This article was provided by Dr. Cale Copeland DC, a chiropractor at Victoria Family Chiropractic in Victoria, BC Canada. If you would like to learn more, please visit https://www.vfchiro.com/

Sit Up Straight

When I was growing up posture was never something I thought about. Many people remember their parents reminding them to sit up straight. My Mom never commented on my posture, but I do remember a former girlfriend used to tell me to sit up straight. I must admit that I'm a bit of a posture nag with my own children now because I know how important posture is and how challenging it can be to correct. Growing up, my health wasn't the greatest. As I got older, I wanted better health, but it never occurred to me that my posture may have been partly to blame. I started to see a chiropractor because of back pain after a serious bicycle accident that I was lucky to survive. I became aware that my posture was a problem and I started on a path to fixing it. Chiropractic was integral to my recovery and has helped me immensely, and still does to this day. One great benefit I experienced that surprised me was that my chronic heartburn went away. I believe this was due to chiropractic and improving my posture.

I was rounded in the mid back. This is a common postural syndrome and clinically this is known as a hyper-kyphosis. I hoped I could fix the issue but didn't know if it was possible and if so how. Once I started chiropractic school I became more and more interested in posture. I read articles, books and attended seminars on the topic. It turned out that posture can be changed most of the time. This can be a difficult process and typically it takes time, patience, awareness and often professional guidance or treatment.

It's logical to think that poor posture is simply caused by slouching or slumping. Certainly, this is likely a major contributor because much of our lives are spent sitting and we often hunch forward for work, food and communicating. Other factors that influence posture are injuries such as fractures, spinal fixations or misalignments (what chiropractors treat), certain medical conditions, sprain/strains and even our mood.

The human spine is a brilliant design that is a balance between flexibility and stability. Our spines are made of bone to protect the delicate nervous system and also to support our bodies against gravity and allow for muscles and limbs to attach to. We need the spine to be flexible, but that takes away from stability and makes us more susceptible to injury. Spinal injuries are common and have massive impact on the quality of our lives. Proper posture helps keep the spine stronger and thus less likely to be injured and more (1).

Our posture is not surprisingly linked to our health and performance. Poor posture is one of the greatest indicators of spinal problems. Gravity is relentless and once poor posture takes root it slowly worsens over time unless action is taken to correct. Posture has been shown to impact our mood, how others perceive us as well as a myriad of health issues such as digestion, headaches, fatigue, tension and more. One of my favorite books on posture is Power Posture by Lee Parore. It's very informative and great for couch potatoes or elite athletes (see reference).

Common Postural Faults

1. Head Forward Posture: This is a very common problem that affects our health. The human head weighs on average 10-11 pounds and is designed to sit directly above the torso (2). In this position it creates minimal stress on muscles, joints, ligaments, bones and nerves. When the head moves forward over the body it can increase stress on the spine and its related structure by 4.25 times (3). This may not sound like much, but over time this can create degenerative arthritic wear to the spine and its supportive structures and even alter normal spinal curves (3). This can result in a slew of symptoms form overall wellbeing to heart disease (3).

2. Mid Back Rounding: The mid back is also known as the thoracic or dorsal spine. It normally has a curve or rounding known as a kyphosis. This natural curve can become increased over time with poor posture or slouching. Certain medical conditions such as fracture or ankylosing spondylitis can also cause this, but they are rare. Mid back rounding or hyper-kyphosis puts the spine under strain. Over time this can wear joints, bone, ligaments, muscle, cartilage and more. This process, known as degenerative arthritis, can look unsightly as in a hunch-back appearance. It can also lead to loss of mobility and many health issues ranging from pain to altered organ or digestive function (3).

3. Lumbar Sway: This condition is often associated with forward head posture and mid back rounding. The lumbar spine is the bottom section of the spine above the pelvis. It has a normal curve called a lordosis, and when there is lumbar sway this curve can be increased. A lumbar sway also creates strain on the joints of the spine known as facets because it jams them together and on the lower lumbar discs. Again, when spinal curves or spinal position are altered it creates strain on the spine and related structures. This can and usually does lead to arthritic wear in specific regions. In the case of a sway back, it stresses the lower lumbar region at L4 and L5. Injury is common in this region and is associated with disability and problems with the lower back, pelvis, hips, legs, knees and feet.

