“Your posture follows you like a shadow, and it has a ripple effect into everything you do – how you walk, stand, breathe, and train.”– Jill Miller

Posture.  What IS it, really? 

You know it’s distinctive – you can easily and immediately recognize close friends just by how they move and how they hold their collection of arms, legs, torso, and head together – that configuration is as individual to them as their fingerprint.

But is posture JUST a description of how someone stands and moves – just a math equation of angles, force, and mass?  Or does it go deeper than that?

Mary Bond, author of The New Rules of Posture and Your Body Mandala, says that posture is our “orientation to the present moment.”  It’s affected not only by our bones, muscles, and fascia, but by our thoughts, emotions, traumas, history, chemistry, family, work – by all those holding patterns developed over years of living and being on this gravity-endowed planet.  

Do we need to care about these postural holding patterns?  Does it really matter how we move and carry ourselves?  Is there a “good” vs. “bad” posture?  If the answers to these questions are “Yes,” then let’s take a look at what steps we can take to start to repattern our posture to one that enables us to meet our goals.  

Why is Good Posture Important?

Our bodies adjust to the positions in which we hold them most often.  If you slouch for hours on end, or if you always habitually always cross your right leg over your left leg when you sit, your body will start to adapt to that position.  Davis’s Law states that your muscles adapt to the positions you put them in (getting shorter or longer as needed), and Wolff’s Law states that your bones eventually adapt as well.  Over time, these adaptations can lead to pain, dysfunction, and inefficient breathing.   Jill Miller writes in The Roll Model Method, “Your body conforms to whatever shape you demand of it.  Different muscles strengthen, weaken, tighten, and stretch based on your patterns.  Unfortunately, many choices lead to degenerated vertebrae, bulging disks, herniated abdomens, torn knee cartilage, or stress fractures in hips…” 

Let’s drill down into three main areas impacted by posture – the pain experience, performance, and breath. 

Posture and the Pain Experience

Habitual imbalanced postures can lead to tension in your tissues, uneven wear and tear on joints, and the inability for your internal layers to slide and glide, which can restrict movement.  Some research, however, indicates that there is not a direct correlation between posture and pain – some people with bad postures do have pain, but others with the same posture do not have pain. (1, 2, 3)   Other studies indicate that certain postures can lead to pain.(4, 5)  So where does the truth lie?  

JARGON ALERT

Biopsychosocial model of pain: The biopsychosocial model is an interdisciplinary model that looks at the interconnection between biology, psychology, and socioenvironmental factors. The model specifically examines how these aspects play a role in topics ranging from health and disease models to human development. – Wikipedia.


Posture, along with many other inputs, does affect the pain experience, according to the biopsychosocial model of pain.  These inputs include everything from emotions, memories, and smells, to signals coming from the skin, organs, and musculoskeletal system, which are heavily influenced by posture.
(6) Matthew Taylor, PT, PhD, C-IAYT, international pain expert and leader in integrative rehabilitation notes, “There are aspects of posture that have significant effects on health – respiratory capacity, digestion, occlusion (how the teeth meet). Within that, you can have people with horrible postures, but no pain, and people with great postures with a lot of pain.  Posture is one facet of the very complex thing we call the human experience.” 

Thomas Myers, founder of Anatomy Trains, agrees, writing in Fascia, Function, and Medical Applications, “Although posture is not absolutely determinative of NSLPB (non specific low back pain), there are postural patterns that often accompany LBP.”(7) Addressing postural patterns that often accompany pain can be one, fairly accessible, way to start to alter the pain experience.

Let’s examine a few postures that typically accompany low back pain (and don’t worry – we’ll walk you through how to address these postures at the end of the article!).

