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Question: What does that
re-occurring knot between your shoulder blades, the tension headaches you get
during a stressful day at work, and the low back pain you have while doing the
laundry or vacuuming all have in common?
Answer: They are all caused by
poor posture.
We've all been told as children to "Stand up
straight", "Don't slouch", "Hold your head up". Easy
to say, but hard to do. So, why is it so hard to maintain good posture if its
supposed to be so good for us? The simple answer is because over the years we
have become lazy. We have also developed the "bad habit of bad
posture".
Why is good posture so
important?
Most people think proper posture is just to look good, but
in reality, it is much more important for function. Holding your body in proper
alignment allows you to be a complex machine capable of carrying out the
activities of your daily life pain-free. It also allows vital organs to
function effectively.
When you are not in proper alignment your joints don't work at your optimal
capacity. For example, you won't be able to turn your head as far when looking
over your shoulder if you have what we call 'forward head posture'. To
demonstrate this point, try this experiment: Sit up as tall as possible and
look over your right shoulder. Notice how far you can rotate and how far behind
you can see with only turning your neck. Now slump forward and slide your head
even further forward. Now try the same turn and see how far you can go. You
probably noticed your second attempt was much more limited. That is because the
vertebrae in your neck are closer together and your head stops when these bones
make contact. Can you see how this might affect your ability to reverse out of
your driveway while in the car?
Also, when we have the slumped forward posture, organs such as lungs,
intestines, and stomach are all compressed, limiting their ability to perform
their jobs fully. Constipation, irritable bowel syndrome, limited lung capacity
in sports, etc. can all be helped with better posture.
The last reason good posture is so important is because so many people's chronic
pain is due to muscles and connective tissue either being hyper contracted, in
spasm, or over stretched and weak.
Remember the knot between your shoulder blades I asked
you about in the beginning of this article? Why does it keep coming back even
after your weekly massage? Because you have forward, rounded shoulders the
muscles in your chest and between your ribs are hyper contracted, and the
muscles of your upper back are over stretched and weak. Instinctually your body
knows your shoulders should be held back so these posterior muscles go into
spasm to try to pull your shoulders back, but because they are weak they must
spasm to create stability.
If the doctors have ruled everything else
out, then those tension head aches, migraines, and TMJ pain you have is most
probably caused by tight muscles and connective tissue called fascia, pulling
your bones out of alignment and creating trigger points in the tissue.
Also, in some muscles you can develop a serious situation
where muscles are so tight they cause 'active trigger points' which then refers
pain to other parts of your body in addition to the trigger point area.
You might have your massage therapist relax the muscles and you might feel
better immediately, but as soon as you go back out into 'real-life' with
rounded shoulders, the knot will re-occur and tighten back up. Unless you take
care of correcting your posture, strengthen weak muscles, stretch tight
muscles, and receive myofascial therapy, you may be doomed to a life of knots
and trigger points!
What causes poor
posture? There are seven main causes of poor posture in adults and children. Most of
which can be corrected through the manual and movement therapy discussed above.
The sooner you take care of these postural problems the easier it will be to
correct them. If it is something that you've had for years, you may never
completely eliminate your postural fault because what started out as a
soft-tissue dysfunction, may have developed into a skeletal adaptation.
1) Skeletal or internal organ dysfunction
such as scoliosis, degenerative disc disease, or respiratory conditions.
2) Psychological factors such as low
self-esteem may cause slumped shoulders, and dropped head.
3) Past pain or injuries which have caused
compensatory movement patterns which over time can become habitual. A temporary
limp from a sprained ankle can turn into a chronic walking pattern.
4)Muscle imbalances, either innate or
developed, where opposing muscle forces are not equal and therefore pull you
out of alignment. An example of this is always carrying your purse or bag on
the same shoulder. That shoulder will most probably be higher than the other
one.
5) Excess weight especially around the
middle will pull your low back into a curve as your belly pulls forward.
6) Laziness and lack of movement which
leads to weak, out of shape muscles, ligaments and tendons.
7) Lack of awareness when we are not in
proper posture and lack of knowledge of how to be in proper posture. These last
two will be covered in this article.
Before the modern conveniences of our time, we would be
out climbing trees, working the soil, catching fish, building huts each day.
Today, as we go about our busy lives, we don't move or exercise as much as we
should so our muscles and bones are not as strong as they need to be. When we
do move it is usually without thought and therefore we don't pay attention to
the fact we've got that cell phone cradled between our shoulder and chin, while
we are picking up our three year old, 40 pound, squirming child!
Also, the stresses of life weigh heavy on us ('carrying
the weight of the world on our shoulders'...) In the early nineteen hundreds,
Hans Selye, an Austrian physician studied the effects of stress. The
physiological response to stress is what he called the fight or flight
response. When we were living in caves, we had to either fight off the saber
tooth tigers or run away. Today our stress may come from our boss, deadlines,
traffic or the threat of war.
One of our physiological responses to these stressors is
we naturally try to protect our most vulnerable areas such as our bellys,
hearts, and neck. Therefore we slump forward to shield our stomachs, and our
shoulders begin to creep up closer to our ears so nothing can get to our
necks. Most of us continuously live in the fight or flight response! No
wonder we have that tension headache!
What is Proper Posture?
There is a basic standard I use when
assessing proper alignment in posture. Among other evaluation techniques, we
look at the placement of specific bones.
