Does bad posture lean to pain… Posture is often talked about, in the past it was thought that bad posture would lead to pain and for this reason we should always sit or stand up straight. Fortunately, this has been shown to not be true.
We cannot make broad assumptions that bad posture will inevitably lead to pain within the body but we do know that some injuries are closely linked to certain posture adaptations. It is for this reason that a postural assessment could give you a certain amount of information as to where you might be vulnerable and what exercises or changes could be done to help minimise your risks.
Let’s discuss what circumstances can lead our bodies to adapt certain faulty postures; the leading trouble maker is our work space ergonomics. Where the body spends most of its day is where certain muscles will get lengthened and others shortened over time to accommodate that posture. The muscular fascial system may in turn influence the skeletal system and this where it starts to get difficult to reverse the process. Then of course there is genetics – like father like son. This should be taken note of but can also be controlled to a certain degree through exercises and stretches so that we do not necessarily inherit our mother’s bad neck posture. Lastly, pain is also a factor that should be considered and will often result in habitual postures being adapted to lessen the pain.
Asking the patient to stand and assess their alignment and posture is not enough as these can change dramatically when at work and/or sitting. Static posture is best assessed when the client has been in their working environment for a period of time. At first when you assess the client the posture is normally different but after a few moments they relax and then you can see their true “resting posture”.
If you notice some specific movement faults, examining the different muscles and joints to see if they are lacking range and or strength is important. Just asking the patient to sit up straight is not enough. You have to make sure that the desk set up allows the patient to sit properly while also seeing if their musculoskeletal system allows them the freedom of movement to be in the correct alignment.
Postures develop to allow the person to cope with their environment, and their musculoskeletal system will undergo changes to accommodate that environment. For example, someone spending hours sitting at the computer with their shoulders forward and in a slump position will over time find their front shoulder and chest muscles will tighten in the shortened position while their back shoulder muscles will lengthen and become perhaps lazy. These changes allow them to cope with that sitting posture at work but when having to go play tennis or golf could often hinder the movement or the performance and lead to pain.
When doing a postural assessment we believe that the therapist should not only spend time addressing the static posture at their work station but should also establish through a series of dynamic tests where certain areas are at risk and where the kinetic chain is restricted or perhaps weak and/or lacking stability. As physiotherapists we are trained to identify faulty movements and can easily advise specific individual exercises and different stretches to alleviate and prevent posture related injuries.