If you search out "good posture" online, you'll no doubt be bombarded with article after article on the subject. It's definitely gaining traction in health and fitness circles which is exciting news for a long-time form and posture fan like myself. The disconnect however is in the "why." Knowing what ideal posture looks like is important, but like any knowledge - understanding it makes you far more likely to put it to good use. If you believe in and understand the "why" of proper posture - how to achieve it is far less complicated.

That said, please understand that it is not my goal to overstate the importance of posture. Many healthcare professionals have arguably "blown it out of proportion" and made it the scapegoat for all of your aches and pains. It is a part of health and wellness, but not the only part. Understand that poor posture and poor postural fitness can contribute to pain, but more often the culprit is a sedentary lifestyle.

What is "good" posture?

Posture, in its simplest description is the series of positions in which you hold your body upright against gravity during your day. Based on this definition, good posture is an evaluation of this dynamic process. From a physical therapy viewpoint, good or ideal posture involves holding your body in the optimal position such that the least strain is placed on the body structures while you are standing, sitting, laying, walking, running, dancing, hanging, flipping, tumbling, jumping, etc.

What's exciting about this concept is that good posture is more individualized and varied than most generic online articles would suggest. I know that you've heard it before, but we are all, in fact, unique snowflakes and this individuality extends to our posture. The body positions that represent your ideal posture are likely not the same as those that represent another person's ideal posture.

Proper posture does the following:

Keeps bones and joints in the correct/ideal alignment so that muscles are being used properly (and not overused).
Helps decrease the abnormal wearing of joint surfaces (cartilage and bone) that could result in injury or higher rates of degradation.
Decreases the stress on the ligaments holding the joints of the body together.
Alleviate/avoid compression of nerves and vasculature in the body.
Prevents the spine from degenerating more rapidly and becoming fixed in abnormal positions as we age.
Prevents muscle fatigue/overuse and injury. If muscles are being used more efficiently, this also allows the body to use less energy - which might give you more to spare during your long days.
Prevents/decreases backaches, neck aches and other types of muscular pain.
Improves your physical appearance and form with skills/sports.

If you can find and maintain an ideal posture for you during all the activities in your day, you'll see improvements in your energy, your fitness level, your pain and your skill progression/athletic pursuits.

Good posture is not a static position.

You've probably begun to infer from the statements above that posture is not static. It is not a perfectly stacked spinal column, a neutral head and neck and flat even weight on both feet. It is a state of balance that occurs in the body during movement - one that allows for the increased efficiency and decreased force on structures described above. Posture is not a position, but a dynamic balance of reflexes, habits, and physical responses that keep you upright against gravity and allow you to function in your day. Posture is fluid. Posture changes with your activities over a lifetime. Posture is more about balance and moderation than "spinal neutral."

Beyond that, posture is a physical representation of our personality and mental state. We use our posture to express ourselves within our environment. Our posture can be confident and dominant, or fearful and submissive. We can use it to engage others and draw them into conversation, or close ourselves off and turn them away. How posture is related to emotional health and well-being is not the topic of this article, but it needs to be mentioned - and appreciated. If you understand that posture is the sum of many systems, then you can appreciate just how hard it is to change yours. It is not just a physical change - but a mental one as well.

To find your ideal posture you have to MOVE MORE. You need to develop strength and mobility in the muscles involved in upright motion and prevent imbalances by limiting time in one position. You need to think positive, act with purpose and find happiness in what you do.

What is "poor" posture?

Poor posture isn't as simple as the terms we healthcare professionals often mistakenly use to describe them. Terminology like: upper crossed syndrome, severe kyphosis, increased lordosis, sway-back, or flat back all simplify a static position rather than assess a movement pattern. I would argue that poor posture is any series of positions that cause an increased strain on the body. It cannot be evaluated by a static assessment or a photograph. It is a dynamic problem that allows for increased force on the muscles, bone, and connective tissues that throws them out of balance.