Ways to Improve Postural Faults

1. Chiropractic: The bones or vertebra that make up the spine commonly get stuck, misaligned or don't move in a normal way. This can be from accidents, poor lifting, posture, trauma or just living. Chiropractors are trained to restore spinal function naturally without any drugs or surgery. When the spine is isn't moving normally it makes it very difficult to improve posture. Chiropractic may not fix your posture by itself, but it can make it so that you can. Chiropractic also prevents arthritic wear of the spine and takes pressure off delicate spinal nerves so the brain can regulate and coordinate body function.

2. The Rope: This technique is a great reminder to sit or stand as we should, and it doesn't involve an actual rope. The rope here is imaginary. Picture this rope attached to your upper chest. Then pretend to pull this imaginary rope at a 45 degree angle away from you towards the sky. As you do this you should feel your head and shoulders pull back or retract. It should also lift your chest and straighten your spine and correct the slumping posture we often fall into.

3. Wall Angels: This is another posture correction technique. With poor posture, specific muscles shorten or tighten, such as the sub-occipitals below our skull, and others become weakened like the rhomboids between our shoulder blades. This technique addresses them both like a two for one deal. The wall angel gets its name because its similar to doing a snow angel against a wall. To do it, place your heels against a wall and try to get the back of your head touching as well. Bringing your head back over your body is known as head retraction, and it should create double chins if done correctly. For some people with significant head forward posture and/or mid back rounding, wall angels may be very difficult. To perform optimally, keep your head and heels touching the wall as you slide your arms above your head and back down to your side. Attempt to keep your wrists, elbows and shoulders in contact with the wall the whole time. If you are unable to do this, don't give up, just do the best you can. Over time with work and perhaps specific professional treatments, most people can significantly improve or even normalize their posture.

4. Devices: Certain orthopedic devices are designed to improve posture. Some of these devices are terrific and backed by research. Many people need specific devices to get the results they desire. Healthcare professionals such as chiropractors are well versed in clinically proven orthopedic devices and the specific needs of each individual. X-rays are often needed to determine proper usage.

5. Improve Mood: Everything we've talked about so far has been ways to physically address and improve posture, but did you know that your mood can also play a role? When we feel confident, heathy, safe and happy or posture often mirrors that. On the other hand, when we are sad, anxious, fearful or stressed we typically slouch or slump. Using techniques to improve your mood can also have a big effect on affect your posture and body language. Examples of techniques to improve mood can be focusing on things to be grateful for or positive self-talk.

6. Strengthening: The muscles that stabilize and support the spine are commonly referred to as core muscles. For a variety of reasons, these muscles can become weak. There are hundreds of ways to improve core strength and getting professional guidance is typically very helpful. On a basic level moving the body is the key and even something as simple as walking helps. Great exercises to start with that don't require a gym membership include performing body weight squats, planking or doing the bird-dog and dead bug exercises.

7. Stretching: Muscles and joints have a tendency to shorten and stiffen if we don't move and stretch them. Stretching is one of the greatest and most satisfying ways to improve joint health and keep the body youthful. It doesn't need to be complicated or expensive and can be done in a couple minutes or less in the comfort of your home. Professional guidance can be very helpful from a healthcare provider who understands what your body needs. Usually stretches that are difficult can often provide the greatest benefit. For example, some people struggle with touching their toes, but this is very important for back health. Start slowly and aim to feel a good stretch. The more regularly you do it the better.

References:

1. Parore, L. (2002). Power posture: Your blueprint for a powerful body (pp. 4-5). Apple Publishing Co. Vancouver.

2. Brain, M. (2009). How much does the human head actually weigh? How stuff works brainstuff, viewed 25 February 2019, <https://www.brainstuffshow.com/blogs/how-much-does-the-human-head-actually-weigh.htm>;

3. Anterior and Vertical Translations of the Cervical Spine Increase Stresses up to 4.25 Times; Likely Accelerating the Development of Spinal Arthritis and Disc Disease, viewed 25 February 2019, < https://cbpnonprofit.com/2016/05/23/anterior-and-vertical-translations-of-the-cervical-spine-increase-stresses-up-to-4-25-times-likely-accelerating-the-development-of-spinal-arthritis-and-disc-disease/>;