As Dr James Wyss explained in last Monday’s article, common problems related to poor posture are treatable with the appropriate lifestyle changes, daily postural exercises taught by a physical therapist, and by making ergonomic changes. Here, Evelyn Hecht, a licensed physical therapist and frequent contributor to Women’s Voices, details some good postural exercises. —Ed.
Take the Photo Challenge
Let’s tackle some basic lifestyle/ergonomic issues. The first step in achieving good posture is to become aware of your posture during work and at home. An easy way to find out is to have your coworker take some random photos of you throughout the work day (no poses!). The best shots are the side and back views, to see how your spine curves. At home, have a family member take photos of you preparing meals, reading on the couch, etc. When you look at the photos later, will you marvel at how upright, and centered you are, and how you maintain your natural spine curves throughout the day? Probably not!
Just by looking at your photos you can figure out some of the changes you need to make in your sitting/standing/moving positions. Good posture is based on keeping the natural curves of the spine during most activities. This is called maintaining a “neutral spine”; it requires a strong core and a flexible spine. Your body should not be placed in extreme positions for hours at a time. For example, a hyperextended position—standing with both knees locked—can cause lower back tension, but, conversely, a hyperflexed position—sitting in a slumped, rounded posture—can cause back and pelvic pain.
A Good Sitting Posture, Detailed
Sitting is what we do most of our day—to work, eat, learn, read, watch TV, and during transportation. Over time, poor sitting positions cause muscle tension, joint restrictions, strength deficits, and pain that physiatrists diagnose and physical therapists treat every day.
Set up your computer/reading/art/work space to fit your body, to help support and maintain the natural curves of your spine, instead of having your body adjust to the space. The chair seat should be at a comfortable height, so that both feet (heels and toes) can touch the floor. Feet that are unsupported create tension in hips/legs/the lumbar spine. If you are petite and your feet do not touch the floor, use a footrest.
When you’re sitting, the two bones at the bottom of the pelvis, where your hamstrings attach (ischial tuberosities) and the center of your pelvis should be in contact with the chair seat. Your lower back should rest against a lumbar cushion, either already built into your chair back or purchased separately and strapped around the chair back. The lumbar cushion gently pushes your lower back forward, to maintain its natural inward curve. You should not slump backward to sit on your tailbone (coccyx), nor should you lean too far forward to put weight on your pubic bone. Don’t sit on one side/hip: This creates imbalances at your sacroiliac joint, hip, and lumbar spine.
When your lower back is resting against a lumbar cushion at the back of your chair, this frees the thoracic spine, shoulders, and neck to stack one on top of another, rather than careening forward. If you find yourself hunching forward to see the computer screen or to reach the keyboard, adjust the placement of this equipment so it is brought closer to you and there is no need to strain forward.
Lastly, during every hour of sitting, work/read/draw for 50 minutes, then get up for the last 10 minutes to take a brief walk, do a stretch, pet your dog, do something else. Research shows that 50 minutes’ work plus 10 minutes of change recharges your brain/thinking powers. This timing is a great way to re-evaluate your posture and prevent buildup of faulty postural patterns.
A. Upper-Body Lift
Try this 3-part exercise in sitting or standing position.
If you’re doing this exercise in a sitting position, keep your pelvis centered on the seat as described above, your lower back resting against the lumbar cushion. If you’re doing this exercise in standing position, keep both knees slightly bent.
1. Think of an invisible string gently lifting your sternum (the bone in front of your chest) upwards. You should feel your upper body move from a rounded upper back to a more elevated posture Hold this as you . . .
2 . . . roll your shoulders up toward your ears, back, then down and hold. This opens the front of your shoulders Maintain this position as you finally . . .
3 . . . gently tuck your chin toward your neck (think of creating a double-chin position).
Hold all three positions together for a count of 20 seconds to one minute. Make sure to breathe slowly while holding the position Repeat. Do three times a day.
B. Thoracic Twist Combined with Deep Hip Rotator Stretch
A simple stretch to open the hip muscles and the midspine.
When we’re working on a computer, we tend to get into a rounded-upper-back and forward-head position. Our midspine, called the thoracic spine, can become restricted, as do our hip muscles. Here is a simple stretch to open both areas.
Spine and Hip Rotator Twist:
1. Sit in a sturdy chair, your buttocks slightly away from the chair back, feet comfortably touching the floor or on a raised stepstool.
2. Cross the right ankle over the left knee
3. Place the left hand on the outside of the right knee.
4. Place the right hand on the chair seat behind you
5. Turn your upper body as far as possible to the right while gently pulling the right knee toward your left shoulder. Keep your neck centered over your chest, so you don’t twist your neck too far.
6. You should feel a stretch along your spine and in the right buttock/hip region. Hold for 10 to 30 seconds while breathing slowly.
7. Return to center and repeat once more.
Switch position and repeat to the opposite side
C. Wall Angels
This exercise helps reverse the effects of a forward-head, rounded-shoulders posture.
Do you remember making snow angels as a kid? “Wall angels” are the grown-up version. This exercise increases the strength of your upper back and posterior shoulder to reverse the effects of a forward-head, rounded-shoulders posture.
- Stand with knees bent. Your buttocks, lower back, upper back, and back of your head are against a wall. Tighten your stomach to keep your core stable. Bend your elbows comfortably by your sides, with the back of your hands touching the wall.
- Keeping this body position, slowly slide both hands along the wall, raising both arms until your hands meet overhead.
- Slowly lower. Do 10 reps. If it is difficult to go full range, try ½ or ¼ range.
There are additional excellent postural exercises—targeting abdominals, pelvic floor, and lower back muscles. Consult your local physical therapist to learn a tailored-exercise home program that is right for you.