The Importance of Posture

May 3rd, 2012 By Steven Knope, MD

One of the most important aspects of health is having good posture. Though many people exercise their muscles in the gym, most don’t understand the role of a strong and flexible spine. This includes the thoracic spine—that part of the spine surrounded by your ribs.

Good posture, which I’ll define shortly, is necessary for everything we do, from walking to your mailbox to lifting objects. It is important in all sports. Once you become aware of the importance of good posture, you will begin to notice your posture and those around you. Next time you go to a restaurant or a shopping mall, just look at the people around you. See if you can recognize any common patterns.

Good posture is manifest by a person who stands tall, with his or her head high, with the ear overlying the middle of the shoulder.

Head-Forward Posture: The most common postural abnormality is the so-called “head-forward posture.” Due to life in our modern society, the majority of people have some degree of head forward posture. This posture is easily recognized when you look at someone in profile. If you see a person whose head extends out over their chest, such that the ear is not aligned directly over the shoulders, they have head-forward posture. As you can see from the picture below, a strong upright posture conveys a completely different physical impression than a head-forward posture.

An example of head forward posture.

What is wrong with Head-Forward Posture? From a mechanical point of view, your head amounts to an 8 lb bowling ball that is supported by your upper thoracic and cervical spines. For every inch that your head extends forward of the neutral position, you effectively double the stress on your neck muscles to hold it upright. This causes neck pain, and loss of mobility in the and neck and thoracic spine.

In addition, when the thoracic spine is flexed for long periods of time, your upper body tends to become fixed and blocky. You lose flexibility of your thoracic spine, which compromises all of your bodily movement.

Dowager’s Hump: As we sit at computers, or work with our heads hung over desks or operating room tables, our thoracic spine begins to develop an excessive curve. In cases where the bones become weak, and people suffer compression fractures and spinal degeneration, the result is a Dowager’s Hump, pictured below.

An example of Dowager's Hump.

Improving Your Posture: It is important to work on your posture and improve it, before extreme and permanent changes take place. In most people, posture can be improved. Your thoracic spine can be made more flexible, as can your neck.  However, these changes take a fair amount of awareness, time, and effort to correct.

So what can you do to improve your posture?

1. First, be Aware of your posture. When you catch yourself slumping as you pass by a mirror, get your posture back into line. This will take repeated effort until good posture becomes second nature.

2. Practice Sternum Up Posture: It is difficult for most people to think of complex movements, like “chest up, shoulders back, and head held high.” For most people, it is easier to just think of a string extending from your sternum (breast bone) to the ceiling.  Think of a string pulling up on your sternum. If you think “sternum up”, most of your posture will fall into line.

3. The T Rack: There is a device that was developed by a physical therapist in Australia called the T Rack (or “thoracic spine” rack). When used over time, the T Rack can reverse some of the excess curvature of your thoracic spine and make your spine more flexible. However, this kind of stretching takes a disciplined and concerted effort. Being a cyclist, I’ve used this device for many years to maintain a strong posture. If you are interested in purchasing a T Rack and working with this device, speak with me first and I’ll help you to develop a program.

Good posture takes work, but the payoffs are considerable. If you have questions about your own posture, feel free to address this with me during your next visit.

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