Good posture is a key factor in preventing many pelvic, hip, lower back, mid back and neck pain. If we spend most of our day sitting in a slumped position, our knees crossed, our shoulders rounded forward and our head jutting in front of our body, and do nothing to counterbalance via exercise or change of pattern, overtime, muscles become tight, joints lose their flexibility, nerves get pinched, our breathing is compromised, our abdominals become flabby, and off to the doctor we go. These common problems related to poor posture are treatable with the appropriate lifestyle changes, daily postural exercises taught by a physical therapist and by making ergonomic changes.
TAKE THE PHOTO CHALLENGE:
Let’s tackle some basic lifestyle/ ergonomic issues. The first step in knowing good posture is to become aware of your postures during work and home. An easy way is to find out is to have your coworker take some random photos of you throughout the work day (no poses!) The best shots are the side and back views where you can see your spine curves. At home, have a family member take photos of you preparing meals, reading on the couch, etc. Later you can look at the photos and marvel how upright, centered and how you maintain your natural spine curves throughout the day (probably not!)
Just by looking at your photos, you can figure out some of the changes you need to make. Good posture is based upon keeping the natural curves of the spine during most activities. This is called maintaining a “neutral spine” and requires flexible muscles, joints and having strong muscles. Our body should not be placed in extreme positions for hours at a time. For example a hyperextended position, ie standing with both knees locked can cause lower back tension, conversely, a hyperflexed position , ie sitting in a slumped, rounded posture can cause back and pelvic pain.
GOOD SITTING POSTURE - Detailed
Sitting is what we do most of our day - to work, eat, learn, watch TV, read and mostly sit during transportation. Over time, poor sitting positions causes muscle tension, joint restrictions, strength deficits and pain that physiatrists diagnose and physical therapists treat every day.
Set up your computer/reading/art /work space to fit your body, to help support and maintain your natural spine curves instead of having your body adjust to the space. The chair seat should be at a comfortable height, so that both feet (heels and toes) can touch the floor. Feet that are unsupported create tension in hips/legs/lumbar spine. If your body is more of a petite size, so your feet do not touch the floor, use a footrest.
When sitting, the two bones at the bottom of the pelvis where your hamstrings attach, called Ischial Tuberosities (IT’s), and the center of your pelvis inbetween the IT’s should be in contact with the chair seat. Your lower back should rest against a lumbar cushion, either already built into your chair back, or purchased separately and strapped around the chair back. The lumbar cushion gently pushes your lower back forward to maintain its natural inward curve. You should not slump backward to sit on your tail bone (coccyx) nor should you lean too far forward to bear weight on your pubic bone. Don't sit on one side/hip as this creates imbalances at your sacroiliac joint, hip and lumbar spine. (See photo 250)
With your lower back resting against the back of your chair against a lumbar cushion, this frees the thoracic spine , shoulders and neck to stack one on top of another, versus careening forward. If you find yourself hunching forward to see the computer screen or to reach the keyboard, adjust the placement of this equipment so it is brought closer to you so you do not strain forward.
Lastly, during every hour of sitting, work/read/draw for 50 minutes, then get up for the last 10 minutes to take a brief walk, do a stretch, pet your dog, do something else. Research shows that 50 min work/ 10 min of change recharges your brain/thinking powers. This timing is a great way to re-evaluate your posture and prevent build up of faulty postural patterns.
A Upper body lift: done either in sitting or standing position and has 3 distinct parts
If doing this exercise in sitting, keep your pelvis centered on the seat as described above, your lower back resting against the lumbar cushion. If doing this exercise in standing, keep both knees slightly bent.
1) Think of an invisible string gently lifting your sternum (the bone in front of your chest) upwards You should feel your upper body move from a rounded upper back to a more elevated posture Hold this as you:
2) Roll your shoulders up towards your ears, then backward, then down. This opens your front of your shoulders Maintain this position as you finally:
3) Gently tuck your chin towards your neck (think of creating a double chin position)
Hold all three positions together for a count of 20 seconds up to one minute. Make sure to breathe slowly while holding the position Repeat. Do three times a day.
B Thoracic twist combined with deep hip rotator stretch
While working at a computer we tend to get into a rounded upper back and forward head position. Our midspine, called the thoracic spine can become restricted as well as our hip muscles. Here is a simple stretch to open both areas\
R Spine twist:
Sit in a sturdy chair your buttocks slightly away from the chair back, feet comfortably touching the floor or on raised step stool
Cross the R ankle over the L knee
Place L hand on outside of R knee.
Place R hand on the chair seat behind you
Turn your upper body as far as possible to the right while gently pulling the R knee towards your L shoulder. Keep your neck centered over your chest, not to twist your neck too far
You should feel a stretch along your spine and in R buttock/hip region Hold for 10 up to 30 seconds while breathing slowly.
Return to center and repeat once more. Repeat to the opposite side two times Do twice a day
C Wall Angels
Do you remember making snow angels as a kid? “Wall angels” are the grown up version of snow angels This exercise increases strength of your upper back, posterior shoulder to counteract the effects of a forward head, rounded shoulders posture.
1) Stand knees bent, your buttocks, lower back, upper back and back of your head are against a wall. Tighten your stomach to keep your core stable. Bend your elbows comfortably by your sides with the back of your hands touching the wall.
2) Keeping this body position, slowly slide both hands along the wall raising both arms until your hands meet overhead. Slowly lower. Repeat 10 reps. If it is difficult to go full range, try ½ or ¼ range.
There are more excellent postural exercises, for example keeping your abdominals, pelvic floor and lower back muscles flexible and strong is key. Consult your local physical therapist to learn a tailored exercise home program that is right for you.