What posture are you?
Have you ever noticed someone with really bad posture? What does it make you think? Or have you ever thought or been told you have bad posture? Your partner, colleagues or friends may say stand up straight or sit up straight! Understanding what type of posture you have is the first stage in correcting your posture and bringing yourself closer to better posture.
So what is posture?
First up lets get into some technical terms that can help you understand posture. Here are the names of the common curves in the spine.
Kyphosis or Kyphotic
A kyphotic curve is a curve that moves anteriorly or forwards. It can also be called a convex curve. This type of curve is the typical hunch back where the upper spine is curving forwards. There is supposed to be a natural kyphotic curve in the upper spine or thoracic spine. When your posture comes more forward say from sitting hunched at a desk then this posture will be exaggerated and can then cause dysfunction in the spine, ribs, shoulders or neck. This can then lead to pain such as burning pain between the scapula, shoulder impingements, neck pain, headaches, rib pain, chest pain and more. A kyphotic posture is also one of the most noticeable poor postures as people can see that you are hunching forward. As you get older this posture will become more engrained, like the wrinkles on your face and will tell the story that you have had this posture due to your lifestyle.
Lordosis or Lordotic
There is also a natural lordotic curve in the lower back and in the neck. In the lower back this can be seen as the hollow in the small of the back. When excessive it can be seen as though a person is sticking their bum out or the technical term “ducks bum”. There is also a lordotic curve in the neck as well.
Scoliosis or scoliotic
Scoliosis is a lateral or side bend of the spine. So if you were looking at someone from behind with their shirt off it would look like and S bend in the spine. Scoliosis usually has a component of spinal rotation with it as well meaning that the ribs on one side will look like they stick out further that the other. If you were tilting to the right side ( also called convex left as the cover part of the curve is on the left side) the rotation is to the opposite side. This is due to the way the facet joints glide on each other (a bit more technical for this blog).
Scoliosis is a word that will probably strike fear into your heart, especially if you have it or have been told you have it. We wrote a whole blog about scoliosis which you can read here. The truth is most of us will have some degree of scoliosis and it is perfectly normal. Most general asymptomatic scoliosis is functional, meaning that you may be right handed and work at a desktop computer all day using a mouse. This would mean you will tilt slightly to the right side and therefore over years your spine will being to curve over to that side. This can be reversed.
Structural scoliosis on the other hand is a whole different beast. Structural scoliosis means that this is the way the bones and joints have developed. It is usually more pronounced and causes pain and dysfunction in the body including the spine, hips, shoulders, neck, ribs and more. Unless discovered early when the spine is still growing there isn't a huge amount you can do to fix it, only manage it and stop it getting worse.
Scoliosis can also be coming from a pelvic imbalance. If the pelvis is higher on one side then because the spine sits in the pelvis it will curve over the lower side. This will then make the spine appear to be curving. This posture can arise from standing with one hip pushed out to the side. Or sitting by leaning to one side. Men wearing wallets in their back pockets whilst sitting can also put the hips out.
This posture is often misunderstood and confused with the lumbar lordotic posture. If you look at the picture for a sway back you will see that the pelvis is actually pushing forward (anteriorly) of the imaginary plumb line running through the body, whilst the upper trunk or thoracic is shifting backward (posteriorly). The lower lumbar is actually flattened and not lordotic. There will also be a hyper extension of the hip and knee. This means that the glutes and hamstrings will usually be on all the time when standing. This could lead to hip, glute , hamstring and lower back pain. Symptoms such as sciatica can also appear as in this posture the glutes and piriformis muscles will tighten up and therefore compress the sciatic nerve.
This could also lead to hip, knee and ankle problems in the lower limb. With the chest collapsed you could see problems in the thoracic, neck and shoulders as well. Chronic headaches may also occur.
Sway back can also include:
weak hip flexors
weak external obliques
Weak upper back muscles
Weak deep neck flexors.
Shortened hamstrings & glutes
Shortened upper internal obliques
Shortened chest and anterior fascia of the chest
Shortened neck extensors (headaches)
So what is correct posture?
Ok so the “correct” posture is to have a nice lumbar lordotic curve, followed by a gentle kyphotic curve in the thoracic spine and then again another gentle lordotic curve in the cervical spine or neck. These curves allow the spine to be strong and flexible as well as absorbing forces when lifting things and sitting. Once the posture moves away from this correct posture problems can occur leading to soft tissue injuries, joint problems and potentially intervertebral disc problems.
In the case of posture there are some really nasty postural issues which can be structural in nature meaning that there isn’t all that much you can do to fix them, only manage them and try not to let the structural issue get worse. For instance if you are kyphotic (hunch back) then sitting slumped forward will only make this issue worse. You may not be able to fix your posture and have the perfect spine, but at least it wont get worse and may even get somewhat better.
