Unless we are born with a structural or functional abnormality, as we develop from infancy our posture naturally forms as an optimal relationship between our joints and gravity. Our spinal curves are properly proportioned, with the weight of our head balanced on top of our spine. Our shoulders hang relaxed in line with our ears, our pelvis sits in a neutral position, and our body weight is centered over the arches of our feet.
This posture is achieved and maintained through soft tissue quality and nervous system activity. Our bones are not stacked like blocks to create joints. They are held in suspension through tension maintained within the soft tissues. Tension is created and adjusted by impulses from nerves that are coordinated in the brain and spinal cord. The relative tension of muscles and connective tissues on opposing sides of a joint determines the local position of the joint structures.
The body-wide fascial (connective tissue) network that wraps and supports every structure of the body in a continuous web provides for tension pathways that span the entire body. This means that the position of one structure affects, to a greater and lesser degree, the position of every other structure within the body.
Our bodies must always maintain muscle tension and activity throughout the body to hold all our parts together as a whole and perform essential functions like respiration, circulation, and digestion. Additionally, tension must constantly be adjusted to our environment and desires to move.
This complex task of managing muscle tension depends on two components. First, is the intake of sensory information from various sources. These sources include the vestibular system within our inner ear, sensory nerves within muscles, tendons, and joints, and visual input from our eyes. These sources provide information about the tension, length, and rate of change of muscles, the position of joints, where we are in space, and how we are balanced within gravity.
The second component of managing muscle tension is the processing of sensory input and the generation of motor nerve impulses that stimulate responding muscle activation. The unconscious maintenance of posture and essential muscle activity occurs in the brain stem. Fine-tuning of balance and motor control is layered upon the brain stem’s activity by the cerebellum. And from our cerebrum comes another layer of impulses that execute conscious decisions about posture and movement.
All aspects of our life strongly influence these activities of the nervous system. How we hold ourselves up in the world reflects all our inward and outward experiences. There are reciprocal relationships between tissue quality, repetitive movements, prolonged postures, thought patterns, emotions, and what form our posture takes. This means that our thoughts and emotions change our posture, and this new posture affects how we feel mentally and emotionally. It also means that our repetitive movements and prolonged postures change our posture, and these changes affect the quality of our soft tissues. This in turn affects our ability to move freely with optimal joint alignment.
Likely most people living today in industrialized areas of the world experience a degradation of posture away from optimal alignment and a decline in range of motion as they age. Part of this can be attributed to inevitable forces in the aging process or results from injuries or illness. However, the onset and degree of these changes are dramatically influenced by lifestyle factors over which there is a large potential for personal control.
Speaking from the perspective of what appears common in the United States, our naturally formed posture of early childhood begins to be radically impacted upon entrance into school. Here children are trained to sit for long periods in chairs with little to no guidance or encouragement in proper sitting posture. Most are put in shoes with a padded cushion that lifts the heel higher than the toe surface putting the entire muscular chain of the back side of the legs in a shortened position. Most notable is the decline of physical activity and outdoor play among children as our population has generally become increasingly sedentary.
The effect of prolonged sitting on posture is profound. There is a strong tendency for the abdominal core and spinal stabilization muscles to soften and shorten along the primary curvature of our spine (creating our fetal position) increasing the curve of our mid and upper back so that we are bent forward. When this occurs, the head and shoulders follow into a forward position. The hip flexor muscles within the pelvis and running down the front of the thigh are also held in a shortened position because sitting decreases the angle of our thighs compared to our hips from 180* to about 90*.
Two compensations tend to arise in the secondary curves of the spine (those we create to achieve an upright position) in the lower back and neck as a response to the increase in the primary curve. As the head moves forward with the increased curve of the upper back the head must be lifted to prevent the eyes from looking downward which increases the curve of the neck. When the hip flexors become habitually shortened and no longer return to their optimal length this creates a pull on the pelvis that can result in the pelvis’ resting position having a forward tilt. This increases the curve of the lower back as it must further extend backward to pull the torso upright in opposition to the forward tilt of the pelvis. These two compensations create the tendency for excessive compression of the vertebral discs in those two locations. This increases the possibility of disc damage, vertebral slippage, and disturbance of the spinal nerves.
Continual use of a computer that is positioned so that one or both arms must be continually raised holds the shoulders not only forward but also up toward the ears. The holding of the shoulders forward and upward is also exaggerated by fear, stress, and anxiety as this posture expresses fright and protection. A collapsed, slouching posture is not only created by physical conditioning like curling up on sofas or looking down continually at a phone, but it can also reflect depression, rebellion, withdrawal, or other dark emotions.
The longer postures and repetitive movements are engaged in the more the tissue quality is affected. Muscles that are continuously contracted develop a higher resting tone over time. This means that muscles no longer return to the same length and level of relaxation as previously done. Additionally, the connective tissues surrounding and binding muscles to each other and various structures compact and harden reinforcing the new positioning. Over time tissues are potentially remolded in dramatic ways to reflect a person’s physical and mental habits.
The degradation of posture negatively impacts our physical and mental health. It decreases our ability to breathe fully, for blood and lymph to circulate freely, for our joints to move in a full range of motion and with proper alignment, and for our organs to operate optimally.
Joints that are out of alignment do not move along the pathways that they were designed to move. This can lead to the grinding away of protective cartilage within the joints, compression of nerves, and increased risk of injury from degraded stability.
When we do not hold our spine long and upright our diaphragm and lungs cannot expand fully to allow full, deep breaths. Shallow breathing reduces the amount of oxygen available to all the organs and encourages a stress response within the body. This hampers the body’s ability to digest, metabolize, and eliminate properly. It also decreases mental acuity and memory recall. With less oxygen reaching the brain and higher levels of stress hormones circulating, feelings of unease, anxiety, and depression will have a greater tendency to be present.
Improving posture becomes increasingly difficult as we age because the habits that created our posture are more entrenched both in the wiring of our brains and in our soft tissues. Additionally, since our resting or normal posture is largely controlled unconsciously, we are frequently unaware of how we hold our bodies. Fixing posture requires an integrated approach that incorporates analysis and interventions into our joint alignment and tissue quality and consistent, prolonged cultivation of awareness of what our bodies are doing.
Improving joint alignment requires identifying imbalances in muscle firing and adhesions in connective tissue. Muscles held in a chronically shortened position need to be stretched while the muscles on the opposite side of the joint that are over-stretched and weakened need to be strengthened and encouraged to fire. Lengthening of shortened muscles and breaking excessive bonds in connective tissue that restrict the range of motion can be done with static stretches, self-myofascial tools like foam rollers, or by a massage therapist. Muscle strengthening must focus on deep, small, stabilizing muscles, not on superficial, big-mover muscles. This means working to balance on one foot and doing deep squats in good form before picking up weights.
Cultivating improvements in posture behavior requires analysis of sitting and standing posture, walking gait, and how we hold ourselves while we work. This may mean getting assistance from someone who can give us observational feedback. It may also mean looking at the arrangement of our workstations or how our joints are aligned while doing repetitive tasks. Generally, we must sit less, move more, stretch often, eat nutritious food, and drink water. Above all, it demands our attention. We must continually remind ourselves to look at how we hold our bodies and adjust them to an improved form.
Fixing posture is not easy, particularly the older you are. It may involve discomfort and it certainly takes patience and sustained effort. However, the results of the work to reverse or at least slow the degradation of posture are mighty as they potentially improve body-wide systems function, reduce pain, improve range of motion, and decrease the risk of injury.