Does Posture

     Actually Matter?

Posture. We’ve all heard it – “stand up straight”, “squeeze your shoulder blades”, “stop slouching”

When we think of posture we think of how we are aligned. Posture is really how we move and respond to external forces. It’s a state of constant movement and adaptation to stressors like gravity and physical challenge.

We know that there is no ‘perfect posture’. The best posture is the one that is the most comfortable. When it stops being comfortable, that’s when we need to move around and re-position ourselves.

Potentially only time posture and form REALLY matters is if we are lifting heavy weights (or if we want to be the next Miss Universe).

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Upper-Crossed Syndrome 

Every manual and physical therapist has been taught about upper-crossed syndrome at some stage. It is an outdated theory about muscle imbalance which supposedly causes all kinds of joint and muscle pain. The upper-crossed model reflects what we think of when people talk about bad posture – a forward head carriage and hunched shoulders.

The simple truth: many people with textbook perfect posture are in terrible pain, and many people with this ‘upper-crossed’ posture have no pain.

More and more, research tells us that where our body sits in space is not a cause of pain (1,2). Dr Jason Silvernail (DPT, DSc, FAAOMPT) has synthesised the research to determine that there is poor reliability of postural assessment and poor correlation of muscle tightness with strength or pain (3).

Simply put, individual muscles are no longer the focus of treatment or rehabilitation. Any form of exercise will help with pain!

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Long-Term Consequences of Posture 

When posture is talked about as a pathology it makes us anxious that we’re destroying our body. A search of the evidence showed no study that concluded that posture is detrimental to our long-term health.

The evidence does show that there is a lack of association between pain and spinal asymmetry, increased spinal curves, pelvic tilt, physical stressors or length length differences (4).

Most commonly, people worry that poor posture leads to arthritis. Again, there is no evidence available. It is possible that posture plays a part in the development of arthritis in the neck and back. But there are other factors that we know contribute to a much greater extent (genetics, trauma, body mass index).

As we age we cannot tolerate the same physical stressors we used to. (Just ask anyone who fills in for their friend’s basketball team 15 years since their last game.) Perhaps this is what happens when some previously effortless postures start to cause pain. It’s not that our posture has caused arthritis, but that we have normal age related change and just can’t tolerate what we could previously.

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When Posture Is a Problem

Our body is a champion adapter and can deal with most of what we ask it to do.

The issues come when we repetitively do the same thing for a long period of time. Think sitting at a computer for 5 hours straight without moving, carrying your 18 month old on your left hip 100% of the time, standing at the cash register and only moving a handful of steps in your shift … the list goes on.

This is called postural stress. It is one of the most common reasons people come to see an osteopath. Postural stress underpins those niggles that arise when we don’t move enough or position ourselves awkwardly for an extended period.

It doesn’t mean that you have a posture problem, it means that you body isn’t coping with the challenges placed upon it. This is when your osteopath can provide symptomatic relief and give you advice about general forms of exercise and optimising your ergonomics. Usually relief is easily achieved by limiting the obviously poor positions!

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Our Tips for Posture 

  • Any form of exercise is enough. You don’t need to specifically strength your lower traps or your ‘core’
  • Move around during your work day. Stand up, swing your arms, walk to get a drink of water. Change what you’re doing to make your body feel better
  • Don’t be so hard on yourself. Unless you are desperate to have supermodel posture, how you stand really doesn’t matter. You aren’t doing any damage to your body

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References & Resources 

(1) Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. European Spine Journal. 2007;16(5):669-678. doi:10.1007/s00586-006-0254-1.

(2) Barrett E, O’Keeffe M, O’Sullivan K, Lewis J, McCreesh K. Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review. Man Ther. 2016 Dec;26:38–46

(3) https://www.somasimple.com/forums/forum/physiotherapy-physical-therapy-manual-therapy-bodywork/general-discussion/23859-enough-already-upper-lower-crossed-syndromes

(4) Lederman E. The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain. CPDO Online Journal. 2010 March;1-14. www.cpdo.net

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For more sensible reading on posture visit the following articles

https://www.painscience.com/articles/posture.php#table_of_contents

https://www.theguardian.com/lifeandstyle/2018/mar/05/are-you-sitting-comfortably-the-myth-of-good-posture

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