Over the years I have assessed thousands of peoples posture and one thing I have noticed is that no one has the perfect spine you see in all of the skeletal charts. I always wonder if maybe the “perfect” posture is actually the abnormal posture and who is this actually based on. If you look at multiple drawings or images of the skeleton it always appears to have the perfect curves but realistically if you are alive and have used your body for your whole life then your life will have had an impact on you posture.
But I don’t stand very much
These postures are all assuming that you are standing up a lot. In this sedentary, seated world we live in we need to consider the seated posture we all have. This is a really good point. So what if you don’t stand very much? How can these postures affect me then. Well the way you sit will be affecting the way you stand or you could also say the way you stand is because of the way you sit. For example if you sit slumped at the computer all day then when you stand you may find that your shoulders are still hunching forwards or your kyphotic.
How do you sit?
Are you sitting on your tail bone or sacrum (with your bum tucked under)? If so you could be compressing the sciatic nerve and lumbar discs. This is the typical slumped back in the chair posture.
Are you sitting perfectly with you feet flat on the ground, your knees bent at 90 degrees, you backside right back in the chair, a hand width between the back of the knees and the seat so that your legs can take some of the load of you torso. Are you sitting on your sit bones (ischial tuberosity) giving the natural lumbar lordotic curve which then makes it easier to have a gentle kyphotic curve in the thoracic and then a natural lordotic curve in the neck so that the head can be supported comfortably.
Is your head forward or looking down? This will stress out the joints and discs of the neck and over time cause premature degeneration leading to pain.
Are your shoulders slumped forwards. If so try to lift your chest from the sternum. Often the collapsed chest will naturally lead to the shoulders slumping forwards. Try to relax the shoulders and don't force them back as this will also fatigue the back of the shoulders
The way you sleep can also have an affect on your posture. The sleeping position that is the most neutral on the spine is sleeping on your back. If you sleep on your side with one leg over then this will twist your spine. Also if you sleep on your front you could be encouraging a sway back posture by flattening the lower back.
There are many other postural variations that we haven't gone into here. You can have a combination of posture's as well. Such as Kyphoscoliosis where this is a combination of kyphosis and scoliosis. You could also be kyphotic and lordotic.
So what can I do to improve my posture?
Remember that this is the hunch back posture. To prevent or to correct this you need to work to open up the chest and mobilise the soft tissues of the front of the body. A simple way to do this is to stretch your chest in the doorway. Another great way to open the chest is to lie on a foam roller with it perpendicular to the spine. Begin just above the ribs and then extend your back over it. Lay there for around 30 seconds and then move the roller up a couple of inches and repeat. You should be able to use at least 3 different positions.
Strengthening exercises to strengthening the upper back and lower back muscles will help you to keep your body upright.
Yoga can be great at opening up the front of the body by using back bends.
A hyper-lordotic lumbar curve can be prevented or corrected by releaseng the soft tissues ast the front of the hips and the lower back. The way to do this yourself to stretch the hip flexors including Psoas, Iliacus, Rectus Femoris, Tensor Fascia Lata and Sartoirus.
Strengthening the glutes and lower abdominals (core) are really important to counter this posture. If imagine muscles like a tug of war on joints, if one side is really strong and dominant then it will pull towards its side. Balancing out muscles is the key to stabilising the pelvis and bringing it into alignment.
To help correct and prevent functional scoliosis (the one created by poor posture or repetitive actions) you can work on side flexing the spine such as stretching over to the side and rotational stretches.
Having a strong and stable core is also important to help align the spine as best we can. Doing rotational core work such as cable wood chops can help to correct or prevent tilts and rotations in the spine.
If there is a kyphotic element to the scoliosis then extension stretching like the cobra or foam rolling as outlined in the kyphosis section will also be beneficial.
Yoga can also help here as it is composed of stretches in all different directions.
A sway back can be caused by lazy muscles of the pelvis and core. This can just be you pushing your hips forward and just hanging out on the ligaments rather than using muscles to hold you up. This could be a sign of a weak core and weak upper back muscles. Often the glutes are tight from being constantly squeezed.
Stretching and release of the glutes, hamstrings, chest and thoracic will help to take the tension off the soft tissues. Strengthening of the hip flexors, core and upper back muscles will help to rebalance the muscles leading to improved posture.
With all of these postural issues it is important to stress that without a correct understanding of your posture it is really hard to correct it. You will need to be assessed for this by a professional as you can’t possibly see all of these things yourself.
Postural awareness is then the most critical of all elements. If you do all of the stretching and exercises but still choose to stand with the hip pushed out to one side then all of that work will have been in vain as you won’t make very significant changes.
If you would like to have your posture assessed and work towards correcting then book in now.
As always if you have any comments, questions or even to let us know you have enjoyed this article then feel free to get in touch or share on social media.
Thanks for reading.