Head Forward Posture/Upper Cross Syndrome

Posture Graphic, Photograph of woman in poor posture standing and "slouching" forward and

 

If you spend your days at a computer, you’ve likely spent time in this posture, which is characterized by a caved-in chest, hunched shoulders, and the head jutting forward in front of the shoulders. This posture is not only associated with low back pain, but it also can cause upper back and neck pain, headaches, and decreased breathing capacity.(7, 8)

Photographs of Poor Posture: Left photo pictures woman thrusting hips forward, right photo depicts woman thrusting chest out, both common poor posture habits

Pelvis Thruster

In this posture (pictured on the left in the image above), the pelvis is projected forward, and the rib cage shifts backwards and is no longer centered over the pelvis. This posture can contribute to low back pain, as it shifts the center of gravity to the sacrolumbar junction (where your pelvis meets your low back).(7)  It can also cause imbalances in the muscles of the lower leg and glutes, and even more importantly it affects the “reciprocity of the respiratory and pelvic diaphragms, which affects breathing and core strength.”(7)

Chest Thruster

If you view the Chest Thruster posture from the side (pictured on the right hand side in the image above), it looks as if the person is ready  to launch off a ski jump – the hips and shoulders are both in front of the ankle.  This posture can also contribute to low back pain, as it causes imbalances in the hip flexors and the deep lateral rotators of the femur.(7)  Again, the chest is no longer centered over the pelvis, which affects breathing.

Did you notice a common theme with these postures?  They all impact the breath!  

Posture and Breath

Breathing is something we do mostly unconsciously about 20,000 times per day. How we breathe and where we breathe in our bodies has global impacts – affecting immunity, mood, pain, muscle tone, balance, digestion, heart rate, sleep, cognition, and chronic pain.  As mentioned above, many postures affect the placement of the ribs over the pelvis.  When the ribs and pelvis are not centered over each other, the main muscle of respiration, the diaphragm, is affected. On inhalation, the diaphragm should descend slightly, pulling air deep into the lungs.  This movement also gently massages the viscera, facilitating gut motility and the ability of your organs to slide and glide within the abdomen.

When the diaphragm cannot descend on the inhalation, our resilient body will find another way to breathe. This usually means that the accessory muscles of respiration (the neck and shoulder muscles) are recruited to help bring air into the lungs.  When we use these “supra-clavicular” muscles to breathe, it can lead to chronic neck and shoulder pain, and it signals the nervous system that we are in a sympathetic state, spiking stress hormones which break the body down over time.

To understand the domino effects of poor breathing and how it can be a driver for many chronic pain conditions, check out this video from Matthew Taylor, where he describes the global effects of upper chest breathing, and for a deeper dive into the diaphragm and posture connection, check out this article from Tune Up Fitness.  

Posture and Performance

If posture can impact your pain experience and ability to breathe well, it obviously will influence your ability to perform at your best. Long-held postures reduce the range of motion accessible to you, resulting in diminished movement potentials. Jill Miller puts it best when she says  “Your spectrum may become NARROWER and NARROWER if you don’t use your full range of motion intelligently. In other words, if you are always leaning into ONE posture and not living into others, your range of motion will restrict around your “leaner” posture, and that can create wear and tear on your joints and ultimately LIMIT your ability to have other posture possibilities.” 

Explore this for yourself.  Put your body into the Sloucher or Pelvic Thruster position and see how easy it is to do hip circles or hip figure 8s.  Next, organize yourself so that your hips are over your ankles and try again.  Which version felt better in your body?

It’s clear that posture is important. Inefficient postures can lead to pain, disordered breathing, and a decrease in performance.  So how do we transition to better postures?

How Can I Improve My Posture?

“Posture is the mirror of the soul.” Ludwig Wittgenstein, Philosopher

Postures develop around our thoughts, emotions, daily habits, and environment.  When we are sad or depressed, our bodies begin to cave in and become more slumped, and when we are happier and more energetic, our postures get bigger and more expansive.

Likewise, when we are stressed, our posture is affected – muscles tighten up, breathing gets constricted, our shoulders start to creep up to our ears. Next time you are stressed, try the following exercise to really tune in to the effects that stress is having on your posture.

Woman lies in constructive rest position; two yoga bolsters propping up knees, a folded blanket on the abdomen and alpha self massage balls in hand to add weight and comfort
Constructive rest with Alpha Self Massage Balls used as weights in hand
  • Check-In with your body before getting into Constructive Rest: 
    • How far can you rotate your neck from side to side? 
    • How much tension do you have in your neck or throat?
    • Can you take a long, deep breath? 
    • Are you wired or relaxed?  How fast is your heart beating? 
    • If you look in the mirror, are your shoulders and hips level, or is one side much higher than the other? 
  • Check-out:  After 10 – 15 minutes in constructive rest, how did your rotation, tension, breathing, heartrate, and posture change, with just a few minutes of rest and breathing? 

