Have people told you that you should ‘stand up straight’ throughout your life? Should you even try? Posture is an area that is fraught with arguments regarding whether or not it is important to ‘Stand up straight’ as if you don’t, you “will develop pain”.
What IS ‘straight’posture anyway? Posture is actually very changeable – we move all the time, after all. Therefore it is better to talk about good posture rather than standing straight as posture is really more about the way you live, the shape of your flexible skeleton. It changes according to mood and it is very difficult to change permanently. Changing posture to improve how you stand is like changing your personality – you might succeed for a short period but you will find it very challenging to do so ‘for ever’ – how you stand is how you are!
I have talked about the idea that if muscles are too ‘tight’ or ‘weak’ then your posture will suffer but over the years and studying a lot of research, it is difficult to find any to support that theory. If a muscles is ‘tight’ it is not necessarily weak, nor does it mean that you will definitely suffer pain as a result. We need to find out why it is tight or weak and see if we can help to stretch it or strengthen it.
I gave up examining patients statically years ago. Instead I bought a step machine and got patients to walk up and down on it to see how their bodies reacted. All the twists and painful cries the patients displayed told me much more about what was actually causing their pain than just looking at them standing in one position.
This is because poor posture is more an issue of how we perform actions in a strange way that irritates our bodies because doing so regularly may well overload our joints and that causes pain. For example if we sit watching TV on a soft sofa with one knee bent up underneath us for hours every evening, we stand a higher chance of developing knee pain as the pressure in the knee joint from being bent like that for long periods is irritating to the knee. Therefore that is an example of poor posture but unlike correcting your static posture, it is easily avoidable – it is something we can easily choose to avoid and far more controllable than trying to make ourselves ‘stand up straight’.
How does hunching over a lap top irritate – is THAT poor posture too?
This has been studied at great length. Accord to the collective results of ten different experiments it is almost certainly not a cause of shoulder pain. A large 1994 study of kyphosis or ‘hunched over posture’ in older women found no connection either; not even the 10% with the worst kyphosis had “substantial chronic back pain, disability, or poor health”. There are lots of people with very odd curves in their spines who never suffer from back pain.
Therefore not having ‘straight posture’ MAY contribute to pain but not necessarily. It is more about movement or lack of it while in a poor posture rather than the poor posture itself and about abnormal strain on your tissues rather than how you are put together and how you stand.
I keep saying in my articles – what we try to do is to treat every patient as an individual and posture is an individual’s ‘trade mark’ it is how we recognise them and pain arises more from how they use their bodies rather than how they stand and whether they stand up straight.
Carrying a heavy backpack slung over one shoulder is a postural strain — it is a circumstance that makes it difficult to be comfortable or to maintain what we probably think of as a good posture. Typing incessantly is a postural strain. It’s not a bad habit, it’s something that (some of us) have to do — and it is a challenge to our bodies.
Much “poor posture” is just awkwardly coping with a postural strain. We as chiropractors are trained to observe how you do what you do and give you pointers to change posture to avoid that strain, rather than aiming for the ‘perfect posture’. If you have no idea what you are doing wrong then you don’t think you have to change it!
If a patient has upper back pain from sitting at a computer all day and we can show them what they are doing wrong and suggest a few changes they can make to improve that working posture and they make those improvements … that can resolve the issue.
Ergonomics is the science of arranging or designing things for efficient use, specifically to avoid these types of postural strain. This is not just a question of getting a ‘good chair’ it is more about how you use the chair and where you position things on your desk or if you twist all day to talk to people as they come in behind you because your desk faces the wall. All of these things are not postural issues but rather ergonomic issues.
I am often asked if bad posture leads to arthritis. There was a study in 2012 that demonstrated that people who already have arthritic knees have a way of walking that is “consistently different” than people with healthy knees, but that also they probably weren’t walking differently because of pain. That is, the crookedness probably caused the arthritic pain, as opposed to arthritis just making them walk crookedly.
Again with the knee, one of the most popular theories in musculoskeletal medicine is that uneven control of the kneecap — due to abnormal anatomy and/or posture — will cause the cartilage on the underside of the kneecap to degenerate painfully, which in turn causes a common kind of knee pain, patella femoral syndrome. And yet, in fact, degeneration of that patellar cartilage can be painless.
I reject the “stand-up-straight” definition of good posture. Good posture is not necessarily about straightness! And yet it is essentially the only widely used definition, even by people with supposedly very learned opinions about posture. .
I am not saying we shouldn’t stand up straight. I am just saying that there is good reason to doubt anyone who claims to know that good posture is a matter of being well-aligned. It is more about how you move and chiropractors can ensure that all your joints move optimally therefore when you do adopt poor posture you are less likely to feel pain.
Much of what we perceive as “poor posture” is the result of biological adaption over decades and is unlikely to change without a truly heroic effort.
If you wear high heels for many years, your calves will actually shorten, and it’s not clear how easily that can be undone. On the other hand, if you grow up climbing trees, you will earn amazingly stretched calves that allow your ankles to bend halfway (45˚) to the shin two to four times greater than the average urban person!
“Squatting like a baby” is a faddish fitness goal — and hopelessly unrealistic for most people. But if you grow up squatting regularly from a young age, it’s no problem!
If you also have optimal strength, stability and skill because you use your body a lot, you will maintain ability to change posture much more easily than us sedentary city dwellers.
A child can adapt in ways that are possible only in the plasticity of a rapidly growing body, and for the adult to try to undo it is like trying to straighten a wooden plank.. Other changes may occur only over vast spans of time, or because of variables we have little or no control over. The result is that some adult “postures” are simply impossible to change — we really do get locked in.
And yet we can change. Stretching CAN increase flexibility, with a lot of work and I will discuss this next week.. For the office worker who feels locked into a typist’s hunch — I know I do, as I type this — isn’t it worth at least trying to sit better? I think so – but remember we need strength and flexibility not necessarily to be able to stand up straighter than the next person.
If you have pain regularly when working or doing things daily, call us and let us get your joints moving and advise you how to correct the postural problems you display.