The lifestyle we know today differs from the one known centuries ago in essentially every aspect. The majority of changes were beneficial (less manual labour, technological advancement, etc.) but with such came also unfavourable modifications. In the context of today’s article, we will focus on one of those – the abundance of sedentary behaviour.
Nowadays our lifestyles became considerably more sedentary, but mostly more stressful, resulting in negative consequences regarding physical fitness and body posture. Those changes inevitably lead to experiencing feeling unwell, headaches, misalignments and pain in virtually every body segment. Regarding workplace environment consequences as such can be seen as a decline in productivity, motivation and increased time off work.
“Regular physical activity with an emphasis on physical strength is a NECESSITY for healthy and quality life – adequate posture will come as a result.”
What is body posture?
Before further usage of terms like good and bad posture, it is high time to elaborate on the definition of what posture even is. Posture is the fundamental position of the human body and its segments when in a motionless position (standing, sitting, laying down) or when in motion. Throughout history, human beings have had drastic evolutionary changes regarding anatomical structures and their functionality, resulting in what we call today a standing posture. The main reason for such changes was enabling a two-legged type of walking which is uniquely human. For those modifications to happen our bodies had to adapt by adjusting musculoskeletal structures in hip joints and the lumbar region of the vertebral column and furthermore resulting in pelvic tilt changes.
“Favorable stance is by definition a reflection of a good level of physical fitness, where muscles can adequately support your body by maintaining its stability and creating efficient movements. Therefore the standing stance is the attitude assumed by the body in which the least strain is placed upon joints and their surrounding structures”
Role of antigravity muscles
Standing posture is primarily enabled by the spine and so-called: “antigravity” muscles. This otherwise eminently complex anatomy of the mentioned segments can be divided into two systems, the passive system (bones and joints) and the active system (muscles and ligaments).
The fundamental part of the passive system is the vertebral column, which is shaped in the healthy curvature also known as the double-S curve. The cervical and the lumbar regions are known as two lordosis ( the inward curve) and the thoracic region is known as a kyphosis (the outward curve). Such curvature dictates the shape of the skeletal structures so that the centres of gravity of the structures are superimposed on the same optimum weight distribution line resulting in trunk stability and acting as a shock-absorbing mechanism (Schuler in Waldmann, 2011). As such, we can hardly improve the passive system through the perspective of stance correcting and exercise.
However, we can have an immense impact on the muscles of the active system, which controls our stability and stance. The antigravity muscles are a specific group of muscles and as can be understood from the name their main function is to counterbalance the pull of gravity and maintain an upright posture, enabling body proportions and good balance. Considering the number of muscles in the human body, antigravity muscles come short in numbers, nonetheless, they are considered one of the strongest. Some examples of the mentioned antigravity group are cervical and abdomen muscles, erector spinae, gluteus maximus, iliopsoas, quadriceps femoris, hamstrings and lower leg muscle group (Caprenter, 2019). Sufficient strength and flexibility of mentioned muscles are a prerequisite for “good” posture, while also ensuring the protection of the spine (abdomen muscles play a crucial role in ensuring pressure regulation in the abdominal cavity while in movement).
In addition to the required strength and flexibility, a fitting neuromuscular control is likewise a necessity. With the upright stance, there is a constant need for adjustments when displacing or moving oneself in order to achieve a so-called dynamic balance (Burgar, 2017). As a solution, our nervous system regulates such balance by maintaining “tonus”, a continuous partial contraction of the muscles attached to body segments.
Reasons for why and how misalignments in posture occur?
Nowadays we are living quite contrasting to centuries ago, hence our antigravity muscles are not as adequately strengthened and aware of their activation, resulting in stance misalignments, which lead to corresponding pain and complications.
“Charles Sherrington, a neurophysiologist said in 1931 that “A stance is like a shadow following body movements”
The emergence of bad posture corresponds with the adaptation to an excessively sedentary lifestyle. Such a way of living can lead to unwanted muscle modifications. As such, those muscles become shortened and weakened due to a prolonged contracted position, shifting the position of joints along the way. As a better way of understanding this, we can present an example of an office worker named Janez, who spends approximately 12 hours a day sitting and does not participate in any sports activities in his free time.
Due to the considerable amount of time spent sitting and hence the long-lasting maintenance of specific unfavourable muscle shortening positions, Janez’s hip flexors (iliopsoas) become shortened. The aforesaid position furthermore prolongs the hip extensors (gluteal muscles), leading to a specific forward pelvic tilt (“anterior pelvic tilt”). Imbalances such as those mentioned lead to other body compensation, for our bodies, must always work as a whole. Anterior pelvic tilt results in stretching and weakness of abdominal muscles as well as the deep trunk stabilizing muscles, causing further additional pressure to the lumbar region of the spine. As a result, lumbar lordosis becomes increased and for the spine to follow the natural curvature so must increase the thoracic kyphosis ( protraction of shoulders and shortened chest muscles) as well as the cervical lordosis (seen as forwarding neck position).
