POSTURE! DOES IT MATTER?
We have all heard of posture in one way or another; bad sitting posture, bad standing posture, "text neck," good posture, plum line posture, shoulders back, forward head, etc. What exactly is "good" or "bad" posture? For that matter, what exactly is posture and is it as important as people might believe it to be? Lets investigate.
Posture is NOT a static position. Posture should be more thought of as your body's response to factors that are resisting a grossly upright and functional position. These can range from gravity and other environmental influences to anatomical abnormalities. "Good" posture (head back, shoulders back, pelvis perfect) has been drilled into our heads since an early age. But why? What does science have to say about this? Does the evidence support "good" posture? Does it support "bad" posture as a cause for pain? The answer is....kind of. Let me explain.
First lets look at a simple example of shoulder pain. This individual has shoulder pain when reaching high overhead. They also happen to have a very kyphotic posture (think Quasimodo). Now having a very forward curved thoracic spine 100% can limit the shoulder blades ability to move and creating an impingement in the shoulder causing pain. In this case, yes posture can have some impact on pain. Another easy example of "bad" posture. Kneeling for hours on end, sitting back on your ankles. Sure this will cause pain, because you are over stressing tissues at endrange and causing irritation. Now lets consider a different example. An individual has back and neck aches that are not always constant but there none the less. They are diagnosed with poor posture because of rounded shoulders, forward head and decreased lumbar lordosis (lower back curve). The claim here is that there is an imbalance with the muscles. Some are too long while others too tight. Does this hold up? The answer is NO. There is almost no research or data to support these findings and them being the cause of pain.
In the rehab world (PTs, chiros, personal trainers, physicians) posture is used time and time again as a cause for aches and pains. Frankly it is an easy thing to but blame on. Patients are then to perform postural exercises to strengthen the lengthened muscles and stretch the tight muscles with the goal of "correcting" the posture. Problem is, you're not really correcting it. "But Sam," you'll say, "people feel better and their pain goes away. What gives?" Yes their pain may improve or go away completely. But it is for different reasons, rather than correcting posture. A general exercise routine with strengthening and stretching would have the same results. This is what is getting them better. They are exercising in a controlled and safe manner and retraining their proprioceptors, central nervous system and brain. Boom, pain relief!
Now before everyone goes into a panic, let me clarify one last point. There is bad posture. It is just not as prevalent in causing issues as you may think. Yes, severe scoliosis can restrict lung and organ function. Yes, severe posture changes can cause skin break down and pain. This is not the "bad" posture I'm talking about. I'm talking about the teen that is slumped over texting, the forward head position, the slightly sway back posture. These have almost no impact on pain. Even scoliosis....have you ever wondered why not everyone with scoliosis has pain. If their posture is all "bad" why don't they all hurt?