Is Bad Posture Causing Increased Pain?

“Sit up straight.” How those words resonate with childhood. Little did we know then how that simple phrase would impact the rest of our lives.

That “sitting up straight” could define our pain well into our adult lives. Our posture defines our daily activities without recognition. It influences such simple tasks that we perform.

For the average person postural positioning may not seem important; however, for someone who is managing or experiencing pain, postural positioning can have a huge impact on their life.

What is Good Posture?

good posture

While many people attribute posture to sitting or standing straight, postural positioning can include lying down, sitting and standing. Beyond that, posturing is divided into two positions: static (still); or, dynamic (movement).

The “ideal” posture is the ear over the shoulder, shoulder over the hip and hip over the ankle. This “ideal” posture is commonly threatened by the use of cell phones, sitting for long periods of time and overall fatigue.

As our lives have become more sedentary, it is common to see people bent forward with elevated shoulders. If not conscious of our posture while sitting, our low backs can be placed constantly in a flexed “C” position.

Often times we are cleaning our residence, reaching in a cabinet or holding a child with undesirable posture that puts stress on muscles and joints that are not designed to take that load. Overtime our habits tend to compound these issues. Education and awareness can help improve daily positions. This allows us to maintain proper posture and improve activity tolerance.

Proper Posture: A Self Assessment

While consultation with a physician or physical therapist is recommended if experiencing pain or developing a personalized plan of care to assess your needs, here are some basic evaluation tools you can do at home:

Lying

What is your sleeping position at night? Do you wake up on your side, back or stomach? What is the firmness of your mattress? The answers to these three simple questions can provide insight into sources of pain.

For example, if you are a side sleeper, a pillow may help to facilitate proper spinal alignment and improve awareness of your head position while sleeping.

Sitting

Look at the types of chairs you spend most of your time. Take notice how you are sitting (statically) right now as your read this article. What type of chair are you in? Do you sit with your legs crossed or do your feet rest comfortably on the ground. Are you in a comfy couch or recliner? How supported is your pelvis and low back?

desk posture

If you have a desk job, there is a lot of time spent sitting. Assessing the support of the pelvis and lumbar. A lumbar pillow or a rolled up towel can provide the support needed to improve posture.

Arrange your work space or sitting area where your feet can touch the ground and modify your setting to help you (eg. lowering your chair or putting your feet on a step). Also take note of where your computer screen is located as it should be eye level. Having good posture while you are on your phone or reading is also important.

Posture does not just apply to work. When you are at home, note where you like to sit. How supportive/unsupportive is that place? Do you take breaks to change positions while reading, studying, or playing video games? What positions are most troublesome? Small changes can help to improve posture and still allow you to perform your favorite activities.

Standing

Consider your daily activities (dynamically) including lifting, reaching, dressing, work and housework. Are you in a mostly forward position? Do you experience neck and shoulder pain with tasks? Do you feel your core muscles activating as you perform your daily activities?

Some things to consider with postural positioning in standing include your footwear, your desk and counter height. Do your shoulders lean forward? Does your low back bend forward? Is there back pain or shoulder pain with standing? Can you make small changes with how you position yourself while you wash the dishes? When dealing with childcare, monitor how you hold the child. Try to switch your positioning often from sit to side to decrease risk of pain.

I Have Bad Posture…now what?

Being aware of your posture is the first step. Before beginning any exercise program, it is best to consult your physician. Next, consultation with a medical provider, and ultimately a physical therapist, to assess muscular strength and deficits to create a well rounded program.

Exercises for Posture

Before you have the opportunity to be assessed by a physical therapist, there are some basic posture exercises that you can begin. If you are experiencing pain with any exercise stop and consult with a medical professional.

Scapular retraction

Sit with ideal posture (ear over the shoulder, shoulder over the hip and hip over the ankle) in a sturdy chair. Gently squeeze your shoulder blades together, as if you are going to squeeze a ball between them. Make sure your shoulders don’t begin to creep up to your ears. Perform 10-20 repetitions throughout the day to help improve postural positioning.

Upper trap stretch

trapezius stretch

Seated with ideal posture, gently tilt your head to one side, keeping your head over your shoulder. Keep your shoulder down. You should feel a gentle stretch in the side of the neck away from the direction you are tilting. If you need more of a stretch, gently pull your head towards your shoulder, like shown in the picture below. For an added stretch, you can put your opposite arm behind your back. Hold 20 seconds and perform 3 repetitions on each side.

Seated hamstring stretch

Balance Exercise 11a Hamstring Stretch

Seated with ideal posture, scoot toward the edge of a sturdy surface. Preferably a chair or table. Bring one leg forward and rest your heel on the ground, with your extended leg’s knee straight. Keep your back straight and lean forward until a gentle stretch is felt through the back of the thigh in your hamstrings. Hold for 20 seconds and perform 3 repetitions on each leg.

Corner stretch

corner stretch

Do not perform this stretch if experiencing shoulder pain. You can perform this stretch in a corner or doorway. Facing the corner in a staggered stance (one foot in front of another), place your hands on the wall about shoulder height. Gently shift your weight to the front leg, feeling a gentle stretch through the chest, or pectoral muscles. You should keep your head neutral (ears over shoulders) and looking towards the corner. Hold for 15-20 seconds for 4-5 repetitions.

Am I fixed yet?

Like anything consistency is key when it comes to posture. Rome was not built in a day, likewise your posture won’t be top notch after a few exercises.

Awareness and practice is the best way to improve your posture. Building positive habits takes weeks to months and consistency is key. The more effort and consistency on improving posture, the better it will become.

These exercises are not a means to an end, but rather a springboard to get you to “stand up straight”. Further consultation with a licensed physical therapist can further your progression and ensure better results.

This was a guest article by physical therapist Jennifer Heine, DPT. If you would like to contribute to the blog, you can learn more on the write for us page.

Tim Fraticelli DPT, MBA, CFP®

Tim Fraticelli is a Physical Therapist, Certified Financial Planner™ and founder of PTProgress.com. He loves to teach PTs and OTs ways to save time and money in and out of the clinic, especially when it comes to documentation or continuing education. Follow him on YouTube for weekly videos on ways to improve your financial health.