Daily habits such as texting, attending endless Zoom meetings, hours of shuttling kids around to after-school activities, mouth breathing, and static living affect our postures as well. Cultural influences also impact how we hold ourselves; trying to look shorter, skinnier, taller. Likewise, the clothes, shoes, and chairs we use influence how we sit, stand and move. Biological inputs such as injuries or surgeries, scars, poor nutrition, and dehydration also impact posture. Even the postures of our parents, siblings, and friends have an influence. Need proof?  Look at family pictures – do several members have the same little head tilt to the left, the same hip cocked off to the side? Watch how parents walk and then notice their children; you will find amazingly similar gait patterns. 

Now that you have a better idea of how you got to where you are today, it’s time to begin the work of learning how to embody a posture that works better for YOU.

Awareness

Building awareness is the first step towards moving to a posture that facilitates more movement potentials.  Mary Bond notes, “If perceptual orientation (orientation to the ground and the spatial field surrounding us) is incomplete, the body finds alternative ways to feel secure – gripping toes, clenched pelvic floor, held breath, tense shoulders. Such tensions configure body parts in ways that limit movement.”   

To become aware of our unconscious habits, it’s vital to SLOW DOWN and sense into our internal environment, which can be difficult for us modern humans who often spend more time in our heads than in our bodies.  Matthew Taylor says, “Posture is subconscious.  Our culture says you feel bad because you have a bad part, so people are looking outside themselves to see what is wrong in their body.  YTU is great because it slows people down and gets them to begin to look inside and sense their internal environment.  It begins to get them to attend to how they feel.  It starts the cycle of awareness and change, and at the same time generates a different posture.”  Self-myofascial release (SMFR), is an excellent tool for improving this internal sensing.  In the “Repatterning Your Posture” section below, you will be guided through several sequences to help you embody your posture.  For a more in-depth discussion of the benefits of SMFR, check out this article.

Take a moment right now and check in with your posture:(9)

  1. Is your head drooping forward, in front of your ribcage?
  2. Are your shoulders slumped forward?
  3. Is your low back rounded into a C-shape and collapsed?
  4. Are your legs crossed?
  5. Are your breaths shallow, or are you breathing deeply through your core?

As you started to tune in to your posture, were you able to clearly feel where you are in space?  Are certain areas of your body more difficult for you to see from the inside? Mary Bond notes that the pelvis is a body blind spot for many people, which can be problematic since, “tension in the pelvis restricts free transmission of movement through the hips into the legs and feet as well as up through the spine and torso.”  Read about healing the pelvic floor for a deeper dive into this topic.

Ok, so now you have a better idea of your current state.  What’s next?

Repatterning Your Posture

Good posture means standing and moving in a way that minimizes friction on joints, enables our bodies to resist the force of gravity in an efficient way, and facilitates appropriate breathing patterns. A good baseline for standing posture is “skull over ribs, ribs over pelvis, pelvis over knees, and knees over feet and pointing both feet forward.”(9)

While this is a good template to work from, the truth of the matter is, human beings vary widely and there is no one “perfect” posture that fits all humans. As Matthew Taylor puts it, “There are 7.5 billion human beings that represent an entire spectrum of postures, from very soft, flowy postures to rigid, military postures. There is incredible diversity of postures.  There is fallacy in this idea of a “perfect posture.” Research also indicates that “normal” postures vary tremendously across individuals.(6) Roop Sihota, DPT, Strength & Conditioning Coach, echoes this, saying that the “correct” posture for a person is very individualistic; it depends on the person and his or her specific goals. He asks, “What do you want to do that you are unable to do?  If you want to pick up your kids, roll, run, jump with them, will your posture enable that?

And that gets us to the true crux of the matter – posture is dynamic. The perfect posture for you, is the NEXT posture. It’s vital to keep moving, keep adjusting postures, and keep exploring different joint configurations.(10)  Static postures leave our tissues subject to injuries, dehydration, and reduction in movement options. Nerve impulses from those static areas get quieter as well, and when this occurs, the brain will tamp down the movement potential of that area in an attempt to maintain safety.

