by Dave Rohe
Did your mother (grandmother, auntie, dad) nag you to “Stand up straight!” when you were just a whipper snapper? Guess what, they were right.
While body symmetry left and right is a new age myth, front to back balanced alignment is not, and this is the alignment the nagging was all about. Look at people from the side and you will see an assortment of postures, some of which are likely to cause problems. Look at the posture, any posture, from the side and check these points of reference for best posture: ear over shoulder (cheekbone vertical over breast bone); shoulder over hip; hip over ankle. Try watching for it the next time you’re at the beach, it’s much easier there. The further out of alignment these points get, the more likely the person will have discomfort as a result. That’s payback for not “standing up straight”.
The most commonly seen misalignment is ear in front of shoulder, which goes with slumped shoulders (in front of hips), the classic “not standing up straight”. But, since a person’s head, neck, upper back and shoulders are all closely related, this posture can result in anything from headache, to backache, to one or both sore shoulders. Likewise, a sore shoulder can result in slumped shoulders and forward head. You can start with any original problem and get any combination of the above. For example, a person with an injured shoulder will have a much more difficult time with recovery if the injury is on top of bad posture.
Improper posture has been acquired over time, by endless repetition. The posture is now a habit, and feels normal to the wearer. It may have originated from an injury, but more likely just from inattention. Mom wasn’t around any more to provide reminders. So, if posture is an acquired habit, can it be changed for the better? How do you change it?
Yes, you can change it, by repeating a substitute (hopefully improved) posture repeatedly over time. Does it work? Yes. It is one of the few guaranteed physio outcomes available. But it is only guaranteed if you do the repetitions of the new posture. One way to NOT change a posture is to straight away assume the new and improved posture, holding it steady hour after hour. That way goes pain and disorder, mainly because you are asking your body to make multiple sudden changes of muscles, joints and ligaments, without allowing for the adjustments necessary. So, if a patient comes into the clinic with a sore shoulder and forward head with rounded upper back, I’ll recommend treatment to help the shoulder recover, but will also strongly recommend the patient begin changing the posture habit little by little, every day a little more. That way, in three weeks, the shoulder will likely be feeling better, helped along by the improved posture, and the new posture will nearly be permanent. Three weeks is what it takes to correct a postural alignment, assuming the patient has the self discipline to repeat the new posture pattern. And the proof that the new posture is permanent is that the old posture now feels odd, rather than normal, and the new one feels right. Even if the shoulder injury is not completely repaired within the three weeks it took for the postural change, it will now much more likely be successfully rehabilitated than it could have been with bad posture.
These comments are general in nature. Be sure to check with your physio or doctor if you are not sure whether they apply to your situation.
Dave Rohe is a recently retired physio having practiced in New Zealand since 2004. He originally qualified in the USA, subsequently practicing in Malawi, Egypt and Cambodia prior to emigrating to New Zealand in 2003. He has enjoyed management positions in pediatric and adult outpatient facilities as well as taught physiotherapy for 15 years at the University of Georgia. He is currently living in Parakai with his wife, Sharon Robinson, a local midwife, near his adult children who are working, and one of whom is studying to qualify as a physio through the programme at the University of Otago. His articles previously appeared in local newspapers in Taranaki and on the blog site sponsored by NZSPT.