If you have ever been told to “stand up straight” you may think that good posture means standing with your head up, back straight and shoulders back. If you look at a model of a typical, healthy spine from the back or front it appears to be a straight column of vertebrae stacked on top of one another. When you view the spine from the side, however, you will see that the spine is actually curved in several places. In the neck the spine curves toward the front creating a small arch or “lordosis” in the neck. It then switches directions and a gentle backwards curve or “kyphosis” can be seen in the thoracic spine followed by another reversal and lordosis in the lumbar spine. This normal alignment of the spine allows for all of the movement we expect from the spine, proper shock absorption capabilities, and good alignment from the head to the feet.

While this alignment may be considered “optimal,” it is unrealistic and unnecessary to maintain this posture all of the time. Whenever possible, being able to achieve this posture and hold it is important as it means that the muscles, ligaments, tendons and bones that work together to create posture are strong enough and positioned well enough to achieve this neutral position. However, we need our body to be able to tolerate all kinds of postures to carry out our everyday activity. Think about the posture needed to sit at a desk and type on a computer as opposed to the posture needed to stock low shelves at the grocery store. If you are experiencing pain or discomfort while holding these postures or noticing changes in your alignment that are harder to correct, postural retraining can be very helpful.

In some cases like scoliosis, leg length discrepancies or thoracic kyphosis, 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 pain or discomfort associated with these conditions and minimize progression of spinal curvature.

If you decide to work with a physical therapist to help with your posture issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT DOES POSTURAL RETRAINING LOOK LIKE?

Postural retraining begins with an assessment of one’s posture and the components of posture. The physical exam may include:

• Muscle length assessment
• Postural muscle strength assessment
• Palpation of muscles or areas of pain or discomfort
• A visual assessment of posture in different positions or while performing different tasks
• Assessment of joint mobility

Once your physical therapist has identified postural impairments they will create a plan of care consisting of treatments in the clinic and exercises to be performed at home. The goals of postural retraining physical therapy include reducing pain and discomfort as well as the following:

Improve flexibility: 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 improve flexibility in the spine and hips and any other joints that can affect posture such as the ankles, hips, and shoulders.

Build up your strength: 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.

Optimize your movement: Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of posture. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you move and train your muscles to perform those movements in the safest and most effective way possible.

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.

If you are ready to improve your posture and address aches and pains associated with the postures you hold each day, call the team at Evolve and schedule an evaluation with one of our physical therapists.