Does it really impact your health?

Probably since you were a young child, you’ve been hearing about sitting up straight so you have good posture. As an adult, like most individuals, you don’t think much about what position your body is in when you’re sitting or standing. You should be because it can have significant impacts on your health. What are these impacts? How can you correct your posture to minimize these effects?

PosturePosture involves your musculoskeletal system, which includes your bones, muscles, joints and other tissues that connect the parts of your body together. This is what provides form, support, stability and movement to your body by having the right amount of muscle tension against gravity. Posture is much more than sitting, it’s the way in which we hold our bodies while sitting, standing or lying down. When you’re doing any of these three, you’re not moving, it’s called static posture. However, if you’re moving, such as walking or bending over to pick something up, it’s called dynamic posture. It’s important to consider both. Posture can be affected by many things, like your age, the type of work you do, the hobbies you enjoy, how you use electronic devices, injuries and the shoes you wear. Your back has three natural curves. The cervical curve is the slight forward curve in your neck, the thoracic curve is the slight backward curve in your upper back and the lumbar curve is the slight forward curve in the low back. When they’re in proper alignment, your spine, shoulders, hips, knees and ankles are balanced. This also means that your body weight is evenly distributed between both feet. If viewed from the side, when you’re standing, your ear, shoulder, hip, knee and ankle should line up vertically. The good news is that normally we don’t have to consciously maintain good posture. Instead, several muscle groups, including the hamstrings and large back muscles, are responsible for doing this. Usually, this helps us to stand, sit, lie and move in positions that place the least strain on supporting muscles and ligaments. This is important because it helps us to keep our bones and joints in correct alignment so that our muscles are used correctly, which decreases the stress and strain on them, joints and ligaments. This allows muscles to work more efficiently, allowing the body to use less energy while reducing the chances of abnormal wearing on joint surfaces, muscle strain/pain and overuse disorders.

Unfortunately, many of us don’t have good posture. In fact, one study found that in any 3-month period, roughly 1 in 4 adults in the US has at least 1 day of back pain. Poor posture leads to excessive strain on your muscles. When held in certain positions for long periods of time, this results in them relaxing when they shouldn’t be. There are several reasons why you may have poor posture. Some physical factors are stress, obesity, weak postural muscles, abnormally tight muscles, decreased flexibility and unhealthy sitting/standing habits. One special physical consideration is pregnancy. Due to their body weight being redistributed, pregnant women are more likely to have poor posture. There are environmental causes, such as an incorrect working posture, repetitive activities at work/home and wearing uncomfortable shoes (ex. high-heels). Some of the signs of poor posture are a potbelly, rounded shoulders and a jutted-out neck/chin (forward head position).

The obvious issue with poor posture is that it puts more stress on certain muscles and joints, which forces them to be overworked causing them to fatigue more quickly and at a higher risk for injury. This also places added tension and compression to structures, like your lumbar muscles, that weren’t meant to bear this weight. Your immune system tries to heal these areas, but that causes inflammation, which when prolonged from poor posture overtime, results in arthritis in nearby joints. In addition, poor posture wears down your bones, joints and ligaments, even changing the way your muscles fire. It also leads to malalignment of your spine or knees, increasing stress on them and further raising your risk of developing arthritis. Misalignment of your hips, knees and feet can prevent your kneecap from sliding smoothly over your femur. Poor foot and ankle alignment can be a factor in the development of plantar fasciitis (the thick band of tissue connecting your heel to the ball of your foot becomes inflamed and causes heel pain). Incorrect posture can cause the tendons in your rotator cuff (a group of muscles and tendons that connect your upper arm to your shoulder) to become irritated and cause pain and weakness. If you regularly sit in a forward, hunched posture it can result in these tendons becoming pinched (impinged). Ultimately, this results in a tear in the rotator cuff tissue, which causes significant pain, weakness in the arm and limits your ability to carry out daily activities.

One common complaint that many people don’t always realize is associated with poor posture are headaches. When you have improper posture, it puts strain the muscles of the neck, upper back, back of the head and jaw. This increases pressure on nearby nerves and triggers tension-type or muscle-spasm headaches. Another problem caused by inappropriate neck posture is forward head posture. This occurs when your head is aligned forward in relation to your spine. For a person with a healthy head and neck relationship, their ear lines up with their shoulder when viewed from the side. When this doesn’t happen, it can cause an improper bite pattern and bring about temporomandibular joint syndrome (TMJ). The temporomandibular joints are the two joints that connect your jawbone to the temporal bones of your skull. Forward head posture triggers them to become misaligned, which makes them more likely to pop, lock, cramp or even go into spasms, giving rise to jaw pain and difficulty chewing.

