828.252.0920 • 862 Merrimon Avenue Asheville, NC 28804 [email protected]

Have you have ever had low back soreness that seemed to be okay during sitting and walking, but got  progressively more achy with standing for a long time – like at a concert, or during a long conversation at the grocery store?  If so, you may be suffering from an inefficient standing posture.

Gravity imposes a force on our bodies all the time. Our positioning, or posture, affects how our body resists this ever-present force.  Much has been said about posture; we have all heard, “stand and sit up straight,” and “pull your shoulders back.”  Physical therapists have terms like, “forward head and forwardly rounded shoulders,” and “kyphosis” (excessive forward rounding of thoracic spine).  Poor postures can contribute to stress and strain on ligaments, tendons and muscles.  Much like a repetitive movement performed by an assembly line worker over and over, poor postural habits may have a cumulative effect on the vertebral ligaments, intervertebral discs, facet joints, and other weight bearing structures around the spine, resulting in pain.  The scientific data on the relationship between posture and pain is somewhat mixed – but sometimes, relatively simple corrections to how we hold ourselves can improve comfort levels significantly.  The kind of pain or ache that increases the longer a particular position is held, often will respond quickly to improved postural alignment.  This effect may be relevant in either sitting or standing, and in the neck, shoulders, or low back.

Good posture is like a column of stacked blocks.  In the picture below, the “normal posture,” shows head over shoulders, shoulders over rib cage, rib cage over hips, hips over feet. With the downward force of gravity directed into the feet, there is no buckling in the neck or low back.  Every other postural pattern in the picture shows some deviation from this norm.  Most of the aberrant postures have head in front of shoulders, shoulders and rib cage behind hips, and the normal curves of the spine exaggerated. This sets up a misaligned column of blocks, and the force of gravity buckles either forward or backward, putting strain on the structures forced to hold the person up. This strain builds over time and pain can result.

Finding your most aligned posture can be broken down into a few steps:

  1. Equal Weight-Bearing – Shift your weight back and forth and side to side on your feet.  Slowly make the movement smaller until you feel like you have equal weight on each foot, and that the weight is evenly distributed from the front to the back of each foot.
  2. Pelvic Neutral – Stand with feet shoulder width apart and place hands on hips. Think of the pelvis as a bowl filled with water, tilted forward or backward the water pours out accordingly.  Tilt back and forth until you find what feels like the middle of the movement, this is your neutral – pelvis should be near level – water is still.  Most people need to drop their tail down to achieve neutral.
  3. Knees Unlocked – Bend knees slightly, of just “unlock” your knees to avoid hyper-extension; this may help with pelvic motion as well.
  4. Rib Cage Over Hips – Place one hand on your chest and the other hand on your belly. If you look down – your hands should be stacked one on the top of the other.  Often, habitual posture has the top hand behind the bottom hand. Keep hips where they are and bring top hand and chest stacked over the bottom hand.  This places the rib cage over the hips.
  5. Shoulder Blades Down – Shrug your shoulders up toward your ears, roll them back and then let them fall down to where they relax comfortably, and let your arms hang at your sides

BREATHE and relax! Efficient posture should not take a lot of work or muscle activity. It also has the added benefit of allowing our abdominal and core muscles to do their job with less effort and be ready for pushing, pulling, and lifting. This posture should help ease low back soreness during prolonged standing.  So stand tall and be aligned – how we hold ourselves matters.

Article contributed by Michael Abbas at Mountain Physical Therapy

logo in color motion