Andrew Gallagher
In the previous article in this series I discussed the basic physiology of good posture, outlining both it’s physical and psychological benefits .of In this instalment I would like to focus on the effect of posture on our physical health and in particular the fact that corrective postural therapy can not only be used to treat pain and disability arising from common musculoskeletal conditions but indeed can help prevent many of these conditions occurring in the first place.
The role of posture and its connection to health has been long recognised since ancient times. The earliest literature, particularly within Hindu and Greek traditions, that suggest that an upright posture is beneficial for achieving a balanced mind, mental focus and spiritual alignment.
One could argue that because of the nature of our modern lifestyle with it’s reliance on screen based technology for both work and pleasure, the need for postural awareness has never been greater. Whether when using a mobile phone, I pad or time spent in front of a computer, most people will adopt a stereotypical posture, resulting in head forwards, rounded shoulders, flat lumbar spine and flexed hip joints.
When considering musculoskeletal health, it is important to appreciate that this sustained dysfunctional posture can both cause and also be a result of musculoskeletal dysfunction. That is why postural correction is so important in the treatment of common musculoskeletal conditions. This is particularly important in the management of many chronic conditions such as back pain and headaches. I believe it can be argued that any intervention to improve musculoskeletal wellbeing must eventually address under lying postural issues. If left these unattended these issues can lead to a condition becoming chronic in nature. In addition by engaging In postural re-education it encourages individual patients to be actively engaged in the treatment process laying the foundation for ongoing self management . This is particularly important as postural re-education takes time to take effect and the resultant observable benefits are similarly achieved over time.
Good posture in the prevention and treatment of headaches: Whilst the causes of headaches are varied ,for the purpose of this discussion I will focus on tension and cervicogenic headaches( headaches arising from the cervical spine).As mentioned above poor sitting posture results in the typical head forwards posture sometimes referred to as “ tech neck”. This posture sustained over time places mechanical stress on the neck muscle’s Accordingly the muscles at base of the skull and each side of the neck shorten making it difficult to correct head posture as well as limiting overall neck mobility. Further to this ,these tight muscle’s may go on to develop trigger points (hypersensitive areas of muscle tension ) which will often refer pain to the head and face region, which the individual experiences as a headache.
In turn this poor posture, will impact the shoulder girdle resulting in not only their rounding, but additionally the shoulders internally rotate which in can result in irritation of pain sensitive structure ‘s such as bursa’s and tendons. Clinically this can be seen in the development bursitis and rotator cuff tendonosis.
Once poor sitting posture has been established it can be difficult to correct, simple instruction’s such as “sit up straight “, “drop your shoulders”, or “tuck your chin” in often ineffective. This is because there is a neurological effect of sustained poor posture. In simple terms over time muscle imbalances develop that lock in poor posture. Bad posture then becomes habitual and the individual experiences this posture as the new “normal.” Attempts to correct this are frustratingly ineffective as the adaptive changes that the muscles have undergone result in a fundamental change in their physiology. Often these attempts paradoxically reinforce the muscular dysfunction that maintains bad posture.
Based on the above is it possible to re-educate posture?, . Yesit is but it takes time and involves not only exercises to rectify muscle imbalances , but requires retraining of an individuals awareness of the body in space .as well . In addition the retraining movement patterns that restore body alignment must be incorporated into the individuals daily routine particularly when engaging in screen based technology’s .In the third article in this series I will explore these concepts in greater detail.
I would like to finish this article by discussing the preventive measures that can be utilised to ensure good posture is maintained specifically when engaging with screen based technology’s .To prevent poor posture from developing one needs to focus on both the development of optimal sitting posture as well as giving consideration to standing when working at a screen, the latter of which I will discuss in the third article in this series.
Optimal Seating Posture: 1) Back and spine: Sit back fully so your sine is supported by the chairs back rest maintaining the spines natural S curve. The back rest should be adjustable so it can be positioned in the curve of your lower back.
2) Head and Neck: Keep your head level and centred directly over your shoulders. Ensure the height of the monitor is adjusted so the top of the screen should be at or slightly below eye level so your gaze is directed slightly downwards.
3) Shoulders: These should be relaxed and held slightly down and back.
4) Elbows and Wrists: Elbows should be close to your side at an angle b/n 90 and 120 degrees, forearms should be parallel to the floor and wrist in neutral or slightly flexed.
5) Lower Body Positioning: Your thighs should be parallel to the floor, plant your feet flat on the floor and if required use aft rest if your feet don’t reach the floor.
It is important to take regular rest breaks from your screen as fatigue will facilitate poor posture, therefore you should get up and move regularly , around every thirty minutes.
Andrew Gallagher is an experienced physiotherapist who works locally at Springs Medical