Taking care of your body and improving your posture does not need to be complicated. In a nutshell – you need to move more and move in different ways. In the Optimal Body podcast, Dr. Jen Esquer and her co-host Dr. Dom recommend the “30 for 30 exercise” which simply means, every 30 minutes, move your body in the opposite way for 30 seconds (see gif below). You can set a timer on your phone (or use an app such as Stand Up!) to remind you to stand up and move. You can also play with different ways to sit in your chair or sit on the floor.

 

 

Dr. Sihota echoes this sentiment, saying, “If you want to maintain a full range of motion, you need to move in many different ranges and neurologically challenge yourself with new movements. Get out of your comfort zone – take a dance class, do yoga, try martial arts or ballet.”  He also suggests “gamifying”  your movement – set up a trampoline in your office, or hang a tennis ball from the ceiling, and as it swings around, try to dodge the ball, restricting your movement at your hips or knees – make it fun, make it interesting, make it safe – then it will be a sustainable practice. 

What about those pesky postures we mentioned on that outset – the ones that are often implicated in low back pain?  Here are some comprehensive strategies to start to repattern your posture.

Head forward posture/Upper Cross Syndrome

If you can escape from the cast of your chair, the following sequences will aid you in undoing these postural habits.

You can also check out this Union.Fit class where Jill Miller teaches you how to Unroll the Crouch, Clench, and Cradle Position.

Posture Sequences for Lower Leg and Gluteal Imbalances

The following two sequences will help address the lower leg and glute imbalances caused by this posture, enabling you bring your pelvis more in line with your chest.

These sequences will target the imbalances in the hip flexors, enabling more optimal ribcage/pelvis alignment.

Adults have developed habitual postures over the course of decades, so it will take some time to start to unwind those and introduce a wider range of postural options. Kids, however, are still in the process of learning how to stand, sit and move well.  How can we encourage them to develop habits that will help them retain their resiliency?

How to Help Your Kids with Posture

Posture adapts and changes as we grow.  As we roll, creep, crawl, stand and walk, we learn how to find balance in our muscles and structure by trying new things, failing, and learning. It’s critical to provide children with an environment and people to foster exploration and play, so they can find balance and stability in their posture over time.  

Dr. Jennifer Hutton, pediatric physical therapist, tells a story about working with a mom who was concerned that her 13-month old was not crawling yet. To figure out the cause, Dr. Hutton put a toy on the opposite side of the room and watched the mom and toddler. As soon as the baby cried for the toy, Mom got up and got it for her. The very intelligent toddler realized that if she cried, she didn’t have to go through the trouble of crawling to get the toy herself. This is a great example of the need to organize a child’s environment to encourage movement and play.  

In this current COVID-era, many kids are stuck sitting, staring down at a computer for school, learning poor postural habits along with their math and social studies. However, we can turn this into an opportunity for postural playfulness. How many different positions can your child find in which to sit? Can you find stable and unstable surfaces for them to sit or stand on?  Can you build different workstations that encourage switching between standing and sitting?  If kids must use a hand-held device, encourage them to hold the devices at eye level (which has the side effect of decreasing screen time because their arms get tired), or to lay on their backs and hold the screen over their faces.  Keeping the learning environment as dynamic as possible will help kids learn what works for their bodies and what feels good, building self-efficacy, says Dr. Hutton.

If you see your child starting to develop extreme postural habits, you can help them find their way to center. When Dr. Hutton works with her pediatric clients, she finds that external cues are helpful.  For example, instead of telling a child, “stand up straight,” she puts an X on a wall in front of them and has them look at the X. To help children find neutral in their joints, she guides the child through the extremes of their joints. For example, if a child has a tendency to tilt her pelvis forward, she will guide her back and forth from an anterior to a posterior tilt, and have her figure out what feels balanced to her. This helps the child understand herself better.  Likewise, if she notices one of her clients is holding his breath during a movement that shouldn’t require a lot of bracing (like getting up and down from the floor), she will encourage him to sing the ABCs as they go through that action, which enables breathing to become more reflexive. 