However, aches and pains aren’t the only problems that poor posture produces. It can negatively impact many areas of your body. One simple example is that if you sit in a chair for hours every day with poor posture, you’re at risk of having circulation issues, such as blood clots. These can result in heart attacks, strokes and several other serious medical conditions. Improper posture can negatvely impact your ability to breath. In order to breathe properly, your diaphragm needs to have space within your thoracic cavity to allow your lungs to properly contract and relax with each breath. When you’ve got good posture, your body is lengthened and in proper alignment, which allows this to occur. Poor posture compromises the natural curvature of your spine, which doesn’t allow this to happen. Besides breathing, your posture can affect the function of your abdominal organs as well. If you sit in a slouched position after a meal, you increase the pressure placed on your abdomen, which can force stomach acid to go in the wrong direction resulting in heartburn from acid reflux. If you sit with your lower back rounded, or sacral sitting, it can have numerous undesirable impacts on your body. This posture shortens and tightens the pelvic floor muscles and when the pelvic floor muscles are tight and weak, they cannot exert power and strength. Pelvic floor muscles are vital to help you go to the bathroom. If they’re weak and you’ve got increase pressure in your abdomen as a result of the way your sitting, you’re more likely to suffer from incontinence. Also, when pelvic floor muscles are weak, you’ll have a harder time expelling feces, which means you’re prone to constipation. One last important thing that pelvic floor muscles contribute to is the ability to have orgasms during sex. If the muscles are weak, then orgasms might be weak or nonexistent. This is true whether you’re a man or woman.

Besides the physical impacts on your body, there is some research suggesting a link between posture and mental health. We know that poor posture can negatively affect your energy level, but it may also affect your mood. A 2017 study published in the Journal of Behavior Therapy and Experimental Psychiatry demonstrated that an upright posture may provide an increase in the positive affect, reduce fatigue and decrease self-focus for individuals who have mild to moderate depression. A previous study done in 2014 and published in Health Psychology produced similar results. When you think of the posture of someone who is depressed, you probably imagine someone with a closed in, curved inward and looking down. When you think of someone who is anxious, they raise their shoulders and have tight muscles. The same holds true for good posture. When you sit up straight, you often feel more confident and in a better mood. What scientists aren’t sure of yet is whether or not posture plays role in developing certain feelings or is just an expression of how your feeling.

According to the American Physical Therapy Association, there are several ways to check to makes sure that you have good posture. The first is to stand with your back against a wall and your heels about three inches from it. Once in position, put one hand flat against the back of your neck (with the back of the hand against the wall) and your other hand against your lower back (palm facing the wall). If you can move your hands forward and backward more than an inch or two, you need to readjust your body to restore the spine’s normal curves. Normally, you should be able to just barely slide your hand between your lower back and the wall. If there’s too much space, draw your bellybutton toward your spine, which helps to flatten the curve and brings your lower back closer to the wall. If there’s not enough space, arch your back just enough so that your hand can slide behind you. Next, walk away from the wall while holding a proper posture. After a moment or two, return to the wall to check to see if you kept it. Another technique is to stand in front of a full-length mirror. Keep your head straight, so your ears are level. After making sure of this, check to make sure your shoulders are even and the spaces between your arms and sides is equal. Without moving, look at your hips to makes sure they’re level. When you get to your knees, they should point straight ahead and be relaxed. Your ankles should also be straight.

If you don’t have good posture, there are things that you can do to improve it. The simplest way is to be aware of it. By doing this and knowing what correct posture is, you consciously correct yourself. In a general sense, good posture is having your chin parallel to the floor, shoulders even, neutral spine, arms at your sides with elbows straight/even, abdominal muscles braced, hips/knees even and pointing straight ahead with your body weight distributed evenly between both sides. Keep in mind that an exaggerated military-style, shoulders-back posture is just as bad for you as slouching. Let’s take a closer look at the best way to sit, stand and lay down.