Examples might include:

Slouching down on the couch for 6 hours during a Netflix binge.
Propping up on your elbows while on your stomach to read in bed for 90 minutes.
Crossing your right leg over your left during a lengthy dinner party.
Leaning against the wall on a 45 minute metro-ride with more weight on your left leg than right.
Lifting a heavy box by bending at the waist and using the back (rather than the knees) as your prime mover.
Compensating for biceps weakness with shoulder internal rotation during a pull up on aerial silks.
Hinging in the low back during an up-dog position to compensate for loss of motion in the thoracic spine.
Arching the low back during bench press to "increase power."

Beyond this, poor posture is more than just a variation from the anatomical ideal.

For example, an elderly woman with advanced stenosis (arthritis in the spine) would feel less pain with a rounded back as compared with a straight spine. She has adapted this posture to take pressure off the body structures (discs, nerves and spinal cord) and DECREASE the strain while she goes about her day. If I were to come in and "fix" this posture by forcing her upright, I might do her more harm than good. Her ideal posture isn't "poor posture" for her - though it might be for you.

Another example would be a change in resting scapular position on the dominant side of a an elite volleyball player. This compensation has developed over time to address a need of their sport and altering it might negatively affect their performance. Basically, if it's not broken don't fix it.

Postural Strain

Postural strain is a circumstance that forces us to vary our position from our ideal posture. Examples might include carrying a heavy purse/suitcase on on side, leaning over a computer all day to meet a deadline or sitting slightly askew in an economy-class seat during your flight to Korea. These situations require you to move in positions that are not a part of your ideal posture. Postural strain is the factor that you can control and modify. The challenge lies in recognizing it. Many of us miss the cues that our bodies gives us when the strain exceeds the strength of the structures that it is placed on. By the time we realize it, we have pain and now it's an uphill battle to overcome it.

When we are younger, we are less vulnerable to these strains, and often we move enough to never reach them. As we age, we become more vulnerable to them. With age we tend to become more sedentary, we loss flexibility, we gain weight and we have more stress (an emotional postural strain). These factors are what contribute this increased "vulnerability" and these are the factors that you can modify!

How do you improve your posture?

(Finally...that took forever!)

First, I'd argue that "improving your posture" shouldn't be the goal. It may be semantics, but instead think of it as improving your postural awareness (as in awareness of postural strain) and improving your postural fitness (as in your muscular health and mental well-being). Focus on why you are interested in being more attune to you posture rather than just "having better posture." Are you trying to improve upper body strength for aerials? Do you hope to lift more weight in the gym? Are you tired after work with neck stiffness and headaches? Are you already short and just want to appear taller? (I had to sneak my reason in there...)

Trying to fix your posture by just sitting up straight is ineffective. I find it immensely frustrating that this seems to be the general solution offered up by most healthcare professionals. As we've discussed, posture is a combination of many things - most of which are subconscious (balance reflexes, emotions, mood, etc). How then are you going to focus on posture consciously and get anything else done? Even if you're borderline superhuman and can do it all - you're likely to develop a rigid and artificial posture that looks something like the diagram below:

Pay attention to your body and better identify postural strains:

When you are in a posture that doesn't agree with you, your body sends signals. Often we brush these off as the task at hand "takes priority" and we press on.

Feeling of difficulty/strain with a daily activity.
- Carrying a heavy bag, sitting in an awkward position or conforming to a chair that doesn't fit you.
- In this case, it's best to find an alternate method of performing the activity. For example, get a bag with wheels or take something out. Move your body such that you are not twisted/leaning in the chair and can face the activity head on. Add a lumber support/foot stool/headrest so you are relaxed and supported in that chair.
- Basically, if you feel strain, you need to make a change!
Fidgeting or shifting positions constantly.
- This is your subconscious basically screaming at you to get up and move.
- Take the hint, get up and move around (see below for the reasoning behind this)
Pain, numbness, tightness, pins and needles or other unpleasant sensations in a body part
- If it hurts, don't do it. Solid advice in medical jokes - solid advice in medical reality.
- Identify triggers (ex: "Every time I fall asleep on my right arm, my hand falls asleep") and avoid these positions. Its true that not everyone should sleep on their stomach or lean on their elbow at their desk. It's individually specific so listen to your body!
Soreness the day after (recurring)
- If you have residual stiffness/pain the day after an activity (and that activity wasn't a physical labor or workout) chances are that postural strain is to blame.
- Make note of these patterns to identify the trigger and avoid it (Ex: sitting in a meeting with my head turned to the end of the table/screen = neck stiffness and a migraine the next day. Solution: turn your chair in the meeting so you are facing the head of the table square on.)

