Humans are distinct from animals in many ways, one of which
is that we stand and walk erect. But just how erect varies
from person to person, sometimes dramatically. Most of us,
with constant parental prodding, stood relatively straight
during childhood.
But gravity takes its toll as we age and many of us
demonstrate a perceptible slouch by the time we reach middle
age. Certainly posture has a significant impact on overall
appearance. But its impact on health is important as well.
A person with poor posture is more likely to suffer back
pain, neck pain, headache and other discomfort. When the
spine is kept in good alignment, the individual is less
likely to experience back discomfort or related problems.
Maintaining proper alignment becomes even more important as
people age and have a natural tendency to slouch anyway.
US Marines demonstrate good posture! The head is directly in
line with the shoulders, which are directly in line with the
pelvis. Poor posture is something less than that, although
the degree can certainly vary. Poor posture is not the bane
of only the middle-aged or the out-of-shape.
Even young children may start to show some signs of
slouching, although it usually becomes more noticeable in
adolescence. One recommends that the problem be investigated
to ensure there is no developmental deformity such as
Scheuermann's Kyphosis, which is rounding of the upper back,
or spondylolisthesis, found in some people with swayback.
It's impossible to change the situation just by telling a
child to stand up straight, although that is what most
parents tend to do. Instead, kids should be encouraged to
exercise regularly. Good posture will usually be one of the
results since overall muscle strength is what will keep the
skeleton supported and maintain good alignment into
adulthood.
However, being athletic does not always mean having a
straight spine and coordinated extremities. Even athletes may
demonstrate poor posture. If you look at basketball or soccer
players sitting on the sidelines, they are often hunched over
even though they may have looked great when they were
playing.
Poor posture is often caused by lack of muscle strength,
particularly in the upper body. Even if people have strong
lungs or strong abdomens, that does not mean they will stand
up straight. They need to do exercises that specifically
strengthen the upper body.
Posture is affected by a number of factors. How one spends
most of his time is very important. If you have to sit in one
spot for much of the day, your posture is probably going to
suffer. The same is true if you have to carry heavy loads or
bend over a lot. All of those actions put prolonged stress on
the spine and may tend to cause slouching to compensate for
the strain.
Extra weight also puts stress on the skeletal system and
makes the muscles' work more difficult. A few kilos of added
weight can throw anyone's posture off. It may therefore be
more difficult for a person who is even slightly overweight
to stand up straight for long periods of time.
Weight gain during pregnancy can tax the musculoskeletal
system because the abdominal muscles are stretched over the
expanding uterus and they become less effective in
maintaining spinal alignment. But with a good strengthening
regimen, most women can correct the problem even during
pregnancy.
And certainly they can correct posture problems after
pregnancy. If the woman was in good shape prior to the
pregnancy and had good upper body strength, she should be
able to bear the increased weight with a minimum of
displacement. And even that will not be permanent if she
pursues a regular strength conditioning program after her
pregnancy. The body has a remarkable ability to recover.
Footwear usually is not a factor in posture but very high
heels can have some effect. If the heels are really high,
they have a tendency to make the individual stick out in the
back and to shift the weight into a different direction. For
that reason, that type of shoe is probably not the best
choice, especially for someone who will be wearing them for
long periods of time or for long distances.
Fatigue also has an adverse effect on posture. It is hard to
stand up straight if you are exhausted. You can often tell
when people are tired just by looking at the way they are
carrying themselves.
Of course normal aging has an adverse effect on posture.
Especially in women, the normal Lordotic and Kyphotic curves
become exaggerated as the vertebrae become compressed.
Compression fractures are common, particularly in
postmenopausal women. Drying out the vertebrae disks that is
associated with aging further accentuates the curves. As the
curve increases, so does the pain.
What's the best approach to achieving and maintaining good
posture? We recommend the following steps for maintaining a
healthy back and good posture:
1. Exercise regularly. General conditioning exercises such as
walking and swimming are excellent exercises for
strengthening the back. A program of strength training that
concentrates on the paraspinal and abdominal muscles is also
beneficial.
2. Try to flatten the lumbar curve as much as possible in the
course of daily activities. This can be done, for example, by
driving with the car seat as close to the steering wheel as
possible, by putting the feet up on a stool when sitting or
standing and by sitting in a firm, straight backed chair.
3. Extend the Kyphotic curve by sticking the chest out or by
lying down on the stomach and raising the chest about 20
degrees for a few seconds several times in succession.
4. Avoid sitting for more than 30 minutes without a break.
Get up and walk around or stretch periodically to give the
back a change in position.
5. Avoid activities such as riding a racing bicycle that tend
to cause bending and hunching forward.
6. Forestall the onset of osteoporosis by taking the adequate
amounts of calcium and vitamin D and by engaging in outdoor
activities and weight-bearing exercises.
7. Lose excess weight and keep it off. Even a slight amount
will "weigh" heavily on the spine and can upset balance. We
recommend that people who must sit for long periods of time
use an ergonomic kneeling-type of chair. Those chairs are
excellent for the back because they make it impossible to
slouch. If you did slouch, you would fall over backwards.
We also advise that patients be reminded to sit up straight
after exercise. Many people maintain great posture when they
are exercising but as soon as they get back in their car,
they slouch or sit way back so that their back is not
properly supported. That negates the positive effects of any
exercise program. To maintain good posture, people have to be
conscious of how they are standing, sitting and moving just
about all the time. They have to do all three activities
properly on a consistent basis to make a lasting
difference.
2005 Dr. Reuven Bruner. All Rights Reserved.
Contact him at: POB 1903, Jerusalem, 91314, Israel; Tel: (02)
652-7684; Mobile: 052 2865-821; Fax: (02) 652-7227; Email:
dr_bruner@hotmail.com
