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The connection between posture and pain

24 Oct 2018 by Russell Visser


Have you ever experienced neck or shoulder pain from sitting in the same position for a period of time?

In our experience, most people who present with pain or injury have postural imbalances that contribute significantly to their problem. Improving posture, strength and mobility can help you move more freely with less pain and stiffness.

What we find in our assessments

 1. Tightness and trigger points in the muscles at the front of the chest and shoulder: usually the pec major and minor, upper trapezius and levator scapulae (which run from the shoulder blade to the neck) and biceps.

2. The shoulder joint is often sitting forward with posterior tightness in the joint capsule and weakness in the muscles that stabilise the shoulder blades and bringing them back towards the midline.
3. Restricted movement in the neck and thoracic spine, particularly rotation and extension and reduced  movement in the ribs.

Why is this important to know?

This posture results in an increase strain of the neck muscles because the head is pitched forward and it takes increased muscle activation to keep your eyes level.
Decreased mobility in the thoracic spine and ribs reduces capacity for breathing and full movement of the diaphragm.

These immobile and weak dysfunctional regions can also contribute to pain in other, more remote areas of the body.

Why does this happen?

Poor posture has become more common because many of our modern work tasks  involve prolonged  sitting and computer based work. We don’t move enough and our head and shoulders are held fixed and slumped forward.
A generation ago more people had manual jobs which required being on their feet, changing positions and moving between work areas. This constant movement allowed for better mobility in the neck and shoulders and strain did not build up to the same degree because of static loading.

Prolonged static postures cause a accumulation of strain in our bodies. When the amount of strain exceeds a safe threshold, our brains are alerted to send out protective guarding responses which can lead to feelings of pain and stiffness.

This protective guarding cycle leads to poor movement patterns due to pain and relative immobility.
All these are warning signs for us to change our behaviour or seek help.

What this looks like

Poor posture with head forward and shoulders rounded, leaning forward.

 

Good posture with sitting tall, neck and shoulders in alignment.

Standing posture.

 

What you can do about it

The first step is to change your posture so there is better alignment between you neck, shoulders and pelvis in standing and sitting. Good cues are to sit tall, draw in your chin and square your shoulders. In standing, try drawing in your tummy and standing tall.
If this does not help to reduce pain, careful assessment and then treatment to improve joint stiffness, nerve gliding, muscle tightness will reduce the protective guarding response initiated by the brain,improve mobility and reduce pain.

Along with careful systematic assessment and treatment, we also suggest three simple exercises to improve posture and joint mobility. The video below will take you through how to do these.

1.Step in front of an open door with your elbows and shoulders level and the forearm supported by the doorway frame. Gently lean forward and let your shoulders open up and feel a  stretch in the front of your shoulder and chest. Make sure you keep your neck neutral and relaxed as you perform this exercise. Hold for 10 seconds by five repetitions.

2. To improve the thoracic rotation sit in a comfortable chair with your feet flat on the ground to keep your pelvis stabilized. Gently turn your shoulders, turning your spine using your arms on your thighs to assist. Make sure you breathe normally and don’t strain. Hold the  stretch for 10 seconds and alternate from left to right

3. Sit on the floor with your knees bent and feet flat on the ground. Reach behind you placing your palms on the ground with your arms straight. From this position gently lift and open your chest while squeezing your shoulders back and your shoulder blades together. Feel a stretch in your chest and in the front of your shoulders. Feel the shoulder blades squeeze together. Do five stretches holding for 10 seconds.

These are three simple exercises that when done regularly help to gently and progressively stretch away from joint stiffness caused by prolonged sitting and working a desk or computer.
These exercises work both on mobilising joints and muscles and places a steady stretch on the connective tissue around joints which gradually adapt over time. These exercises work very well over time and should be incorporated into a daily stretching or warmup program.
Remember that mobility is the key to good health and as a consequence you have more freedom of movement, can exercise more effectively and just feel a whole lot better.

How you can self test

Do a quick scan of your mobility by first looking at your posture in the mirror. Is your head forward with your shoulders slumped and rounded?
Try turning your head to either side and then your trunk and reaching overhead. How far can you go? How comfortable is the movement?

If indeed you do feel your movements are restricted or painful, it may be worthwhile to start these exercises.

If you continue to have problems with pain or stiffness and  would you like more information about managing these issues.

Feel free to call us at Northwest Physiotherapy Group, either through our website or message us through our Facebook page.

We are here to help!

 

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