Posture - Part I

 According to the Posture Committee of the American Academy of Orthopedic Surgeons, posture is defined as the relative arrangement of the parts of the body. It is a state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity. Under such condition, the muscles will function most efficiently. It is an alignment of the musculoskeletal system in such a way that the body moves and functions with maximum efficiency. [1]

According to Magee, ideal lateral standing posture is defined as “a straight line that passes through the ear lobe, through the bodies of the cervical vertebrae, the tip of the shoulder, midway through the thorax, through the bodies of the lumbar vertebrae, slightly posterior to the hip joint, slightly anterior to the axis of the knee joint, and just anterior to the lateral malleolus. [2]

Poor posture is a faulty relationship of the various parts of the body, producing increased strain and stress on the supporting structures and in which there is less efficient balance of the body over its base of support. [1] For example, when the head has migrated forward and the ear lobe does not line up, that is a bad posture of the head. When every inch of your head is forward in posture, you are adding additional weight. If your head posture is three inches forward from the correct position, you will have added three time the normal weight, and additional 10 to 15 kg of load on the spinal column where the head and the neck joins the back. [3]

Poor posture is the source of many body aches. Symptoms include back and neck pain, headache, fatigue, and potentially, even breathing issues. In extreme cases, bad posture can even lead to internal organ damage by restricting blood supply to these areas. This adoption of poor posture can start in our early childhood years and progressively develop over time into pain, discomfort and for some, debilitating illness. The effects are never felt immediately as neck and back problems develop over time and can start from a very early age, for example, from poor sitting posture at school. [3] 

We also tend to deviate from the ideal posture due to many factors, some of which are easier to correct than others. Changes can be hereditary, due to injuries, mental and physical illness, sports (muscle imbalance due to increased use of one group of muscles versus another, often seen in golf, tennis, ballroom dancing, etc) or work related factors such as poor sitting habits. [4]

Another, less obvious effect of compromised posture can be emotional issues. People who walk and sit straighter automatically project authority and confidence. [4]

Ideal posture is important because all the curves are in a normal range, which minimizes the impact of gravity and maximizes the ability to absorb shock with minimal impact on the joint and surrounding muscles. [4]

By addressing and treating the identified postural concerns, in addition to other assessment findings, physiotherapist help their patients achieve their highest level of physical functioning.

[1] Britnell, S.J et al (2005). Postural Health in Women: The Role of Physiotherapy. J Obstet Gynaecol Can; 27(5): 493-500

[2] Tucker, S., Meyer, L., Porter, J. (2007). The Relationship Between Physical Fitness and Standing Postural Deficits in Middle School Adolescence Ages 12-14. Proceedings of the 3^rd Annual GRASP Symposium, Wichita State University

[3] Owen, M. Pain and Posture go Hand in Hand. Fitness Function. C.H.E.K. Institute

[4] Grifoni, Z. Recognizing your postural type. Synergy+ Physical Therapy & Pilates Studio