By Dr. Scott Wacker | PT, DPT, OCS, CSCS, CGFI-M3, MCT
CD: What does good posture mean? What does it look like? How do you know if you have poor posture? And what is “text neck”?!
SW: Good posture refers to the ability to effectively maintain an efficient body position that minimizes physical stress on the body. This generally refers to an upright and precisely stacked position with minimal deviations forward and back, side to side and overall symmetry left to right. It could refer to being seated, standing, or while performing activity etc. Detailed analysis or even just eyeballing photos from the front, back, and side can help you know if there are deviations. There are even Apps for your mobile device available to assist the analysis. Outside of appearance, another indicator of bad posture can also be pain. Back and neck pain, shoulder and hip, even headaches and numbness/tingling (such as sciatica or carpal tunnel syndrome) can all be correlated to poor posture. A good Physical Therapist or other musculoskeletal professional can help sort this out. "Text neck" is the unfortunate result of sitting and staring at our devices for too many hours of the day. I'm sure we can all picture what it looks like when someone is holding his/her phone in one hand and staring down at it while texting. The result is a neck position that is unfavorable with plenty of stress on your cervical spine.
CD: Why does good posture matter? What are some health problems that might arise from poor posture?
SW: Posture matters because if you are not efficiently stacked to minimize the negative effects of gravity for extended periods of time, undue stress occurs throughout the body. This can happen in a variety of tissues and oftentimes becomes noticeable in the form of pain. As stated above, poor posture can result in back and neck pain, shoulder and hip pain, headaches, and numbness and tingling down arms and legs.
CD: What are a few ways to improve your posture?
SW: The first way to improve posture is to know HOW it is bad. Which areas of the body are taking the stress and are there mobility issues or strength issues, or a combination of the two? Again a good Physical Therapist can help with this and to rule out any red flags AKA potentially serious underlying medical issues. Once this step is taken care of, consideration should be given to removing environmental factors contributing to WHY postural faults are present as well as treatments and exercises to correct poor posture. For example, some of my favorite mobility drills commonly target tight hips and flexed or rounded thoracic (mid back) regions. Postural strength can be reinforced with gravity enhancing exercises such as overhead press, deadlifts, jumping rope, crawling, farmer carries, hanging, etc. These all inherently teach postural verticality! If nothing else, avoiding being in any one position for an extended period of time and instead focusing on assuming a large variety of body positions can improve your posture.
CD: If someone has been slumping their whole life, is it “too late” to work on posture? Is the damage already done?
SW: As with many things in life, some irreversible effects can come from years or decades of bad habits. However, this does not mean enough progress can’t be made to feel and look better regardless of age. One thing is for sure, continuing to slump and not attempting to correct postural faults will only accelerate the process.
CD: With millions of people now working from home we are sitting and on devices more than ever. I’ve read to raise your screen to eye level, get an external keyboard + mouse and hold your phone up to eye level when using. True? Do we need a fancy chair? What are you suggestions around setting up a workspace and using Technology?
SW: My number one recommendation is to have a variety of positions you can get your body into versus relying on a single perfect ergonomic position. It’s ok to sit some but try to not sitting in a chair for a change. Instead, sit in a variety of positions on the floor. Kneel, lay down, stand, squat etc. Indeed there are a number of good tools to assist ergonomics but don’t forget even with the perfect ergonomics, any one position becomes repetitive for your tissues quickly so keep moving!
CD: What about kids who are now also sitting and on devices up to 8 hours daily? What are their health risks and how can we help keep them healthy?
SW: Just as with adults above, variety is key. They should be kneeling, standing, on their tummies, taking motor breaks, etc throughout those 8 hours. In the bigger picture, we have to admit the human race has surely done itself a disservice by telling kids not to wiggle once they get to school age. Do you ever wonder why inherently kids are amazing movers on playgrounds as they near school age and by the time they graduate from college are unable to do many of the physical movements they once were able to? School and our conventional lifestyles may train the brain (or at least the touchscreen fine motor skills) but certainly have tainted posture and how well we physically move. Let kids move and encourage a variety of positions. Balance out indoor screen time with anything and everything moving though nature and the outdoors!
CD: There are also many people now working out at home and utilizing workouts via their TV screens, iPads and phones. Any suggestions for people on an at-home exercise space around things to watch out for or how to set it up in a way that encourages good posture?
SW: A few suggestions: Choose programming/instructors you are familiar with who use good verbal cueing so you don’t have to constantly be looking at your device. Use earbuds or bluetooth speakers to amplify the sound. Utilize mirrors when available to help mimic and correct position and technique. Try to place your device where you can keep your head/neck neutral and be willing to move your device as you go on/off the floor for instance during a workout. Perhaps you want to use your 70” flat screen on the wall to watch your home workout vs your 5” phone? Otherwise remember a theme of stacking your spine and good posture especially as you get fatigued. Once good posture and/or technique is lost during a workout, it’s not ok to slop through more repetitions or add more weight to the workout and continue.
CD: Does footwear matter? Do I have to give up my ugg boots?
SW: This is one of my biggest pet peeves, footwear. Do you think a skyscraper would ever stack up and stand tall with a tilted or squishy foundation? Of course not! Our feet are designed to give us input up the line contributing to posture. Fat Foamy shoes and or lifted heels thwart neurological information, demand postural compensation, and sacrifice us physically in so many ways. The solution is simple. Be barefoot as often as possible (like indoors or in your yard). Otherwise opt for zero-drop (flats) and minimalistic style shoes. One company that qualifies and offers a great variety of casual and fitness shoes is Vivobarefoot. (Maybe they will send me a promo pair for mentioning them!?)
CD: What about how you sleep? Side vs back vs belly? Impact on posture?
SW: The important thing to remember about sleep is that getting consistent, restful sleep is important nightly. Making yourself try to sleep in positions that aren't natural for you and stressing out when you wake up in your go to position is counterproductive. With that said, try to avoid face down (prone) as your go-to position if you can help it. Inevitably this encourages an extreme neck position which will become dominant to one side. Then feeds into a postural asymmetry. Otherwise use (and don’t use) pillows to keep the spine reasonably in-line. All too often heads are propped significantly out of position by big pillows.