Posture

Feel Better – Look Better

Poor posture is readily acknowledged but rarely proactively addressed in the gym.  We all know that we don’t stand or sit as straight as we should - when’s the last time you got within a foot of your car’s headrest? What’s more worrying in my opinion is that all too often we accept poor posture and the daily aches and pains it brings with it.

What would you give to get rid of your lower back pain, headaches, aching joints and sore muscles? Some of these things actually become so much a part of life for some of us we don’t even stop to consider how good we COULD feel without them. Of course there are some conditions that will affect posture on a structural level and therefore concessions must be made in your training to work around them.  Trauma, for example, may render a particular joint or muscle incapable of performing certain movements but your best efforts should be made to keep things working as much as they possibly can.

There are all manner of reasons as to why our posture can suffer, not least our deskbound way of life, stress levels (stress and psychology as a whole play a huge part in posture) and a cervical spine more adept at looking down at a mobile phone than holding our head up.

Posture is partly down to awareness and conscious thought but it CAN be trained. I don’t like my clients to try and force themselves into ‘correct’ posture but instead to learn what it feels like through good exercise technique in the gym. This is largely because trying to hold yourself consciously in position every second of every day in the vain hope that it’ll stick usually ends in new problems and an awful lot of frustration.

We inevitably end up avoiding certain movements, activities or exercises that we either find difficult or altogether impossible, rather than questioning WHY we can’t perform them correctly or without pain. By eliminating the movements we struggle with, we inevitably favour exercises that we CAN do (largely because they make use of - rather than conflict with- our imbalances) and often this only serves to exasperate the issue that was hindering us in the first place. Gradually over the course of time we will notice that our progress is slowing and our repertoire is dwindling.

People will also claim that it is a question of what you are trying to achieve through your training and therefore whether a particular exercise is essential in the first place. Are barbell deadlifts and squats essential? Certainly not in most cases, but desirable? Oh yes! They are both incredibly valuable movements that a healthy body should be capable of completing accurately. They will have a positive effect on posture itself (when done correctly), athletic performance and on body composition as a whole.

At any given moment in time you may not be able to complete a particular exercise with proper form to keep you safe, and therefore alternatives must be employed to work the same muscle group in a safer manner.  This should be a means to an end, not the permanent solution that it usually becomes. We should be using these alternatives to help correct the imbalances that forced us away from our original plan in the first place. Yes, you should use an alternative but with a view to improving your posture to a point where the original exercise can be completed safely.

I can fully understand (first-hand, trust me) how frustrating it can be having to take steps backwards to correct an inherent flaw or imbalance with our posture that is preventing us from completing a seemingly non-essential movement in the gym. After all you could just do something else instead right? That, however, is wilfully disregarding what your body is trying to tell you – something isn’t right, help!

In the simplest and most painfully honest of terms – we don’t want to take the time to correct these problems when we could just bypass them and get on with the elements of the ‘fun stuff’ that we can manage.

Diagnosing the causes of poor posture can be complicated and the correctional techniques very particular – even as Personal Trainers it can often fall outside of our level of expertise and more often than not requires the input of more than one profession to get the complete picture. Certainly it is not in the realms of self-diagnosis. It can be confusing as the pain caused can often be referred from an entirely different area of the body and often the reported problem is in fact a symptom of compensation being made to accommodate a less obvious problem.

When injured, the body can make neurological alterations extremely quickly (hours, not days) that will alter how your bodyweight is distributed in order to protect the afflicted area and allow you to carry on with life. This however can instigate a posture-destroying domino effect as one joint/muscle compensates for another and this in turn effects how the next joint/muscle in the chain is loaded. And so on and so on…

Below you will find out about some of the more common postural imbalances we encounter here at TSC. Look familiar?

Kyphosis

The term Kyphosis refers to a rounding of the thoracic or sacral regions of the spine.  Whilst a healthy spine will have a natural thoracic curve (20-45 degrees) anything beyond 45 degrees is considered as Hypokyphosis and could result in pain, breathing and digestive difficulties as well as neurological compromise (loss of balance/coordination).

There can be several causes of an excessive kyphosis namely:

• Poor posture (postural kyphosis – most common).
• Malformation of vertebrae (Congenital Kyphosis).
• Degenerative diseases (Arthritis).
• Developmental problems (Scheuermann’s disease, Osteoporosis).
• Trauma of thoracic vertebrae.