Due to mentioned modifications, Janez can experience troubling pain in his neck and lower spine region, resulting in headaches.
All adjustments to body posture are PROVEN to, firstly ensure different painful conditions and finally even lead to chronic conditions regarding musculoskeletal structures (Kinser in Colby, 2007), such as facet joints wear and tear as well as discus hernia, as will be mentioned further along the way.
Excessive sedentary lifestyle
Due to the sedentary way of living and neglected physical activities, essential human movement abilities are being diminished (Herc idr., 2017), leading to a lesser quality of life. The consequences of an excessively sedentary lifestyle can be nowadays seen in young children and young adults, as they are adjusting to unfavourable body positions. With correct physical activity and exercise such changes can be corrected, or else they will prolong well into their adulthood and manifest as serious problems when aging.
There is a multitude of abnormal or incorrect body stances, which are divided into groups according to the expressed areas of irregularities and disproportions of muscle structures (Burgar, 2017). Some of the more known are kyphotic lordotic posture, reflex posture, military-style posture, and flatback (Jakovljević, 2010). Postural abnormalities are codependent with a mass of internal and external factors, affecting physical development. Some of such factors
Kyphotic lordotic posture: The main trait of such posture are exaggerated spine curvatures. The reason behind such abnormalities is shortened hip flexors and neck extensors in addition to weak extensors of the thoracic region of the spine and abdominal muscles.
kyphotic lordotic posture
Reflex posture: Such posture is one of the most common lousy or incorrect postures, predominantly known among office workers who spend the majority of their time with their necks in extensive flexion. Common traits are increased lumbar and cervical lordosis and thoracic kyphosis with the head being slightly shifted forward.
reflex posture
Military-style posture: includes exaggerated lumbar lordosis while having flattened thoracic kyphosis. The Head remains in its neutral position. The aforesaid stance can be compared to the rigid posture of a soldier.
military-style posture
Flatback: Pelvis is tilted in what is known as posterior pelvic tilt, resulting in decreases in lumbar lordosis and thoracic kyphosis. Thoracic lordosis however is increased, hence shifting the head slightly forward.
Flatback posture
The risks related to poor posture
As previously mentioned, poor body posture is proven to lead to disease and chronic deformation of bone-muscle structures. Probably the most frequent side-effects related to poor body posture caused by long-term sitting are chronic pains in the lower back area. The main reason for that is the enlargement of the lumbar lordosis and the aforementioned increased burden in said area.
In the long-term, chronic back pains which are caused by poor body posture, lead to the wearing out of the facet joints. Why is that so? If we take a step back for a moment, and return to the passive and active system of sustainability of body posture mentioned earlier. The systems must be in coordination with the neurons through activation of muscles in order to enable stability of the torso and a dynamic balance, so that gravity can pass through the axis of the joints – thus the movement of the body is achieved economically and safely.
In case of poor body posture (weak or shortened muscles), the force of gravity does not pass through the axis of the joints, thus causing additional disbalance of the body and exposure of the spine to additional loads.
Since the muscles are still weak (Janez’s example), the entire load is transferred to the facet joints and joint structures.
In the long run, this leads to wear and tear and problems that can last for years.
Chronic neck pains
The other most frequent condition are chronic neck pains. The mechanism here is also very similar to the mechanism of chronic lower back pain – due to increased neck lordosis, the head “falls” further forwards, outside the body’s gravitational center, thus greater forces act on this constituent. As a result, tension in the neck muscles increases, resulting in chronic pain.
Since poor or broken posture is associated with muscle imbalances, muscle weakness and inadequate mobility, it must be clear to us that this inevitably affects our body biomechanics during movement.
Our basic movement patterns that we use in everyday activities are thus inefficient and sooner or later lead to injuries.
As such, I would highlight a higher risk of disc herniation in particular. In most cases, it arises precisely from repeated loads on the intervertebral discs, which are the result of prolonged sitting and poor posture.
Poor body posture is mostly referred to as “flexed posture”, as the trunk is constantly slightly bent, which is by far the most dangerous position for disc herniation. In addition, due to sitting and lack of movement, the discs are not properly hydrated, as the hydration of the discs is ensured by a sufficient amount of movement.
Dehydrated discs are less resistant to forces and thus offer less protection to the spine (Videman et al., 1990).
How to fix poor body posture?
A scientifically proven key in the successful correction of poor posture is exercise. Physical exercise is the best method for maintaining and improving the state of correct physiological body posture (Cho and Gong, 2017).
Said exercise must be dosed in small dosages and under expert supervision. However, simply exercising will not accomplish much, as the exercise must become constant part of one’s lifestyle. (Herc et al., 2017)
For example, Romano et al. (2015) state that, from the point of view of maintaining and improving body posture, the most meaningful goal of exercise is to increase spinal stability, improve neuromuscular control, and improve overall strength and coordination.
