Starting when were young we are told to watch our posture, mainly because expressing poor posture tends to transmit a less desirable image than good posture does.
What defines “good posture” though?
If you think about it, a slouched individual sends a different message than someone with an upright posture. The posture we display can be a direct result of emotional factors, biomechanical issues and habits.
The human body is designed to operate in synergy and disruptions in proper posture for too long of a time can have negative consequences.
Postural defaults alter the normal anatomical relationships throughout the body and can contribute towards biomechanical neck pain, shoulder pain and back pain resulting in issues further along the upper and lower extremity kinetic chain.
In this article we will discuss what proper posture looks like along with some simple techniques used to correct faulty posture. These techniques will be useful for the ability to maintain it throughout daily activities, working and training.
But first, have these items on hand to be able to perform the corrective exercises:
Normal spinal alignment consists of maintaining the natural curvatures of the spine, which are cervical extension, thoracic flexion and lumbar extension.
The spine’s natural curvatures allow for load acceptance throughout the body while providing mobility.
Problems arise when these are excessive deviations in these curvatures in such forms as kyphosis; excessive thoracic flexion or hyperlordosis; excessive lumbar/cervical extension.
These deviations can occur from muscle imbalances, environmental factors such as occupation or sport, habitual behaviors and in some cases, congenital or hereditary factors.
Normal posture constitutes a balance of upper cervical flexion, lower cervical extension, thoracic extension and rotation, lumbar extension, flexion and rotation.
The most common postural default is a “forward head” and thoracic kyphosis which results in a head protracted forward so the skull is anterior to the rest of the spine and the thoracic spine is excessively flexed.
This results in excessive extension of the upper cervical segments, limited rotation, limited thoracic extension and rotation and limited shoulder motion.
Illustration of normal cervical position vs. a protracted head posture
To appreciate the difference:
In which position way do you achieve greater cervical rotation and shoulder elevation?
The use of technology has certainly contributed to a higher prevalence of poor posture. Increased use of computers, lap tops, tablets, smart phones and portable video game devices all promote a forward dominance of posture.
Currently, with the recent pandemic and people working from home or remotely, there is more engagement on portable devices in suboptimal positions such as the couch, bed, Kitchen Island or poor supportive chairs.
Many people did not have a proper work from home set up when the pandemic hit but despite the home environment, many workplace settings have less then ideal set-ups for their employees as well.
Example of proper ergonomics and work desk set up metrics
Increasing awareness of posture and practicing simple techniques such as the basic exercises described next, can help prevent postural defaults and the negative results that come with them.
Illustration demonstrating kyphosis posture in the thoracic spine
Start position and end position of the supine chine retraction exercise
This exercise helps to correct the protraction or forward head position.
If your head is in an extended position when lying on your back, which can occur due the loss of upper cervical flexion, use a towel roll under the base of the skull to help keep your head neutral.
Then practice the chin retractions from this position. Eventually you should be able to lie on your back with head naturally in neutral.
Once the movement is mastered in the supine position, progress to sitting and then to standing.
When sitting and standing, make sure your scapula are squeezed back and down to avoid slouching.
Slouching during the seated or standing cervical retraction exercise nullifies the efficiency of the movement as it can tend to block the proper motion of the cervical segments.
Cervical retraction in seated with finger overpressure
The starting goal is to hold for 2 seconds and repeat 10 times. The ultimate goal is to practice this throughout the day when sitting and standing.
This exercise helps to target the muscles on the front of the throat that flex the neck. These muscles tend to get stretched out and weakened with a forward head posture.
It is best to complete this one when lying supine.
Anatomy of some of the anterior cervical muscles
First execute a chin retraction and while holding the position, elevate your head off the floor while still maintaining the chin retraction.
Use a foam roller to help promote thoracic extension.
Prone scapula retraction start and end positions
This exercise helps to train the proper movement of the scapula to correct a slouched and rounded shoulder posture.
This exercise helps for practicing awareness of poor posture.
This exercise helps to train the sub occipital musculature in a more challenging position, quadruped, which forces the neck to work against gravity.
This is beneficial for practicing good control of the neck when leaning forward doing tasks such as lifting or pulling.
Anatomy of sub occipital musculature. These muscles help to coordinate the movements and maintain the angles required to hold the head at various positions.
Close grip row start and finish position
Any type of rowing movement will help promote scapula retraction and to reduce a slouched posture. There are many variances of rowing movements, especially for training purposes but a simple close grip row is a good place to start.
Once the concept is mastered with light resistance and proper form, progression to other types of rows can be beneficial to train the muscles under different demands.
The main focus of the basic close grip row is to ensure the scapula are pulling down and back to correct the slouched shoulder position. Focus on the scapula finishing the movement as opposed to pulling the elbows back past the torso.
Anatomy of back and scapula musculature
Posture correction may seem awkward at first and can sometimes be a challenge to stay compliant with but the benefits of practicing proper technique will outweigh the results of neck, back and shoulder pain.
About The Author:
Michael St. George PT, DPT has been practicing for 10 years primarily in the outpatient and orthopedic setting. He works for a physical therapist owned private practice based in the greater Philadelphia area and surrounding suburbs. Mike is certified through Functional Movement Systems for FMS, SFMA and FCS which consist of screens and testing used to measure movement quality and performance. Mike also has experience with working with numerous surgeons and physicians from the Rothman institute. Currently he works primarily with ACL, meniscus and post surgical recovery and sports injuries, return to sport testing and performance, running evaluation and re training and hand and upper extremity conditions.