Restore balance by varying your body position:

The joints of the body get nutrition through movement because of a process called "synovial circulation." Basically forces on the joint squeeze fluid out of the joint and the release of those forces allow fluid to fill back in. For the most part, there is no arterial blood flow in joints and the cartilage and joint tissues rely on this exchange of synovial fluid for health and nutrition. So, if you aren't moving - your joints are slowly starving.

If you work in a flexed posture at your desk all day, get up and walk/stretch in an upright/extending posture. If you stand all day at a register/counter, sit and relax in a chair (or do child's pose/some flexed variation). Restoring balance to the motions that your joints and muscles encounter keep them healthy and promotes improved postural fitness.

Improve your workplace/home environment:

The term "ergonomics" is a buzzword that most people are familiar with. Basically, it refers to making an environment more efficient for your use. In a situation where you have an ideal ergonomic setup, you have reduced postural strain as much as possible despite having to sit in a static position. Poor ergonomics not only creates direct postural strain — such as holding the shoulder up to reach for poorly placed keyboard or mouse — but also force people to learn bad new habits in order to cope (think chronic rounded shoulders and forward head posture to see the computer screen). Desk jobs have made "slouchers" out of a lot of us!

There are lots of ways to improve your ergonomic setup at work/home. The key is to be creative and identify what isn't working. For example, if your chair causes you pain or constant fidgeting, talk to your boss about investing in a new one and do some research (I suggest heading to Staples and siting in theirs for 5-10 a piece). If you hold the phone between your ear and shoulder and have neck stiffness/issues consider a headset or speaker-phone option. If you tend to sit as still as a statue, try sitting on a therapy ball and forcing your core to work and shift to keep you upright.

One thing to be aware of, a good ergonomic environment doesn't seek to cover up a bad situation. Rather it centers its design around you - and making your desk job/TV habit work with your body's postural fitness. If you've tried the above suggestions without success, consider asking your physical therapist if they do workplace/home ergonomic assessments. Most employers will cover the cost and the benefits are happier employees improved productivity!

Focus on your mental health:

If you're in a bad place emotionally, your posture suffers. I'm not a mental health professional so I won't make any specific recommendations on this subject beyond the common knowledge available to you online. Talk out your problems with a friend, exercise your stress away, get enough sleep and work to eliminate the negativity in your life.

If those aren't sufficient, know that a good mental health professional is worth their weight in gold! Trust your judgement and seek help/advice if needed.

Exercise and stretch your postural muscles:

There's a long list of muscles involved in supporting the body's joints and structures. If you are really struggling, it's always best to seek the advice of a qualified physical therapist or personal trainer so that your specific problem areas can be addressed. That said - in most of us, there are some common areas of weakness and tightness that can be improved with some basic exercises.

Check back tomorrow for a post titled "Posture: Postural Exercises and Stretches"

Summary:

Posture is a fluid concept. It relates to your body and activities as an individual, and no two people's ideal posture will look exactly alike. In the end, your ideal or "good" posture is based on the efficiency of the movement pattern and the stress it places on your muscles and joints. Trust your body and listen to the cues that it gives you.

If you are looking to change your posture to eliminate/improve pain or reach your health and fitness goals, my best advice is to increase your activity level and to MOVE MORE. Adding in tasks that require coordination (yoga, aerials, acrobatics, etc), and especially anything you enjoy (again: yoga, aerials, acrobatics, etc) will help immensely. Ideally, finding an activity that inspires, rather than one that requires discipline will make improving your postural fitness more fun - and you're more likely to stick to it!

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Posture: An introduction.