Posture: More Than Just Sitting Up Straight

You have probably heard it over and over, or you may have even said it yourself: "You need to sit up straight." Everyone knows they should have good posture. Beauty pageant contestants practice with books on their heads to stand straight. People spend money on special chairs and sit on giant exercise balls to improve their sitting posture. But despite hours of practice or hundreds of dollars spent on the next great thing, when people are asked about their posture, they usually say, "it is hard to hold good posture."

If posture is just sitting up straight, why can it be so hard to maintain?

As an orthopedic physical therapist at Mary Lou Corcoran Physical and Aquatic Therapy, every assessment I perform starts with posture. Whether a patient comes in with a knee issue, a foot problem, back pain or even an elbow issue, I start with a postural assessment. Bad postural alignment influences every joint and every muscle in the body. If the postural alignment problem is severe enough, it can even effect internal organs.

When I assess posture, I am looking at more than just sitting or standing straight. That accounts for only one plane the body can move in, the sagittal plane (forward and backward). There are two other planes the body moves in, the frontal plane (side to side, or laterally) and the transverse plane (rotation). The frontal and transverse planes can be hard to see during static posture.

In assessing the human body, one plane of movement directly influences other planes of movement. For example, if a hip joint is posturally positioned into rotation, it limits movement of the hip into forward and backward movement. Also, if a hip is posturally positioned into rotation, it may prevent another area of the body (like the lumbar spine) from moving into forward and backward movement. In turn, if the lumbar spine cannot move forward and backward, it will influence the next area of the body, the ribs and thoracic spine. This process may continue to the top of the head and tips of the fingers. So asking your body to correct posture by moving one part of the body into one plane of movement without addressing the other areas and planes will actually inhibit your body 's ability to achieve "good" posture.

All of this can be complicated. That is where physical therapy becomes important. Throughout the course of a thorough examination, it is the role of the physical therapist to look at a patient's body to determine what might be too tight, too weak, too strong or too loose. Developing an understanding of each individual's posture guides the physical therapist to what needs to be corrected to take the negative influences off the posture of the body. For instance, neck pain may be relieved by stretching hip muscles to help correct the posture at the low back which directly places an undue stress on the neck.

Once neutral postural alignment is restored, it becomes easier to maintain a more upright posture. Unfortunately, the problem does not end there. Why do these postural imbalances occur? Everyone has habits and activities they do every day that create asymmetries, preventing them from maintaining good posture. Discovering what activities are having a negative impact and trying to find a good balance is necessary. One of the most important jobs of the physical therapist is to help the patient learn what can be done throughout their day to minimize the negative impact of their daily activities and work with the patient to develop a plan that helps patients attain (and keep) the balance their body needs to feel good.

With a keen eye and years of clinical experience, the physical therapists at Mary Lou Corcoran Physical and Aquatic Therapy can help you attain good postural alignment and balance across all planes and areas of the body, helping with problems that arise throughout the body and helping you "sit up straight".

Posted by Robert Wolfe, PT, CSCS