“Sit up straight!”
“Put your shoulders back!”
Or my favorite, the feeling of someone’s finger jabbing you in your back until you perk up and sit up straight, no words necessary.
Most likely we have all experienced this moment at some point in our lives, as a child or teenager growing up, a mother or grandmother would pester the importance of standing or sitting up straight. While their motive may have been to instill good posture and manners, I am going to take this a step further.
As a chiropractor, this is me telling everyone to “sit up straight, roll your shoulders back and tuck that chin!”
With today’s technology, workplace and study habits our posture is in trouble. We all find ourselves trapped in this never-ending cycle, sitting all day staring at a device: whether it be a computer, television, smartphone, tablet or kicking it old school with a book. While this cycle is detrimental to posture it can also be detrimental to health and performance.
Let’s face it, sitting at a desk, head down, reading a textbook (typical study posture) has never been beneficial for posture. I’m sure we all at some point tried to get out of studying by saying “it hurts my back.” Unfortunately, with today’s innovations and lifestyle it goes further than “my back hurts.” Our backs are adapting to poor posture. With the amount of time we spend sitting on the computer, checking our cellphones, watching television, gaming, etc. our bodies are in constant “study posture,” or now it may be referred to as “text neck,” “ipad neck,” whatever you want to call it, it shouldn’t even exist.
(Text neck” Courtesy of Dr. Ken Hansraj M.D.)
Your spine naturally has two types of curves. The cervical and lumbar spine are naturally lordotic and the thoracic and sacral spine are naturally kyphotic. This is what creates that S-shape when you look at a spine from the side. These slight curves are present to ensure proper distribution of mechanical stress on the body. As I said earlier, our spines are adapting. Loss of cervical curvature is becoming more and more prevalent in today’s society.
Loss of cervical curvature due to repetitive stress results in anterior head carriage or forward head posture. This results in anterior weight-bearing of the cervical spine, “for every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds,” (Kapandji, Physiology of the Joints, Volume 3) which can have many detrimental effects including:
- Long-term muscle strain, disc herniations and pinched nerves that can result in numbness or tingling sensations down arms in to the fingers
- Stretching of the spinal cord 5-7 cm
- Early signs of degenerative joint disease/ arthritis
- Decrease cervical and shoulder range of motion with reduced stability of the shoulder blades resulting in changes to upper extremity movement patterns
- Weakened respiratory functions
- Decreased proprioception (Your ability to sense stimuli arising within the body regarding position, motion, and equilibrium)
Okay, so these effects aren’t good, but what do the last two mean?
The musculoskeletal system and nervous system contribute to the complex function of breathing as well as your bodies ability to be aware of its presence in space. Increased load on your cervical spine can result in decreased respiratory function, including reduction of lung volume and vital capacity, due to decreased muscle power. To simplify, the extra strain on your neck results in weakened neck muscles, followed by a reduction in respiratory muscle strength, as well as an increased thoracic kyphosis. These musculoskeletal changes, consistent with upper crossed syndrome, result in decreased thorax mobility and discoordination of proper breathing mechanics. Impairing your ability to expand your thorax and take in a normal full breath as well as expel it.
As an athlete:
This affects you because performance is key. Say you are a swimmer, a pitcher, maybe a runner, all of these sports require proper shoulder range of motion whether it is propelling you through the water, throwing a fast ball or improving your mile. Not to mention proper respiration is necessary to provide optimal oxygen for aerobic events. Furthermore, a decrease in proprioception impairs balance, this could affect a cheerleader or gymnast, as well as those who play contact sports, leaving them potentially more prone to injuries.
How can Chiropractic help?
