Poor posture! Yikes!! That sounds dooming. When we talk about poor posture, words like rotator cuff tear, disc herniation, trauma, injury, and more all come to mind. Scary stuff! In our society, we seem to be fixated on our posture. In our obsession, we blame posture for many of our problems.

What if I told you that there is no such thing as poor posture? It is time to buckle up. Sit in an upright or slouched position, and continue reading!    

A few years ago, I was driving from St. Louis, MO to Kansas City, KS. All things considering, it is pretty boring drive. As I was driving, I remember focusing diligently on my posture- tall spine, neck upright, knees shoulder width apart. One could speculate that it was the perfect seated car posture. Since I was sitting in a great posture, I told myself there was no need to stop for a rest break. Four hours later, I arrived in Kansas. Despite the perfect posture, I was sore. My muscles ached, shoulders were tense, and low back craved movement. Moral of the story: Even a perfect posture is not the solution. Movement trumps any isolated posture. 

Posture is defined as “the position or bearing of the body whether characteristic or assumed for a special purpose.” In other words, it is the way we position our body for various activities. Those activities can include anything from sitting in a car to cleaning underneath your kitchen sink. Our posture is our body’s position during all those tasks. It is constantly changing and adapting to meet our current environment. When we confine our posture to a limited space, there is minimal adaption needed. Sore, achy, and fatigued muscles are a common result. 

The research does not support either good or bad posture. We cannot confidently say that poor posture causes problems OR good posture prevents problems. This is because posture alone does not equal pain. Several studies have been published over the past few years that confirm pain is unrelated to our anatomical tissues. For example, 34% of asymptomatic people >60 years old have been found to have rotator cuff tears. Crazy right? One in three people WITHOUT SHOULDER PAIN have a rotator cuff tear Should these people sign up for surgery? I sure hope not. They do not even know there is an issue, and they are doing all of their activities without any problems. There would be no indication for surgery. Therefore, we cannot confidently say that poor posture is the source of our tissue damage or pain response.

In the pictures below, you can see one of my clients squatting with his feet turned completely inward. For most people, this amount of stress of the outer ankle ligaments would cause an ankle sprain. My client can perform this movement because he has trained those tissues to be strong in that range of motion. He can squat with his feet inverted because his body has gradually adapted the tissue to handle that load. He created strong patterns of muscle memory to comfortably perform this movement so that his ankles were strong, mobile, and adaptable to the life activities he was performing. ​

It may be frustrating to hear this information for the first time. I know I was upset. It felt like 3 years of Physical Therapy school was a lie. We have been programmed to believe posture is either good or bad. However, I urge you to take a positive outlook. There is freedom in this information. We no longer need to obsess over our posture. All we must do is move!   

Take Home Action Items:
​1) Sit less and stand more
2) Movement > Good Posture > Bad Posture 
Movement is better for your body than sitting in a good posture and a good posture is better than a bad posture. If there is a 5 minute break at work, get up and walk around instead of doing a chair stretch.
3) Red light postures are NOT  ‘don't ever do postures.'
Think of them as ‘don’t only and always do postures.’ While holding these positions for long periods of time may not be ideal, the posture in itself is not harmful. 
4) Create or find a daily maintenance routine. 
This routine should only take 10-15 minutes and should target the entire body. In the upcoming weeks, Heafner Health will be coming out with short daily maintenance videos. Stay tuned!
5) A body in motion stays in motion. 
Many pains are only more common in the aging population because people change their activity levels. Adopt a diverse workout program that stresses the body in all directions.  Stay active and stay dynamic! 

Author: Jim Heafner PT, DPT, OCS
Instagram: @HeafnerHealth
Websites:
The Student Physical Therapist 
Heafner Health

​Want to learn more from the author:
​Check out his book and other online resources:
1) The Guide to Efficient Physical Therapy Examination
2) The Anatomy of Human Movement
(Save $10 on either above offering by using the promo code: Top10)
3) The Yoga Fix

If you have lived in Colorado for any length of time, you have probably told this story! The end result of the wrong step is often an ankle sprain. At Heafner Health I have listened to this scenario more than a handful of times. Fortunately, the majority of these injuries are only minor ankle sprains.  

Ankle sprains often involve the ligaments on the outer ankle, most commonly the Anterior Talofibular (ATFL) ligament. These ligaments are important for providing strength and stability of the foot and ankle region. During an ankle sprain ("roll your ankle"), the ligaments undergo a quick stretch.

Thankfully, the human body is an excellent self-mechanic. The whole body jumps on board to support the injured region.

• Pain signals send alarms to the brain indicating that activity needs to be modified
• The circulatory system (blood vessels) increase blood flow to the area creating some local swelling
• The immune system sends special nutrients to remove any stagnant fluid and replenish the region
• The musculoskeletal system (muscles and bones) stop activating to avoid further injury

While the time frame for full recovery will vary significantly ​depending on the severity of the ankle sprain,  symptoms should begin to improve within the first few days. Gentle, pain free exercises are often prescribed within the first 24-48 hours to maximize early return to normal activities. Swelling and bruising is common. In fact, it is the bodies natural healing process to aid the injured area. The key is to manage any bruising, pain, and swelling so that normal movement can begin!  If no complications arise, significant improvement should be seen in 4 weeks (It should be noted that 100% recovery can take months in more severe sprains).

Early pain free exercises can help get people back to their normal fitness routine. You must perform the exercises on a regular basis to prevent stiffness or scarring from occurring. The exercises should not cause increased pain, but may cause soreness after completing the routine.

Below are several exercises that initiate movement following an ankle sprain. Please consult a local physical therapist for individual exercise prescription.

Assuming you are healing properly, these exercises will be quickly progressed to more advanced balance and strengthening exercises. Below are 4 examples of more advanced strengthening that is essential in the later stages of rehabilitation.

Once your symptoms have decreased it is important that you take the necessary steps to prevent the injury  from returning.  Below are several tips for preventing ankle sprains.

1) Strengthen the muscles of the foot and ankle
2) Focus on balance and coordination exercises
3) Strengthen the hips and spine
4) Change environmental factors (shoe type, body weight, walking surface)