyone to sit or stand up perfectly straight with their shoulders back and eyes straight ahead at all times is unrealistic and not the definition of good posture. It is good, however, if someone can achieve this type of posture at least for a while because it says something positive about the flexibility, strength and control of their bones, joints and muscles. We just don’t expect them to sustain it continuously and encourage people to sit, stand, lie and move through different, comfortable postures throughout the day.
Because the body is pliable and adaptable, changes in bones, joints, ligaments and muscles can cause changes in posture. Sometimes these changes can be easily reversed and sometimes they become more permanent. Someone who sits slouched all the time, for example, might experience changes in the curvature of their spine or the length of their hamstring muscles.
Instead of referring to any posture as “bad,” we discuss postural impairments. An impairment is a problem with the body's physiological functioning or anatomical structure that can limit or prevent a person from performing certain bodily functions. Postural impairments can have unwanted effects which often lead patients to seek out the care of a physical therapist. Let’s take a look at some of these effects:
Pain: Changes in postural alignment can cause pain. If the position or flexibility of the spine, hips, knees or ankles, for example, changes, it can stress and strain tissues and nerves causing pain. Scoliosis is one example of a postural change that can cause pain.
Muscular fatigue: When the skeleton is aligned well muscles do not have to work as hard against gravity to hold you up. As alignment changes, such as when the head begins to push forward in front of the shoulders, suddenly certain muscles have to work harder to hold the head up. This can cause muscular fatigue and pain.
Balance and falls: If posture becomes asymmetrical or flexibility in the pelvis, hips, neck and spine changes, one’s ability to maintain or regain balance can be affected leading to more falls.
Field of vision: An increase in upper back curvature and forward head posture can force the gaze downward. This can affect your field of vision and make it difficult to interact with others in front of you.
Functional impairments: changes in posture can impact one’s ability to perform daily tasks, work duties and recreational activities.
If you are having difficulty moving in and out of a variety of comfortable postures in sitting, standing or lying, it might be time to intervene. Physical therapists are healthcare professionals who address musculoskeletal conditions like postural impairments.
PHYSICAL THERAPY FOR YOUR POSTURE
Physical therapy for postural retraining aims to address postural impairments and combat the effects of those changes. In some cases like scoliosis, leg length discrepancies or thoracic kyphosis (curvature of the upper spine), full reversal of spinal changes is likely not possible. However, with a proper training program and physical therapy intervention, a lot can be done to lessen the pain or discomfort associated with these conditions and minimize the progression of spinal curvature and other changes in posture.
While postural retraining should always be individualized to your needs, here are some interventions for postural retraining that you might encounter when working with a physical therapist:
Stretching and mobility work: Oftentimes changes in posture are accompanied by muscles that are too short and joints that don’t move as well as they should. Your PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to address this.
Strengthening exercises: You will learn exercises to help strengthen the postural muscles around the neck, upper back, lower back, abdomen and hips to properly control the spine, arms and legs to hold good posture while you are sitting, standing and performing activities
Movement and Biomechanics training: Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of posture.
Schroth Method for scoliosis: If you have scoliosis, you may benefit from a physical therapy technique called the Schroth Method. This technique has been shown to help stop the progression of scoliosis and has been proven to reduce pain.
While we won’t call your posture bad, if your posture is causing you discomfort or interfering with your daily life, it’s time to take action. Call the team at Evolve Physical Therapy today and schedule an evaluation with one of our physical therapists.
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