At this point standing up straight and rolling your shoulders back is not enough, while most of us think we are standing up straight, upon analysis our head is still forward and our shoulders are still rolled forward. A visit to a Chiropractor could result in an assessment and treatment plan that may include:
- Postural assessment
- Soft tissue work and stretching of the tight muscles (see image above)
- Strengthening of the weakened muscles (see image above)
- Chiropractic adjustments
- Research has shown that chiropractic adjustments have been effective in increasing cervical range of motion and decreasing forward head posture, thus increasing cervical lordosis (Gong)
- A recent journal concluded, cervical adjustments that have “previously shown to reduce neck pain and increase joint range of motion, can also help recover the posture of persons with forward head posture and improve their respiratory functions (Kim)”
- Neuromuscular re-education for proprioception and balance
- Kinesio taping for postural correction and proprioception
- Rehab exercises for at home and in the office along with foam roller recommendations
Here are a few examples of useful corrective exercises:
- Chin Tucks
- Performed sitting, standing or lying down
- Place your hands behind your head and interlace your fingers at the base of the skull, keeping your hands firm slightly tuck your chin, pressing the skull into your hands while feeling a stretch on the back of you neck. Imagine sliding your head backwards with the goal of getting your ears back in line with your shoulders, hold for a few seconds and release, repeat 5-10 times, 2-3 times a day.
- Be sure you are not using your neck to generate the movement, do not allow tipping of the chin up or down (it’s a slight tuck)
- This exercise can also be performed without the use of your hands. Resistance provided from a wall, car headrest, or your pillow while lying in bed will also suffice, making this exercise very convenient. There are no excuses to get out of this one!
- You will know you are doing this exercise right if you give yourself a double chin while performing it, consider it character building…
- Backwards shoulder rolls
- Performed sitting or standing
- Roll your shoulders backwards, roll up and backwards while being sure to squeeze your shoulder blades through the motion
- Perform 10 shoulder rolls, 2-3 times a day
- Shoulder blade squeeze
- Performed sitting or standing
- With your arms by your side, squeeze your shoulder blades together as if you were holding a tennis ball between your shoulder blades, hold and release
- A variant of this exercise: Hold your arms out in front of your body at shoulder height, as you squeeze your shoulder blades together bend your elbows drawing your shoulders and arms back. Hold and release
- Perform the shoulder blade squeeze 10 times, 2-3 times a day
- Wall angels
- Performed standing with your buttock and mid-back against a wall
- Place both of your arms against the wall in a 90 degree position with your palms facing away from the wall. While keeping your shoulders down and back, slide your arms up and down the wall. To visualize you are are going from a W position to a Y position then back to W, repeat. Avoid allowing your shoulders rise to your ears while performing the movement.
Perform 10-12 times, 2-3 times a day
- Doorway Pec Stretch
- Performed standing in a door way or in front of a wall.
- With your arm bent to 90 degrees, place the forearm of one of your arms on the wall or door frame with your fingers pointing towards the ceiling
- In a staggered stance, gently press your chest forward to stretch the involved pectoralis muscle
- Hold for 30-60 seconds and repeat with the other arm, perform 2-3 times on both arms, 2-3 times a day
- Be sure to listen to your body, do not stretch beyond the point of mild discomfort
If you have any questions regarding postural assessment or if you are interested in prevention tips or evaluation, feel free to reach out to Dr. Reilly at firstname.lastname@example.org or call for an appointment today (703)-760-8110!
Dale, P. (2013, November 5). Best Exercises to Improve Posture. Retrieved January 13, 2016, from http://www.livestrong.com/article/380524-best-exercises-to-improve-posture/
Eckmann, PhD, T., & Stoddart, BScPT, D. (2015). The Power of Posture: A program to encourage optimal posture. The Journal on Active Aging. Retrieved January 12, 2016, from PubMed.
Fishman, D. (2010, April 22). Forward Head Posture Caused by Texting. Retrieved January 13, 2016, from http://dynamicchiropractic.com/mpacms/dc/article.php?id=54612
Gong, W. (2015). The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine. J Phys Ther Sci Journal of Physical Therapy Science, 27(5), 1609-1611.
Kim, S., Kim, N., & Kim, L. (2015). Effects of cervical sustained natural apophyseal glide on forward head posture and respiratory function. J Phys Ther Sci Journal of Physical Therapy Science, 27(6), 1851-1854.
Exercise images courtesy of webexercises.