Posture FAQ For the Coaches, Therapists, Trainers, Movement Teachers

If you are a movement teacher or coach, you are perfectly situated to help people rediscover their movement potential.  Once you understand your client’s story and their goals, you can help provide them with a safe, supportive environment with which to explore their body blind spots.  Words have power, so it’s vital to not pathologize a specific posture (don’t be the Perfect Posture Police!), but instead encourage exploration.  Matthew Taylor makes the plea to, “Take a step back and be sensitive to the beauty and complexity of being a human.” It’s important to be mindful of our own belief blind spots. He encourages movement professionals to stay current on the research, read the articles that don’t agree with your current opinion, and ask lots of questions to broaden your understanding of your client’s story, posture, and structure.

Dr. Hutton encourages clinicians to work with their communities to share information about postural health.  When there is a lack of good information about posture, some postural issues such as varus (bowlegged) or valgus (pigeon-toed) legs are considered to be “just the way you are.”  They are not recognized as movement deficits that can be addressed before they cause injuries.  Primary care physicians are not always familiar with musculoskeletal issues, so trainers and coaches can play an important role in helping their clients know when it’s important to address postural issues.

Posture is critically important for our overall health and wellbeing.  When we let our bodies fall unconsciously into habitual postures and maintain those static attitudes for long periods of time, we pay a hefty price –  pain, disordered breathing, and reduced performance.  When we bring the light of awareness to how we sit, stand, and move, we start to recognize if our postures are helping or harming us.  Once we identify postures that are causing pain or affecting our ability to do what we want to do in life, we can implement simple action steps to start to unwind those patterns – change up our workstations, take regular fun, brief movement breaks, use SMFR to rebalance tense tissues.  We can discover space to explore and find new ways of being and holding ourselves – not striving to attain a mythical “perfect posture” – but working towards finding  a postural strategy that is custom tailored to our needs.  It will take time to start to change habits that have been reinforced with years of repetition, so be compassionate and patient with yourself as you start to repattern how you orient to your world.

 

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References

  1. Barrett, Eva et al. “Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review.” Manual therapy vol. 26 (2016): 38-46. doi:10.1016/j.math.2016.07.008
  2. Heino, J G et al. “Relationship between Hip Extension Range of Motion and Postural Alignment.” The Journal of orthopaedic and sports physical therapy vol. 12,6 (1990): 243-7. doi:10.2519/jospt.1990.12.6.243
  3. Laird RA, Kent P, Keating JL. How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain? BMC Musculoskelet Disord. 2016 Sep 22;17(1):403. doi: 10.1186/s12891-016-1250-1. PMID: 27658946; PMCID: PMC5034504.
  4. Cramer, Holger et al. “Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain.” BMC musculoskeletal disorders vol. 19,1 109. 6 Apr. 2018, doi:10.1186/s12891-018-2031-9
  5. Hunter, Donald J et al. “Relationship Between Shoulder Impingement Syndrome and Thoracic Posture.” Physical therapy vol. 100,4 (2020): 677-686. doi:10.1093/ptj/pzz182
  6. Pearson, Neil, et al. Yoga and Science in Pain Care: Treating the Person in Pain. Singing Dragon, 2019. 
  7. Lesondak, David, and Angeli Maun Akey. Fascia, Function, and Medical Applications. CRC Press, 2020. 
  8. Vranich, Belisa. Breathe the Simple, Revolutionary 14-Day Programme to Improve Your Mental and Physical Health. Hay House, 2016. 
  9. Miller, Jill, and Kelly Starrett. The Roll Model: a Step-by-Step Guide to Erase Pain, Improve Mobility, and Live Better in Your Body. Victory Belt Publishing Inc., 2014. 
  10. Biddle, Stuart J H et al. “Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future directions from the 2018 Queensland Sedentary Behaviour Think Tank.” International journal of environmental research and public health vol. 16,23 4762. 27 Nov. 2019, doi:10.3390/ijerph16234762
  11. Zafar, Hamayun et al. “Effect of Different Head-Neck Postures on the Respiratory Function in Healthy Males.” BioMed research international vol. 2018 4518269. 12 Jul. 2018, doi:10.1155/2018/4518269

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