“Poor Posture”
A Modern Day Epidemic & Physiotherapy
Poor posture is a modern-day epidemic. Research has shown that children as young as 10 years of age are demonstrating spinal degeneration in x-ray. Certain postures, like: forward head posture, have been linked to migraines, high blood pressure, & decreased lung capacity (less oxygen to your body). A 2004 study in the Journal of American Geriatric Society even showed a significant relationship between bad posture & early death. If you have bad posture, then it is a good news-bad news scenario. Obviously, the bad news is that poor posture has some negatives (and we didn’t even touch on the relationships with self-esteem and confidence), but the good news is that it can be improved.
Posture is how you hold your body. There are two types
Dynamic posture:
Dynamic posture is how you hold yourself when you are moving, like when you are walking, running, or bending over to pick up something.
Static posture:
Static Posture is how you hold yourself when you are not moving, like when you are sitting, standing, or sleeping. Body segments are aligned and maintained in fixed positions.
It is important to make sure that you have good dynamic and static posture
Posture Assessment
In standing Position:
The key to good posture is the position of the spine. The spine has three natural curves - at your neck, mid back, and low back. Correct posture should maintain these curves, but not increase them. Your head should be above your shoulders, and the top of your shoulder should be over the hips
In an ideal posture, the line of gravity should pass through specific points of the body. This can simply be observed or evaluated using a plumb line to assess the mid-line of the body.
This line should pass through the lobe of the ear, the shoulder joint, the hip joint, though the greater trochanter of the femur, then slightly anterior to the midline of the knee joint and lastly anterior to the lateral malleolus.
When viewed from either the front or the back, the vertical line passing through the body's center of gravity should theoretically bisect the body into two equal halves, with the bodyweight distributed evenly between the two feet.
Examples of Types of Standing Posture
Lordotic posture- Lordosis refers to the normal inward curvature of the spine. When this curve is exaggerated it is usually referred to as hyperlordosis. The pelvis is usually tilted anteriorly.
Sway Back Posture- In this type of posture, there is forward head, hyper-extension of the cervical spine, flexion of the thoracic spine, lumbar spine extension, posterior tilt of the pelvis, hip and knee hyper-extension and ankle slightly plantarflexed.
Flat back posture- In this type of posture, there is forward head, extension of the cervical spine, extension of the thoracic spine, loss of lumbar lordosis and posterior pelvic tilt.
Forward head posture - Describes the shift of the head forward with the chin poking out. It is caused by increased flexion of the lower cervical spine and upper thoracic spine with increased extension of the upper cervical spine and extension of the occiput on C1.
Scoliosis - This is a 3 dimensional C or S shaped sideways curve of the spine
Kyphosis - An increased convex curve observed in the thoracic or sacral regions of the spine.
Precautions to be taken while standing:
Stand up straight and tall
Keep your shoulders back
Pull your stomach in
Put your weight mostly on the balls of your feet
Keep your head level
Let your arms hang down naturally at your sides
Keep your feet about shoulder-width apart
In assessing posture, symmetry and rotations/tilts should be looked out for in the anterior, lateral and posterior views. Assess:-
Head alignment
Cervical, thoracic and lumbar curvature
Shoulder level symmetry
Pelvic symmetry
Hip, knee and ankle joints
In sitting:-
The ears should be aligned with the shoulders and the shoulders aligned with the hips
The shoulders should be relaxed and elbows are close to the sides of the body
The angle of the elbows, hips and knees is approximately 90 degrees
The feet flat on the floor
The forearms are parallel to the floor with wrists straight
Feet should rest comfortably on a surface
Why Physiotherapy is must for bad postures?
Education, teach client to:
Be mindful of posture during everyday activities, like watching television, washing dishes, or walking
Stay active. Any kind of exercise may help improve your posture, but certain types of exercises can be especially helpful. eg. yoga, tai chi, and other classes that focuses on body awareness. It is also a good idea to do exercises that strengthen your core.
Maintain a healthy weight. Extra weight can weaken abdominal muscles, cause problems for pelvis and spine, and contribute to low back pain.
Wear comfortable, low-heeled shoes. High heels, for example, can throw off balance and force person to walk differently. This puts more stress on muscles and harms posture.
Make sure work surfaces are at a comfortable height for you, whether sitting in front of a computer, making dinner, or eating a meal
Physiotherapist can identify posture style and provide hands-on treatment, posture correction exercises and helpful home products for you to achieve great posture. Some of objectives are listed below:
Obtain Normal Joint Range of Motion. Necessary to allow you achieve good posture alignment. eg Thoracic Manual Therapy.
Obtain Normal Muscle Length. If muscles too tight client will be unable to attain a normal posture.
Obtain Good Muscle Strength. To be able to pull clients body into the correct posture.
Obtain Excellent Muscle Endurance. Postural muscles need to able to work for hours on end. Poor endurance is a major factor in habitual poor posture.
Normal Nerve Extensibility. Neural tissue needs enough length to allow for normal posture.
Good Spatial Awareness. ie where you are in space. Provide with verbal and visual feedback and assist with postural taping.
Perfect Posture Habits. The hardest part is the initial change, then reinforcing the correct habit
Precautions to be taken while sitting:
Switch sitting positions often
Take brief walks around your office or home
Gently stretch your muscles every so often to help relieve muscle tension
Don't cross your legs; keep your feet on the floor, with your ankles in front of your knees
Make sure that your feet touch the floor, or if that's not possible, use a footrest
Relax your shoulders; they should not be rounded or pulled backwards
Keep your elbows in close to your body. They should be bent between 90 and 120 degrees.
Make sure that your back is fully supported. Use a back pillow or other back support if your chair does not have a backrest that can support your lower back's curve.
Make sure that your thighs and hips are supported. You should have a well-padded seat, and your thighs and hips should be parallel to the floor.
Physiotherapy advice can improve posture
Be mindful of your posture during everyday activities, like watching television, washing dishes, or walking
Stay active. Any kind of exercise may help improve your posture, but certain types of exercises can be especially helpful. They include yoga, tai chi, and other classes that focuses on body awareness. It is also a good idea to do exercises that strengthen your core (muscles around your back, abdomen, and pelvis).
Maintain a healthy weight. Extra weight can weaken your abdominal muscles, cause problems for your pelvis and spine, and contribute to low back pain. All of these can hurt your posture.
Wear comfortable, low-heeled shoes. High heels, for example, can throw off your balance and force you to walk differently. This puts more stress on your muscles and harms your posture.
Make sure work surfaces are at a comfortable height for you, whether you're sitting in front of a computer, making dinner, or eating a meal.
Physiotherapy treatment may include:
Assessment and diagnosis of postural habits.
Postural education and training.
Manual therapy and soft tissue massage.
Dry needling.
Postural taping.
Electrotherapy.
Joint mobilization.
Corrective exercises and movements to improve flexibility, strength and posture.
For more Information:-
Dr. Ravinder Kumar, Ortho Neuro Physiotherapy Clinic, Vasundhara, Ghaziabad.
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