Posture is not a rigid concept. It represents something more fluid with considerable range for change. Despite this, it is often oversimplified, rightly or wrongly, as being “good” or “bad”.
Your posture is affected by many aspects of your daily life, including physical and psychological factors. The former can include how you sit and for how long, how active you are, and if you are repeatably placing strain on your body. From a psychological perspective, how well you are dealing with stress, how balanced your work, social and family life is, and your overall level of self-esteem will all contribute to your posture.
It is widely accepted that psychological factors can drive and amplify how we feel about our pain. Given that poor sustained posture can lead to physical pain, we can’t ignore it but when addressing postural issues we also need to consider the role of the mind.
We will all remember being told by our parents, school teachers and many others not to slouch and to sit up straight. Instinctively, we knew there was some truth to this. Colleagues who work in the field of biomechanics will hold this mantra close to their hearts, recognising that if we adopt poor posture – chin poked forward, holding our shoulders in a rounded position and being slouched in chair – for sustained periods, the overall effect will be that areas like our neck, shoulder region and backs will object and usually alert us by producing pain. This pain comes from joint and soft tissue structures such as muscles and ligaments. They become overloaded and exposed to abnormal forces when they are held in positions they weren’t designed for.
There is no “perfect” posture, mainly due to the myriad variables associated with how we sit and stand, but generally speaking, people are not born with certain posture types. Over time, we develop a posture, depending on our lifestyle. However, some are more common than others. Office workers, for example, may be more susceptible to a “sway back posture” due to bad sitting habits. Over time, these physical factors can affect our overall posture and if left unchecked can contribute to neck and back pain.
This of course is very much a physiological interpretation but equally important and common in people who complain of problems is how a person responds to psychological factors. “Embodied emotional theory” looks at how emotional cues are expressed by the body. These can happen without someone knowing or acknowledging underlying psychological issues. Examples might be when someone unknowingly holds themselves with the shoulders raised or hunched with the chin poking forwards when stressed, or a particularly tall person who stoops in order to make themselves the same as those around them, because they dislike being tall.
It is also likely to be accompanied by something called the “self-validation theory”. This is when the postures we adopt actually affect how we feel emotionally, so standing tall with shoulders back is a confident posture and subsequently can make us feel and appear more confident. Both theories allow us to communicate how we are feeling to others in our body language, whether this is conscious or subconscious.
So can you cure bad posture? There are many sources that give advice with regard to posture, but we must be mindful as to whether it is the immediate symptoms we seek to cure (back pain, for example) or an underlying reason.
My time in clinical practice has shown me that most people want the immediate symptom of pain managed and often will not even realise there is an underlying cause. This lack of insight into what might be driving their posture change often makes it difficult to advise on. Even if they are aware of other factors, people often still struggle to discuss the emotional aspects of their condition.
Of course it would be ideal to address both, but the realist in me knows that the way we treat our bodies is often far from ideal. I would therefore suggest that perhaps rather than thinking about cure, it is better to create awareness and some degree of work hardening.
If someone is subconsciously adopting a posture, making them aware of it means they can take ownership of it and learn to regularly move out of that posture to prevent excessive strain. If someone is required to adopt a new posture due to a new skill or job where pain or discomfort is a feature, maintaining awareness and repeatedly correcting it can ease discomfort.
It’s important to also understand that posture is a continuum that is part of the ageing process. The theory is that when we are younger we can absorb more stress and force on our joints and tissues. For most of us the reality is that as we age we don’t tolerate this as well because of other age-related changes happening to our tissues and consequently take longer to recover.
In all instances I would always recommend educating yourself on how to improve troublesome posture. Simple changes to your daily life, including positioning, lifting technique, exercise tolerance, stress management and work-life balance are all starting points.
It is also about considering both the physiological and psychological stressors. Failure to do this will inevitably lead to repeated episodes, a deepening perception of pain and a delayed recovery. And if particularly troublesome, it may be necessary to seek appropriate advice from a qualified healthcare professional.
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