Rethinking posture: training and supporting optimal posture versus short-term corrections
Posture is the way we position (or align) our body, intentionally or habitually, throughout the day.
These situations may be static - such as when we are sitting or standing, or dynamic - when we are moving (walking, bending, squatting, etc.)
It’s best to think of posture as something that is constantly changing, rather than a fixed ‘correct’ state (or alignment) in which we should position ourselves.
There are transient ways we adapt our posture to suit our surroundings.
Just think of the various types of chairs you sit in over the course the day. Each chair may allow a particular angle of hip flexion that will influence how you position your spine.
There is also the long-term trainable aspect of our posture - improvements in strength and mobility that will have a positive influence on the efficiency of our postural system.
This might be a shift in thinking for some who have thought of posture as a ‘correct’ position they should always hold themselves in, such as standing upright with shoulders back and chin tucked in.
The idea has lingered that ‘bad’ posture will results in pain and injury, however studies that examine this are yet to find a strong link between the two.
Our belief is that we should value biomechanical efficiency and use our assessments of alignment to understand how our bodies have developed or are behaving.
Let’s briefly consider the interplay between our skeletal structure, muscular system and the role of posture in promoting comfort, biomechanical efficiency and overall well being.
How our bones and muscles work to maintain posture
Our skeleton, consisting of 206 intricately connected bones, forms the foundation of our body's alignment and movement.
The way these bones articulate to create joints shapes our posture and influences our ability to perform tasks.
While ligaments and connective tissues provide passive support, the active component of posture is driven by the action of muscles. This support is governed by neural signals and adapts to the demands of our environment and activities.
We have approximately 600 muscles in our body that act to hold us in certain positions at rest, and to initiate movement. Some muscles have a more specific role as primary movers, and others act as stabilisers.
As we navigate our daily activities, the relationship between different body parts continually changes based on factors such as gaze direction, reach, stability requirements and interaction with objects.
Dynamic vs. static posture
Posture can be distinguished as either dynamic (during movement) or static (while stationary).
Assessing static posture traditionally involves observing the alignment of key anatomical landmarks in relation to a vertical plumbline (see image below).
Image 1: alignment of key anatomical landmarks in relation to a vertical plumbline
We still utilise this tool in assessing our clients, however more so as a general orientation than to classify their alignment as good or bad.
It’s quite important to highlight, that if there are natural variations in a person’s morphology, this will dictate their ability to align themselves in a certain way.
Conditions such as scoliosis, pectus excavatum, knock knee and Scheumann’s morphology will all shape the way a person appears in a neutral standing position, but are not something we can correct by cueing them.
Even the angle of our spinal curves, observed from a side-on position, fall within a scope of possible curvatures.
Modifiable deviations are those due to behaviour, imbalances in muscle tone, etc.
The evidence
A study of 1,108 Australian teenagers found that forward head/slumped posture had no association with neck pain and headaches.
Several other studies have not only looked at the relationship between head position and the presence of pain, but also things like range of motion, sensitivity to touch, and the size and endurance of the neck muscles.
Overall, there is no consensus that forward head position causes neck pain - though in older population groups there is an increase in pain severity with increasing forward head posture.
Similarly with low back pain, there has been no link found between slumping posture and pain.
In a 2013 community survey that examined the beliefs around posture, it was found that for people who experience chronic low back pain, a very upright sitting posture was selected evenly as both the best (relieving) and worst (aggravating) position.
A 2019 study involving call centre workers observed an important trend – that the more a person moves between postures in sitting, the less likely they were to experience chronic low back pain.
The nuances of posture
While striving for balanced biomechanical alignment is a good goal, it's important to recognise the nuances and complexities surrounding posture, such as:
Muscle workload: overemphasis on achieving an ideal static posture can lead to overburdening certain muscle groups throughout the day, potentially causing discomfort and fatigue.
Listening to our body: our bodies have intricate needs, and the urge to ‘slouch’ may not always indicate poor posture. Sometimes, it's a response to the body's signals for comfort and relief.
Balance of positions: rather than fixating on a single ideal posture, embracing a variety of positions throughout the day can distribute strain across the joints and muscles more evenly.
The evidence gap: scientific studies suggest that maintaining a specific posture, whether static or dynamic, doesn't necessarily correlate with a reduced risk of pain or injury.
A comprehensive approach to posture
Below are some things you can do to encourage positive posture:
Consider workplace ergonomics: prioritise ergonomics at work by setting up a workstation that minimises unnecessary strain. Aligning screen height, keyboard, mouse positioning and chair height with your body promotes both comfort and biomechanical efficiency.
Gradual adjustment: postural adjustments should occur over time. Focus on conditioning your body to achieve even strength and flexibility in key muscle groups, and optimal joint mobility.
Image 2: A poor work station set up for posture.
Image 3: A good work station set up for positive posture.
In reimagining posture, we move beyond the traditional static alignment mindset and embrace a holistic approach that considers the dynamic interplay between bones, muscles, and movement.
While ideal alignment remains a valuable concept, it's crucial to recognise the complexity of our bodies and the need for balance, flexibility and adaptation. Every body is unique and what is considered ‘good’ posture for someone will be different for another person.
By incorporating ergonomic principles and gradually working towards optimal muscle strength and joint mobility, we pave the way for a more comprehensive and sustainable approach to posture that promotes overall well being.
References:
Physiopedia. (n.d.). Posture. Retrieved from https://www.physio-pedia.com/Posture
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