  • Sitting—Your feet should be on the floor or a footrest, if they don’t reach the floor. Your legs should be next to each other, not crossed. There should be a small gap between your knees and the front of your seat, which should place your ankles e in front of your knees. The position of your knees should be at or below the level of your hips. The backrest should be supporting your low- and mid-back. If it doesn’t, use a back support or pillow. Remember, to keep your shoulders relaxed and your forearms parallel to the ground. It’s not uncommon for your spine to round forward while sitting. If this happens, bring your abs in toward your spine, lift your chest and roll your shoulders back. The goal is to have your shoulders over your ribs and your ribs over your hips. It’s also critical to bring back your head so that your chin is over your sternum. If you’re working at a desk, your computer monitor should be at eye height. Typically, most people place it so they’re looking down, which greatly increases neck strain. A 2014 study labeled the strain associated with this as text, or tech, neck because it’s the result of constantly looking down at your phone, tablet or computer. The study found that when your head is in line with your shoulders, it only weighs about 10 pounds, but for every inch you tilt it forward, the weight it places on your spine nearly doubles.
  • Standing—Standing poorly prompts similar problems for your neck and back as sitting, so the goal is to keep your spine in a neutral position while doing this as well. To this, you need to place your weight primarily on the balls of your feet while keeping your knees slightly bent. Your feet should be about shoulder-width apart. Make sure to stand straight and tall with your shoulders pulled backward and your stomach tucked in. This should allow your arms to hang naturally down by your sides. Keep your head level, so your earlobes are lined up with your shoulders. If you have to stand for long periods of time, shift your weight around. You can alternate from your toes to your heels or one foot to the other.
  • Lying—One of the most vital feature of having a good lying positing is having a good mattress to sleep on. This is different for every person. Typically, a firm mattress is recommended by most experts, but some people find that softer mattresses are better for them. It’s also key to sleep with a pillow in order to get adequate head and neck support. There are special pillows designed to help with postural problems from a poor sleeping position. Do your best to avoid sleeping on your stomach because this doesn’t allow for the proper curvatures of your spine to be maintained while sleeping. If you sleep on your side, place a pillow between your knees to help keep your hips aligned. If you’re a back sleeper, put a pillow under your knees to help them retain their normal flexion while sleeping. You can also try putting a small pillow under your neck and a rolled sheet or towel at your lower back.

One aspect of good posture that many people don’t think about is balance. Not only does this help you stand up straight, but it’s key to helping you maintain correct form while exercising or moving around. This is vital to reduce injuries and improve gains. Working on balance helps to strengthen your abilities in just about any activity, including sports. Muscle strength and balance are deeply intertwined. Your core muscles are those that are in your back, abdomen, side, pelvis and buttocks. They help to form a sturdy central link between your upper and lower body. When they’re weak, it encourages your body to slump, which tilts your body forward and off balance. Strong lower leg muscles are key to assisting you in staying steady when standing. This is why it’s essential to include balance-specific exercises (they’ll build strength where your body needs it) and stretches (they loosen tight muscles) into your workout routine. There are several forms of exercise that help with this, such as yoga or tai chi. Both of these combine physical positions with breathing exercises. In addition, they often include meditation that encourages you to become aware of your body. This mindfulness can help you learn to feel when your body’s posture isn’t correct. Another technique is using imagery. You can do this by imagining a straight line passing through your body from the ceiling to the floor. On this line, your ears, shoulders, hips, knees and ankles should be even and line up vertically. Next, envision a strong cord attached to your sternum and it’s pulling your chest and rib cage upward. While doing this, keep your pelvis level and don’t allow your lower back to sway. Also, think of stretching your head toward the ceiling, this will help to increase the space between your rib cage and pelvis. When you do this, you can feel your body changing, in a good way.

In addition to having good balance, it’s essential to exercise as well. Since obesity contributes to poor posture and over two-thirds of Americans are either overweight or obese, this is probably something that we all could benefit from. When you have extra weight, your abdominal muscles weaken, which causes poor posture. In addition to an exercise routine to lose weight (which should be done under the guidance of your doctor), there are specific exercises and stretches you can do to help improve your posture.