Incrasing spine stability
The stability of the spine is basically increased by strengthening the deep stabilizers of the trunk. Stabilization is initially isometric and is performed in all planes. Exercises must be performed consciously and with good quality, because in order to successfully strengthen and eliminate physical pain, it is necessary to acquire proper muscular activation. After adequate activation and strengthening, this segment also needs to acquire an adequate sense of proprioception, or awareness of the position of body parts in correlation to the overall position of the body.
Awareness of the overall positioning of the body in correlation to space, or (self) control of movement is very important in maintaining proper body posture and preventing pain and chronic diseases of the musculoskeletal structures (Romano et al., 2015).
The feeling of awareness of one’s body in space can only be acquired through physical exercise, more precisely through awareness of the activation of different muscles while performing different strengthening and stretching exercises (Burgar, 2017).
“Once again, it is necessary to emphasize that this type of exercise can only be optimally effective if it is performed under the supervision of an expert who systematically guides you through the rehabilitation process. When learning to activate and when learning how to be aware of body segments, constant constructive feedback is necessary.”
On the other hand, depending on the degree of bad posture, it is necessary to relax and stretch certain muscle groups that happen to be shortened. In doing so, we can eliminate imbalances of muscles and bring the body back into a state of balance. Of course, the following applies: with this type of exercise, we barely eliminate the consequences, and it, as such, cannot be successful in the long term if we do not try to eliminate the cause. If we continue with the example of the office worker Janez, these are, for example, micro and short, but regular breaks at the workplace and ergonomic adjustments of the workplace.
During micro-breaks, Janez can perform prescribed exercises to strengthen weak muscle groups and relax and stretch shortened ones. Ergonomic adjustments include, above all, choosing a chair to sit on (adequate height, appropriate backrest, etc.) and adjusting the height of his computer screen to relieve the neck muscles at least a little.
Some exercises with which you can eliminate bad posture
The exercises I’m proposing are pretty basic. For optimal progress, individual treatment is required, which includes an examination of the condition, determination of the type of incorrect posture, and an individually tailored program of exercises to correct it. The exercises are suitable for performing with small breaks, as you do not need any equipment for them.
Wall skating
Pelvic tilt lying down
Hip lifting
Stretching the pectoral muscles
Hip flexor stretch
»Bird-dog«
»Cat-cow«
Rotation of the thoracic part of the spine
Conclusion
Due to the sedentary lifestyle, we see more and more people with poor posture today. Basically, posture is the position of the body that depends on passive structures (skeleton) and active structures (muscles) – together they determine the position of the joints during static positions (standing, sitting,…) and movements. A proper position or an upright posture enables adequate strength of the muscles, which can also be called antigravity, as they resist the force of gravity.
If the activation of the mentioned muscles is poor or the muscles are shortened due to persistence in bad positions (sitting), certain segments of the body (especially the back and neck) are exposed to additional stress, which inevitably leads to pain and later to chronic diseases of the bone-muscle structures (wear of the facet joints, disc herniation, etc.). This causes serious problems, which only get worse without proper treatment.
It is, therefore, necessary to eliminate bad posture as soon as possible, and here the main and proven best way is physical exercise, more precisely exercise for strength and awareness of body parts in space. Through exercise, muscle imbalances are eliminated, and proper posture is restored. In addition, micro-breaks at the workplace and ergonomic adjustments at the workplace are also recommended, in order to at least alleviate, if not eliminate, the causes of poor posture and pain in the long run.
The exercise should be carried out under the guidance of an expert, as the exercise must be of high quality, and above all, it requires an individually designed, systematic and scientifically supported approach if we want to achieve optimal results.
In this direction, we recommend the system for correcting bad posture at the Global Sports Clinic, where over 100 satisfied customers have already improved their posture in individually designed programs.
References
Burger, T. (2017). Vadba za izboljšanje telesne drže (diplomsko delo). Fakulteta za šport: Ljubljana.
Herc, M., Horvat, T. in Mrevlje, N. (2017). Fizioterapevtske spretnosti 1. Maribor. Alma Mater Europaea Evropski center. Interno gradivo.
Jakovljević, M. (2010). Raziskovalne metode v fizioterapiji. Ljubljana. Zdravstvena fakulteta, Univerza v Ljubljani. Interno gradivo.
Kisner, C. in Colby, L. A. (2007). Therapeutic exercise: fundations and techniques, 5th Edition. Philadelpphia: F. A. Davis Company.
Romano, M., Negrini, A., Parzini, S., … in Negrini, S. (2015). SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises. Scoliosis, 10(1):3.
Schuler, M. in Waldmann, W. (2011). Gesundheisatlas Anatomie. Köln: Neumann & Göbel Verlagsgesellscaft mbH.
Sherrington, C. (1931). Hughlings Jackson lecture on quantitative management of contraction for “lowest-level” co-ordination. British Medical Journal, 7.
Videman, T., Nurminen, M. in Troup, J. D. G. (1990). Lumbar spinal pathology in cadaveric material in relation to history of back pain, occupation and physical loading. Spine, 15(8):728.
