POSTURE - Why it is important and how to improve yours!

What is GOOD Posture? (Aside from looking better, feeling better, functioning better, and having less associated pain):

(The technical explanation) Proper posture ensures that the muscles and joints of the body are aligned optimally, and at the proper “Length-tension” relationships necessary for EFFICIENT FUNCTIONING of “force couples” of muscles, as well as associated joint motions. This means the nervous system can properly recruit all muscles in all planes of motion necessary.

Why it is GOOD posture important? (just a few points on the lumbar spine regarding posture)
-Lumbar disk compression while seated: 30-40% more pressure on disks than standing (with ideal posture) - mainly because the pelvis is immobilized
SO if you sit a lot (have a desk job?) Maintaining optimal spinal alignment seated is critical!
-Flexion of the spine in standing decreases disk integrity by 50%-Adding rotation to flexion decreases disk integrity by another 25%.
-This is a 75% reduction in disk integrity during combined flexion and rotation!

Next, what is "core" stabilization and why is it important?
The core is often defined as an "inner core", which stabilize the pelvis and spine. They are the "deep" muscles that provide stability to the spine/pelvis/hips, etc, while we "use" our body, arms, legs, etc. While the inner core works directly with the "outer core" muscles, they are under separate neurological control. Therefore doing crunches/low back exercise DOES NOT strengthen these inner core muscles (this is proven in many Peer-reviewed studies!!!).

Specifically, the inner core is composed of: Transversus Abdominis (TVA), which is the deepest ab muscle, diaphragm, mulifidus (segmental spine stabilizers), and pelvic floor muscles.

Then there is the "outer core" or "global movers", which move the body in gross movements/large motions (i.e. "abs, erector spinae, external obliques, hip flexors, etc).

Both the Inner Core and Outer Core MUST work together effectively to control posture and stabilize the spine. If the inner core is not working effectively (which is common with postural deviations, low back pain, and is statistically linked more to females (see below))... then pain, dysfunction, altered structure, and even dreaded "paunch belly" can result!

Many people have weak "inner core" muscles, and thus experience back pain, dysfunctional postural patterns, and altered movement in not only the spine and back... but the extremities, feet, head, shoulders, and entire body. This is because the body is connected as an "integrated unit"... so that movement in one area, affects movement in another area. Sometimes however, is there is a "weak link" in the chain, compensation will occur, and as the saying goes, the strong get stronger and the weak get weaker".

Therefore it is necessary to first assess if one has a weak "foundation" for the spine and pelvis... which is the true "core" of the body. As the saying goes, you can't fire a cannon from a canoe! So it is with our core...

Testing the TVA/inner core....

Assess movement: Hand-on (literally), string/forward bend test (string should loosen), prone TVA draw (cuff to 40mm/hg draw decrease 10mm/hg)
Testing inner core/outer core integration... TVA activated, spinal stabilizers (posterior pelvic tilt held), legs up/down with pressure of spine still on fingers

After testing, if you have a weak/dysfunctional core, you need to work on "activating" it!!! This should be done BEFORE working on outer core intensely, and other posture work, as it is a very important key to avoiding injury!


How Does YOUR Posture Measure Up?

Start by taking a good look at the way you usually stand, either by having a friend take a side-view picture or by standing sideways in front of a full-length mirror.
-Does your head protrude forward? Is your upper back hunched forward in a rounded curve? Do your shoulder blades stick out? Do your shoulders round over and fall forward? Are your shoulders tensed and held up closely to your ears? Is your abdomen protruding forward into a potbelly? Is your lower back arched or swayed? Are your knees locked back? Do your ankles roll in, causing your arches to flatten?

These are all common posture problems.

Now remove your shoes and stand with your back against a wall. Place your feet about six inches away from the wall, and hip-width apart. Is there a big gap between your lower back and the wall? Is there a gap between the back of your neck and the wall? Can you not get the backs of your shoulders to touch the wall? Can you not touch the back of your head to the wall without arching your neck? Again, all of these are posture problems.

What is Good Posture?
When you are standing correctly: Your ear, shoulder, and hip are in a straight line from a side view. Your head is directly on top of your shoulders. Your upper back is fairly straight (not slouched). Your should blades are lying flat against your back. Your Shoulders are straight and relaxed. Your pelvis is in a neutral position. Your knees are unlocked.

THE KEY to effective stabilization, posture, strength, and flexibility:

SO PROIRITIZE stretches and exercises!