Most of these conditions require medical intervention depending on the severity and cause of the curvature. These could range from corrective braces to surgical procedures and - in the instance of degenerative conditions - specific exercises to prevent stress fractures of the vertebrae that can worsen the condition. As a general rule, these cases are best referred to a specialist, and those suffering from osteoporosis or arthritis should be advised to avoid any exercise requiring ANY degree of spinal flexion. For this reason we will concentrate on remedial exercises to address postural kyphosis only.

Forward Head Posture (FHP)

Forward Head Posture (FHP) can result from muscular imbalances in the cervical flexors and extensors that require redressing in order to return normal position as well as range of movement.

FHP can also be caused by of more widespread tightness in the both anterior and posterior thoracic musculoskeletal system (tightness of the pectorals, latissimus dorsi, anterior deltoids and abdominals, as well as elements of the rotator cuff or reciprocal weakness in the rotator cuff and rear deltoids and rhomboids). In other words it is often a product of underlying kyphosis.

 

 

Anterior and Posterior Pelvic Tilt

An anterior pelvic tilt occurs when the hip flexors (iliopsoas, illiacus and rectus femoris) shorten and the hip extensors (gluteus, hamstrings, and adductors) lengthen causing the front of the pelvis to drop and the back to rise*.

It should be noted that this, in my experience, is the most common postural issue we see in the gym due to the sheer amount of time we spend sitting down – stretching the extensors and tightening the flexors for hours at a time almost every day of our lives.

Inversely, posterior pelvic tilt occurs when the hip flexors lengthen and the hip extensors shorten causing the front of the pelvis to rise and the back to drop**.

The pelvic angle can be assessed simply by finding the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) processes of the pelvis and measuring their relationship to one another.  Without radiography, it is impossible to calculate the precise pelvic angle, but with a normal tilt using this method the ASIS should be 6-13 degrees below the PSIS and the angle tends to be slightly greater in women and slightly more acute in men.

*It should be noted that in the instance of an anterior tilt the muscles affecting the hip joint form a ‘force couple’ with corresponding muscles of the abdomen (rectus abdominis, obliques) to produce the position and therefore both must be taken into consideration when attempting to correct posture.

** The muscles affecting the hip joint during a posterior pelvic tilt with form a ‘force couple’ with the erector spinae in precisely the same manner. 

The Road to Recovery

So how can we improve our posture and get our bodies back to working the way they should do? In essence it is a very simple and methodical process:

1. Acknowledge your limitations. To start with, identify the exercises or activities you can do, either at all or with perfect form. If there isn’t a traumatic or structural reason as to why this is the case then we may be on to something.

2. Yoga. Taking a Yoga class is a pretty good way to find out how your body moves – or not as the case may be. Since being injured myself, I cannot advocate this discipline enough, and there is good reason why Yoga has been adopted by more and more sportspeople the world over.  Even if it’s not something you continue to use as part of your overall program, it might just highlight something that is clearly out of place.

3. Don’t accept the aches and pains. If something hurts – get it looked at! Too often people carry on with training whilst injured and just try to work around it. Stop it - it may well lead on to bigger issues if left unchecked.

4. GPs are not your best port of call for musculoskeletal problems. GPs are brilliant professionals but this isn’t their area of expertise – they can refer you to someone (and more often than not should do) but I can’t accept the “go home and rest” response when they can’t work out what’s wrong with you in the measly 10 minutes they get.

5. Don’t disregard a diagnosis because it doesn’t correspond with a previous one. Different professionals come at things from different angles, this means that they often cite different reasons for the same overall problem. Sadly they may all be right!

6. Do not give up. I have trained for years for various different reasons. I’ve done a bit of everything from training for aesthetics (we were all young once) to sporting performance and I can honestly say that this is by far the most rewarding use of my time. You will still have bad days from time to time but the days when that pain isn’t there are worth every second of toil in the gym.

 

I hope that from the sheer size of this article you can appreciate the complexity of the subject in question. I hope you can also tell how passionate we are here at TSC to helping you be the healthiest, happiest, pain-free version of yourself. Please feel free to make an appointment with one of the team to discuss your posture and the best course of action.

 

Patrick Latter

Personal Trainer and Fitness Instructor