Poor Posture

How not to sit at a coffee house.
How not to sit at a coffee house…

This picture was taken May 2014 at a coffee shop and anytime I think about posture this photograph comes to mind.  I cringe whenever I think of this picture.  I cringe when I see someone like this at the coffee shop.  I cringe when I realize that it might be me when I was studying at the coffee shop. (I hope not.)
I ask myself, “How is he not in pain?  Or maybe he is.  He’s got to have pain in his neck, upper back (or thoracic spine), low back, shoulder and maybe even his hip from the way he’s sitting.”

Why is this posture so bad?  Recently, The New York Times published an article by Jane Brody “Posture Affects Standing, and Not Just the Physical Kind” that explains some of the reasons why good posture is so important.  She also lists some tips to help with posture.

There are also specific exercises that physical therapists can prescribe to help which entails strengthening the muscles that have become overstretched, and stretching the ones that have become tight because of the habitual posturing.  If you want specific exercises or instructions tailored to you, please see your local physical therapist.

These are my general Physical Therapy exercise recommendations.

  • Foam rollers are great for those with back pain especially upper back (thoracic) stiffness.  In general, I recommend just lying down, face up, with the foam roller along your spine to help loosen the joints in your upper and mid back.  If the back of your head doesn’t touch the foam roller, than place some pillows under to support the head and neck.  You don’t want to hinge on the neck joints while trying to loosen the upper back joints.  I use this position to test if you’ll be able to tolerate other foam roller exercises.  If this is tolerable, or once this is more comfortable, I’ll have my patients lie with the foam roller horizontally across their upper backs, lift their buttocks up and roll up and down to loosen the back joints.
  • Then I like adding a chest or pec (pectoralis) stretch especially a pec minor stretch which can also be done on the foam roller.
  • Finally I like to strength the rhomboids, middle traps (trapezius), and lower traps with different variations of rows.  My most important cue for patients is to squeeze the shoulder blades together and slightly down the back aiming each shoulder blade to the opposite buttock.  Remember, these muscles have become very overstretched from the habitual posture, so will take time to strengthen.
  • Most importantly, even more important than the exercises sometimes, is the poor habit.  If you’ve notice, I said habitual posture/posturing previously.  It’s a habit; it’s something that can change, but will take time and effort to develop a better habit or better habitual posture in this case.  It’s very important that you self-correct whenever you remember.  Many times, I will ask my patients to have their friends, co-worker, family, classmates, and whomever else they’re regularly in contact with remind my patient of his/her posture.

(Stay tune for the specific exercise instruction and I’m working on pictures.)

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