***STRETCH only tight muscles, do not overstretch areas that are not "tight", and may have "laxity" in the join/ligaments.
***STRENTHEN the weak/lengthened. Often these are postural muscles (and often posterior/backside muscles), and on the opposite side of the tight/facilitated muscles that should be stretched. See below for more details.
-Watch form on repetitive movements (i.e. increased exercise or "cardio")
-Be careful to not reinforce compensation patterns (strong-stronger, weak get weaker)
-Neutral grip on machines -watch shoulder elevation and rounded shoulders
-With increase walking/running/most "cardio" - Stretch hip flexors/calves in particular
-Consider foam rolling calves, adductors, IT band, TFL, Lats



SLEEP POSTURE: · The position you sleep in makes a huge difference in how your back feels when you wake up. So whether you prefer medium firm mattresses or concrete hard, it is total personal preference. · What is important is that you always keep your head aligned with your spine. You can strategically place pillows to keep your self in alignment even when you sleep. For instance, side sleepers need to make sure the pillow width is not too low or too high. Back sleepers need to make sure their pillow allows their face to be level with the ceiling. Stomach sleepers only need a very thin, flat pillow . When sleeping on your back, no pillow under the head would be fine but a pillow under the knees can be helpful in keeping the lower back in a neutral alignment. Also, when sleeping on side a pillow between the lower legs can take stress off of the hip joints and lower back.

WORK SURFACE: · Work surface is at elbow level. · Monitor isn't too low or too far away, which will cause you to sit with a forward head position all day. Eyes should be level with the mid to upper part of screen. · Sit with your pelvis in a neutral position: sit squarely on your "sit" bones. Don't let your back bow out behind you. Torso should be an arm's length from the computer screen. · Thighs should be at a 90-degree angle with torso, lower legs at a 90-degree angle with thighs, feet flat on floor. · Don't sit for hours at a time. Every hour or so get up and move around. · Use a copy holder to keep your work at eye level.

STRETCH: · Every hour take a minute and stretch. Place your hands behind your head. Lift shoulder to ears and then press them down as far as you can. Inhale. As you exhale, tighten your abdominal muscles and press your elbows back. Think of squeezing something between your shoulder blades. · Also, you can expand on the abdominal tightening part. Inhale and expand your rib cage as you fill your lungs with air. When you exhale, pull your belly button into your spine and try to feel the bottom of your ribcage pull in as well. Hold for five to 10 seconds, without holding your breath, and repeat a few times. SHOES: · As long as the foot is held level in the shoe, as in athletic shoes, I think it is fine. Wearing heels alters the position of every weight-bearing joint in your body. Heels higher than 1 inch increase a swayback and causes the foot to slide forward in the shoe, putting pressure on toes. Even a 1-inch heel causes a 12-degree tilt in the ankle joint, which in turn cases all the other joints to adjust so you don't topple over · Orthotics/Properly fitting shoes 1) Arches 2) Gait 3) Pronation?

POOR POSTURE AND BACK PAIN: Poor posture places abnormal and uneven pressure on muscles, disks, soft tissue. If your upper back is too curved or lower back sags forward, or your head doesn't sit directly over your shoulders, then the curves of the spine are exaggerated, which places uneven stresses and strains, mostly on muscles but eventually on joints.

Detailed Postural assessment (below) - pratical – static/visual assessment - advanced – overhead squat, pull/push movement analysis, gait assessment on treadmill, etc

A) upper crossed – rounded shoulders and forward head posture -tight/short: pecs (weak rhomboids); -tight: pec minor, levator scap, upper trap (weak lower traps, ant. serratus); -tight: anterior delt (weak posterior delt) -tight: Internal Rotators: subscapularis, (also teres major & lats); ((Weak; External Rotators (Infrasinatus/teres minor, posterior delt) -tight: Sternocleidomastoid, scalenes, rectus capitus (weak: Longus Coli/Capitus)

B) lower crossed – anterior pelvic tilt & increased lumbar lordosis (aka “arched” low back) -tight/short: iliopsoas (hip flexors which attach into iliac & T-L Spine) (weak: gluteus max); -tight: rectus femoris (weak: hams, glutes) -tight: TFL (weak: gluteus medius) -tight: Adductors (weak: gluteus medius) -tight: Erector Spinae (weak: Transverse Abdominis, Internal Obliques, Multifidus) -tight: Gastroc/Soleus (calves); (weak: anterior/posterior tibialis)

C) pronation distortion – excessive foot pronation, knee flexion and internal rotation, and valgus (knock-kneed) position during functional movements -tight: peroneals (weak: post. tibialis, flexor digitorum,/hallucis longus) -tight: Gastroc (calves); (weak: anterior tibialis) -tight: soleus (weak: posterior tib) -tight: IT Band/Hamstrings (weak: vastus medialis) -tight: adductors (weak: gluteus medius) -tight: iliopsoas (hip flexors); (weak: gluteus maximus) -

Questions?
Contact me at: Jason@jasonmaggard.net