Posture in Physiotherapy

One thing physiotherapists are analysing every day is posture, but what is it that determines a good and a bad posture? Is there such a thing as a universally correct posture? Today we will look closer at the simple, yet confusing concept of posture, and see if there is anything you can do to improve yours in order to decrease pain and improve performance!

Firstly, we need to establish a definition of posture.  The Posture Committee of the American Academy of Orthopaedic Surgeons has put together a long and dreadful one, half a century ago. I will not bore you with the full definition, but rather give you a brief excerpt of the important bits.

1. Posture is the state of muscular and skeletal balance in any given position (standing, sitting, lying etc.)
2. A good posture protects the organism from injury and progressive deformity
3. With a good posture the muscles will function most effective

The first point of the definition reminds us that posture should not only be assessed in one position, but needs to be examined from several different angles. For an office worker, the posture of sitting down by the desk at work could tell us a lot of what the cause of shoulder, neck or back pain could lead from, but if you assess a manual worker that spends most of the day on his feet, a postural assessment in a sitting position might not be the most important.

The second part addresses the importance of good posture when it comes to prevention of injuries and deformities. If you, over time, use your body in a way nature did not intend you to, it would react to it and let you know, often with pain as a symptom. It is of utmost importance to pay attention to these signs, as they are the first indications on a possible progressive deformity.

The last section describes the benefits of a good posture and builds on the terms given in the first point. If there is good harmony between length and strength of muscles surrounding a joint it leads to a more economic utilisation of muscle power, which again leads to higher performance. This is important both in everyday life, and in sports activity. If all muscles work in the same direction with a common goal you will run further, jump higher and lift heavier. You will also be able to work longer with no discomfort and due to the absence of pulling and dragging of tight and sore muscles, you will also most likely avoid any pain leading from a poor or faulty posture.

So with that in mind, it is time to look at the importance of a good posture, and what a physiotherapist would do in order to correct or improve posture that is thought to be giving you grief.

On the picture, you see an example of good posture on the left, followed by common types of postural problems. If you imagine a straight line drawn from head to toes, you would like it to pass through the ears, shoulder joint, lower spine, hip joint, knee joint and ankles. With this posture, all the big joints of the body is in an alignment that makes standing upright more or less effortless. However, if you deviate from this golden line, you will have to use muscle power in order to simply stand up straight, and this affects you in terms of increased pain and decreased performance. If you are causing excess strain to your body and have to use extra motor power just to stand up straight, imagine the implication of the strains and pains that are caused during sport activities where everything is amplified.

A chartered physiotherapist will assess your posture, identify the key areas and match this with your perceived pain and discomfort. Once the problem areas are identified, work commences to rectify these through a mixture of hands on muscle release and elongation, and tailor made Exercise Therapy to strengthen weak muscles. With a perfect balance between length and strength, the foundation is set for a pain free life and higher performance.

If you have any questions regarding posture, please do not hesitate to contact us, or to give feedback to this post. It is greatly appreciated!

Chris Smetana, MISCP