When viewed from the front, your shoulders and hips should
be level. Your head should be centered over your torso. Arms should hang
relaxed with the thumb and forefinger pointing forward. Knee caps face front
with a slight turn out to your feet. When viewed from the side everything will
stack up neatly. When we drop a plumb line from the ceiling, it will line up
through your ear, middle of your shoulder, center of your hip, just slightly
behind the center of your knee and in line with your ankle bone.
Just as important you will have an appropriate amount of curves in your
spine. You should have two gentle concave curves in your neck and in your low
back. These curves act as your shock absorber so don't try to completely
straighten them out! Viewed from the back, your spine will be straight, your
shoulder blades even, and again, hips and shoulders level.
How do I know if I have
poor posture?
First, check yours in the mirror to
determine where you need help. If you're really ready for a major overhaul, ask
a friend to help you by taking three polaroid pictures. Wear a bathing suit and
stand in your usual stance. Take a picture from the front, side, and back view.
Now go through the check list above, and see how your
posture falls short. Draw lines on the pictures with a ruler. Is one shoulder
higher than the other? Does your belly pull forward and create an excessive
lumbar curve? Is your head forward of your torso or does the back of your head
line up over your shoulder blades as it should?
How do I learn proper
posture?
The method which we will discuss is based on a system of
pain management and injury rehabilitation called Active
Myofascial Therapy- The Diamond Method®. It is made up of
four components each playing an important roll.
The first and most important aspect is Awareness.
Awareness contributes to 50% of your postural reeducation because if you are
unaware of being in a faulty posture, you won't know when you need to correct
it. You must be aware of times when you are hunching up your shoulders while
working on the computer, or when your head is forward because you forgot your
reading glasses, or when you sleep at night with two big pillows under your
head which only reinforces the faulty forward head posture.
Improving the actual quality of your myofascia (muscles
and connective tissue) through strength development, stretching, and manual
manipulation is the remaining 50% of this postural reeducation equation.
Long-term correction of your posture will only happen when all aspects are
addressed.
Development of a complete stretching and strengthening
program is beyond the scope of this article so please consult a therapist
qualified in this area to help you. For manual and myofascial therapy look for
someone trained to break up trigger points, release tight areas of myofascial
adhesions, and realign scar tissue.
Because you all may have different postural faults, I will
discuss the three most common problems and the postural exercises to correct
them. In Active Myofascial Therapy- The Diamond Method®,
these exercises are called Actions. Following are some of the most helpful
Actions for the stated postural problems and/or conditions.
If You Have: Forward Head and Rounded Shoulders or Neck, Upper Back Pain, Head Aches, TMJ Dysfunction, or Shoulder Pain:
The Wall Stand corrects these two problems. With
your back against a wall, stand with your feet two inches away from it. Now try
to press both shoulders back against the wall, and slide your head back so it
is touching the wall. Keep your eyes and chin level to the floor. If you can't
get your head to touch the wall keep trying, but don't let your chin lift up.
Now apply The Turtle action. Slowly bring your head as far forward as
possible without letting your shoulder blades come away from the wall. Keep
your eyes and chin level to the floor as you now slowly slide your head back
again to try to touch the wall. Repeat this five times and finish with your
head in the back position of The Turtle.
Once you have your head back as far as possible try to maintain that head
alignment while you step away from the wall. This position is where you want to
try to hold your head when you're standing or sitting. If you ever notice your
head has slipped forward into your old faulty posture, just practice The wall
Stand and Turtle a few times and again try to keep it in this proper alignment.
If You Have: Sway Back or
Excessive Lumbar Curve, or Low Back Pain:
Pelvic Tilts to Neutral will help you determine
where your pelvis should be and will help develop flexibility in your lumbar
spine and increase your range of motion. Stand away from the wall with your
feet about one and a half feet apart. Soften your knees so they are just
slightly bent. Bring your low back into as much of a curve or sway back as
possible without creating pain. Then slowly round out that lumbar curve by
tucking your tailbone under as far as possible. Don't squeeze your butt to do
this - it should all come from strong abdominal muscles!
Repeat five times slowly. It's important you do this all without letting your
upper torso move. The area that is moving should be in your pelvis only. Once
you have found your full range, finish with you pelvis held in the mid point of
your range. This is what is considered 'neutral pelvis posture' and where you
should hold your pelvis when standing and walking. This neutral should be the
most pain-free position for your back.
Since I can't actually work with you personally, you must be diligent and work
on these corrections throughout the day, every day.
At first these corrections won't feel natural, and will feel forced and awkward.
That is because 'forcing' the good posture is exactly what is happening. But as
I teach my clients and patients, "Artificial corrections result in
unconscious control" It's a positive cycle which is reinforced each and
every time you correct it. As soon as you notice you are out of alignment do
the Action and make the corrections. Then try to maintain that correction for
as long as possible while going about your daily activities.
The more time you spend in the corrected posture the easier it will become
because your tight muscles will be stretching, your weak muscles will be
strengthening, and your brain will consistently be reminded of where you
'should' be. Eventually your neuromuscular system will be reeducated to
naturally hold yourself in proper posture without your awareness or conscious
control.
Months later if you have pain in your low back you'll
notice it's probably because you are slouching. As soon as you sit up properly
and find neutral posture, the pain will go away.
So now hopefully you see proper posture is
far more important for function than for beauty. Begin to have good posture
now, and your body will thank you in the years to come by continuing to
function at it's maximum capacity with little or no pain.
Good luck and keep your ears over your shoulders!
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