  • Neck—Try the chin tuck, which means you should sit comfortably in a chair, feet flat on the floor, shoulders relaxed/down and head upright. Next, pull your chin down toward your neck, hold for a count of five and release. Repeat these 10 times. You can also try neck extension. For this you’ll need a chair with a headrest. Sit comfortably and press your head firmly backward into the headrest. Hold for 30 seconds and repeat multiple times to build strength.
  • Shoulder/Upper Body—The shoulder blade squeeze requires you to sit straight in a chair with your hands on your thighs, shoulders down and chin level. Draw your shoulders back slowly and squeeze your shoulder blades together then count to five before relaxing. Repeat another three or four times. The shoulder blades press uses an exercise band. Hold the band in front of you at shoulder height straight in front of you and parallel to the floor. Stretch your arms away from your body (think of trying to make the letter T with your arms and body). Hold for several seconds before returning to the starting position. Repeat several times. The arm-across-chest stretch involves keeping one arm straight and lifting it to shoulder level in front of you. Next, bend the arm at the elbow, but make sure your forearm is parallel to the floor. Grasp your elbow with the other hand and gently pull it across your chest. You should feel a stretch in the upper arm and shoulder. Hold for 20 seconds before relaxing both arms. Repeat with the other side. Do each side three times. To do the upper-body stretch, go to a corner and stand with your arms raised, hands flat against the walls and elbows at shoulder height. Next, put one foot in front of the other and bend your forward knee. Exhale as you lean your body toward the corner, but be sure to keep your back straight and your chest/head up. You should feel this stretch across your chest. Hold for 20–30 seconds and then release.
  • Core—You can do abdominal pull-ins either standing or sitting. First, inhale and then exhale slowly as you count of five. While exhaling, pull your lower abdominal muscles up and in. It should feel like you’re trying to get your belly button to touch your backbone. Once you’ve counted to five, relax and breathe normally. Repeat a few more times. In addition to this, there are a variety of crunches, planks and leg extensions that you can try. The key is to take your time and do them properly so you don’t get injured. The Superman stretch is great for your back. Lay down on the floor on your stomach. Simultaneously raise your arms and legs just a couple inches off the ground. Hold for several seconds and release. Repeat several times. The bridge pose is good for your back and core. You can do it when you first wake-up or before going to bed. Lie on your back on the floor your knees bent. Inhale and when exhaling and lift your buttocks and spine, one vertebra at a time, until your shoulder blades bear your weight. Hold for a few seconds while inhaling, then slowly exhale as you roll your spine back down.
  • Pelvis—A great exercise for your pelvis are seated pelvic tilts. This involves sitting on the edge of a chair, putting your hands on your thighs and resting your feet on the floor. While inhaling, rock your pelvis and ribs forward and open your chest and look upward. Hold for a few seconds. Next, during exhalation, rock your pelvis and spine back and look down toward the floor. Kegel exercises are also important to strengthen pelvic floor muscles. The good news is you can do these anywhere. The first step is to identify your pelvic floor muscles. One way to do this is to stop urination in midstream. To do Kegels, imagine you’re sitting on a marble and tighten your pelvic muscles as if you’re trying to lift it. Initially, try to hold it for three seconds and then relax for a count of three. For best results, be careful not to flex the muscles in your abdomen, thighs or buttocks. Make sure you don’t hold your breath. Your goal should be 10 – 15 repetitions per set and three sets a day.

It’s essential to realize that as with any other exercise routine, it takes about four to six weeks to see real change, so don’t give up. Also, bodies vary with some benefiting from muscle stretching and others from strengthening exercises. There are some other important considerations. Even if you have perfect posture while working, you should take a break to stretch and move your body at least every 30 minutes, but definitely every 60 minutes. This can mean taking a short walk whether it’s just down the hall or to the bathroom. This is to help your muscles from becoming stiff. If you can’t leave your desk, try to vary your motion by shifting your position occasionally. Another great option is a standing desk. If you’re worried about the cost of buying a new desk, there are several creative ways to create one from the desk that you’ve already got. If you’re going to be standing for long periods, try resting one foot on a low ledge, stool or box. A key factor that people often forget is to wear comfortable shoes that offer good support, which aren’t high-heels. Any reading material should be held at eye level. Be mindful of your posture throughout the day during activities, such as watching television, washing dishes or walking. Make sure work surfaces, whether they’re in an office, doing a hobby or preparing dinner, are at a comfortable height for you. Be sure to realign posture regularly throughout the day.

Our bodies change as we age, but it’s never too early or late in life to work on improving your posture and how you move. The natural changes that occur make it especially important for older adults to maintain good posture, strength, flexibility and balance. An extremely hunched posture, or hyperkyphosis, affects up to two-thirds of senior women and half of senior men. This posture has been associated with back pain, weakness and trouble breathing. It can also limit everyday activities. No matter your age, if you suspect your poor posture is causing problems for you, you should see a physical therapist. They’ll be able to customize a program of exercises and stretches to improve your core muscle strength and flexibility.

A special consideration is the COVID-19 pandemic. As a result, more and more people have been working from home. This presents many questions and challenges that need to be sorted out. One of the more important is: Where do you work within your house? The answer to this matters significantly because of, you guessed it, posture. Just like when you’re at your office, it’s important to focus on good posture while working from home. Wherever you choose to work, you should focus on elongating your body rather than tensing or rounding yourself into a ball. If you need to spend a significant amount of time in front of a computer, make sure you have a good setup that promotes good posture.

To maintain proper posture, you need to have adequate muscle flexibility/strength and balance. In addition, you must learn to recognize your postural habits and correct them as needed. The pain associated with poor postures is your body’s way of getting your attention to tell you that something is wrong. Don’t ignore it. It’s important to remember that long-standing postural problems take longer to fix than short-lived ones, so stick with it and you’ll be standing tall in no time.