Written by Claire Todd
Posture is all about the positions we adopt during everyday activities or rest such as standing, sitting, sleeping, and working or during sport. Ideal posture or alignment involves a minimal amount of stress and strain on the body and helps us to move easily and efficiently. It is a true state of muscular and skeletal balance which protects the supporting structures of the body against injury and progressive deformity. It is dependent on a multitude of factors including pain experienced, emotions, your body structure and composition and body awareness.
Physiotherapists tend to be very good at observing and analysing posture and how faults could be contributing to your pain or injury. We will probably be observing how you sit in the waiting room or walk into the treatment rooms!
We will identify any tight or weak muscles or joint stiffness or hypermobility that may be causing you to maintain a poor posture. Even if you do not currently have pain or dysfunction, we can identify faulty postures or movement patterns that may cause problems in the future and then suggest ways to correct them.
We will offer advice regarding correct sitting and standing positioning or moving and handling techniques. You may require advice on the set up of your computer and work station or on everyday activities such as gardening or driving or playing your sport.
Pain and dysfunction can develop as a result of poor postures in sitting. As many of us sit for long periods in front of a computer at work this can have serious implications over the longer term and can lead to pain and dysfunction particularly in the neck and lower back and sometimes leading to nerve pain down the arm or the leg.
It is not easy to correct bad postural habits as they tend to be much engrained. However, the first step is identifying them; the second step is correcting them and the final step is to reinforce the correct pattern by repetition, repetition!!
Then the new improved postures should then become automatic !
We will identify which type of posture you naturally adopt in standing. These are generally classified as follows:
Plumb line assessment of alignment
Lateral view – should pass through:
Bodies of Cervical Vertebra
Slightly behind the hip joint
Slightly in front of the knee joint
Slightly in front of the lateral malleolus (the lump on the outside of the ankle)
Kyphordotic – this is an exaggeration of the normal curves in the lower and upper back.
Increased loading on the rear part of the spine in the facet joints.
Increased incidence of overstrain to the Erector Spinae muscles of the back.
Increased flexion (forward bend) to the thoracic (rib cage area) region.
Possible reduced movement around the shoulder region.
Tight overactive hip flexors (muscles that lift the leg).
Long and weak abdominal muscles.
Weak hip extensors (muscles that move the leg back).
Classic Sway Back (Probably the most common) – this is a forward sway of your pelvis
Increased loading and movement shear at the very base of the spine.
Increased vulnerability of the discs due to increased loading of the facet joints.
Increased loading on the front of the hip joint.
Restricted movement of the diaphragm.
Tight or overactive Illiotibial Band, Gluteals, Hamstrings
Long and weak hip flexors, abdominals and multifidus (the deep layer of back muscles)
Flat back – this is when the natural curves of the back are lost and causes the spine to be flat.
For the flexible flat back increased lumbar mobility and load on front of spine
For the stiff flat back increased hip mobility and load and strain
Short muscles at front and back of hip and pelvic muscles
Tight pectoral muscles
Tight and overactive Rectus abdominus (six pack)
Kyphotic – this is when you have an exaggeration in the curve of your upper back.
Loss of lumbar extension
Excessive hip extension /loss of hip flexion.
Reduced mobility in shoulder girdle
Greater loading of the weight bearing joints in the lower neck
Scoliotic – this is when you have a twist or a bend somewhere in the spine. There are variable presentations and the implications of this vary depending upon the area and degree of curve and the direction of the curve.
Poking Chin Posture – this is when you allow the chin to poke out. This posture can often lead to neck pain and headaches and shoulder dysfunction.