PT Perspective

with Jason Lau, Doctor of Physical Therapy

Question:

Is there such a thing as “Perfect Posture”?

Answer:

Short answer, yes. Can everyone achieve this perfect posture? No. Can most people benefit from improved posture? Definitely. 

 Posture basically boils down to efficiency. Here on planet earth we are under a constant source of force called gravity. Do you use your frame (bones) to carry the load of your body with good posture, or do you put stress on your muscles with poor posture?

Have you ever seen these women from Africa carry loads with baskets on their head? Did you ever notice their posture? With the basket on their head their bodies are forced to find the most efficient position to carry the load. That’s why they always have good posture when carrying a heavy load on their head. They have to have good posture to do this day in and day out. The load is too heavy to put the stress on the muscles. Imagine the woman to the right trying to carry the same load while looking down to use her phone. She would not last very long. Instead with good posture she keeps the weight supported by the frame of her body.

The difference with us is that the load on our bodies is spread out over time, rather than a single moment with heavier weights. The load is still there, most significantly our heads. The average adult head weighs 10-12 lbs. This 10-12 lbs. feels weightless to us when our necks are in good posture. Yet as our heads lean forward there is an increase in stress in our necks as the angle becomes greater, as seen in the picture below. The more we lean forward, the more stress we put on our neck muscles. The more upright our posture is, the more we put the stress on the frame of our bodies and off of the muscles.

 One of the crucial factors in our problem is the lack of instant feedback we get from poor posture. We are not compelled to find the most efficient body position like the person with a basket on their head. If the woman lost her good posture and her head tilted forward, fatigue would likely set in within seconds and she would be forced to return to good posture or take the basket off of her head. 

Our feedback is delayed. Most of us start with a relatively healthy neck. A neck that is not in pain and can sustain using a phone, tablet, or computer with poor posture for a few minutes. The ability to sustain and tolerate poor posture is a big part of the problem because we continue to tolerate it. We continue to tolerate poor posture day after day, month after month, year after year until we cannot tolerate the position anymore, and now we get immediate feedback in the form of pain. In other words, we have reached the endurance limit of our neck muscles and from this point on functioning beyond that limit causes us pain.  

Now that we are aware of why posture is important, let’s all just decide to have good posture. Not that easy right? Also, it is not just a matter of memory or will power, though that helps. If we were to simply remind ourselves to have better posture, most of us would fail and revert back to our old habits. There is another factor. Our bodies adapt. Specifically our muscles shorten or lengthen to adapt to the position they spend the most time in. If we spend more time slouched, the muscles in the front of our necks shorten and the ones in the back lengthen. Thus when we are upright we are wrestling against two factors: gravity and our own muscles that are use to the old position. That is why it can be so difficult to improve posture. There is too much stacked against us.

The strategy then is to change our default posture. Practically, that means stretching the short muscles and strengthening the over stretched muscles to return our bodies to a default position of good posture. Once the default posture is more under control, then working against the force of gravity is a more reasonable task. There are many stretches and exercises for posture. I’ve included some of the basics. 

Chin Tucks: 3 sets of 10 repetitions (3 seconds each rep)

Scapular Squeeze: 3 sets 10 repetitions (3 seconds each rep)

Pec stretch: 3 sets of 1repetition (30 second hold each rep)

One thing I should mention is that not every one can achieve perfect posture. Some people have significant scoliosis or kyphosis where the frame of their body is the problem. People with these conditions are unable to achieve “perfect posture” because their bones are stuck in misalignment. However, everyone can improve their posture and the flip side is everyone’s posture can get worse.

Submit your questions for future PT Perspective columns to Jason Lau, Doctor of Physical Therapy at jasonlaudpt@gmail.com