Stop Blaming Posture for the Problem

​Have you ever been to a physical therapist, doctor, trainer, or anyone who evaluates your body or monitors how you move? If so, they have may told you that you have poor posture.

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!    

"Poor posture is not the problem! A lack of movement is the underlying issue."
​-Dr. Jim Heafner PT, DPT, OCS

What is posture?

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. 

Bad Posture Gives the Wrong Message

When someone is told they have poor posture, they often have rounded shoulders, a forward head, slouched spinal position, etc… But what makes these postures bad? The forward head position is simply a movement the neck must perform when trying to get a closer look at something. Bending from the spine is a necessary movement when picking up a low object from the floor. These postures are not BAD; they are simply different MOVEMENTS. 

From a neurolinguistic perspective, telling someone they have poor posture has it's consequences. The words 'good' and 'bad' have strong connotations that our deeply rooted in our biology. ​ We are typically rewarded for good behaviors and somehow negatively punished for bad behaviors.

Good= Green Light = Go
Bad= Red Light= Don’t Ever Do

​If certain postures are bad, we just hit a red light! Bad posture indicates that people should not perform those movements. The red light indicates that slipping into a rounded spine position could immediately predispose someone to injury.  The stigma surrounding bad posture ultimately creates a fear of movement and only promotes movement in a 'good posture.' ​

The biggest problem with the stop light system:
Stating someone has poor posture does not provide adequate information into the person's environment, movement patterns, daily habits, or their pain behavior. It allows for easy blame to be placed on posture, which is only a small piece of the clinical puzzle.    

Classically Coined Good Posture

Classically Coined Poor Posture

"Your next posture is your best posture!" -Dr. Mike Giardina

Poor Posture Does NOT Equal Increased Pain

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. ​

"Our preparedness for the next posture is key!"

Is Sitting in a Slouched Position Fine?

As humans beings we are designed to move. You have probably heard the quote 'movement is medicine.' It is absolutely true! ​All movements are great as long as our brain and body are adequately prepared for the movement! To live healthy lives, we must have the capability to explore the bad posture positions equally as well as we can perform the good postures. It is important that we can move into a 'bad posture' to crouch beneath a low railing. It is equally important that we access 'good postures' to lift a heavy weight. In other words, we must have the ability to adapt our bodies to all of life’s postures. 

So is sitting in a slouched posture fine? For short periods of time it is fine. However, I would not recommend slouching all day at work. At the same time, I would also not recommend sitting all day, period. Upright sitting is more biomechanically efficient, but having good posture alone is not solving any problems.  

The Case for More Movement

From both a physics and biomechanics standpoint, good posture does make sense. When our joints are aligned, there is more freedom of movement and less friction between the boney surfaces. Better alignment and good form should allow for more efficient movement. The one downfall of this philosophy is that physics and biomechanics negate the human brain. We are much too complex to deduce our bodies to machines. A one-size-fits-all package does not exist. Good posture for one person, may be slightly different than good posture for another individual. 

Despite being amazingly complex, one thing is constant for everyone. As humans, we must move to survive. On a microscopic level, our cells are constantly adapting and changing. Externally our skin, hair, and nails are always growing. Neurons are always moving through our nerves to give feedback about our body position.  In other words, we are designed to move.

The problem with many injuries is unprepared movement patterns. Unprepared movement means there is a disconnect between the output from the brain to the muscle. More simply stated, our muscle memory has been disrupted. The detailed GPS in our brain is no longer identifying all the roads on the map. Following a prolonged posture (good or bad), certain movements become less accessible. Using the GPS analogy, we could say these movements are similar to roads that are under construction. These movements must be retrained or else our brain will compensate by taking a side street. The detour eventually becomes overcrowded, overloaded, and unable to respond to stress.   

A good posture may be more efficient than a bad posture, but it still does not solve the missing piece of the puzzle: MOVEMENT.

Where To Go From Here

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

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