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?