Posture, Babies and Bathwater
Posture is a controversial topic. It’s relevance for pain has been properly questioned by fans of “pain science,” while the more biomechanically-minded crowd has worried that a baby is getting thrown out with the bathwater. In previous posts I’ve written about the very dirty bathwater that does indeed need to be thrown out. In this post I’ll provide a few thoughts on taking care of the baby (assuming there is one under the dirty water.)
Extensive research shows that objective measures of postural alignment correlate very poorly, if at all, with pain. But this doesn’t mean that posture is irrelevant to health and especially performance. Posture is a fundamental part of coordinated movement, one of the first skills that a baby learns. We need a well-organized trunk and neck to see the world, coordinate movements of the arms and legs, protect vital structures from injury, and maintain balance. We can barely do anything without a minimum level of postural skill, and that skill must elevate to an elite level if we want elite level athletic performance.
In the context of pain, common experience makes clear that posture is sometimes a dominant cause. For example, I have noticed that standing in the same place for long periods of time at a cocktail party or museum will sometimes make my lower back stiff. It feels better almost immediately when I sit for a few minutes. A slumped position works best, and is also my most comfortable way to rest over long periods of sitting. I have clients with literally the exact opposite set of preferences, which is why they use a standing desk at work and lumbar supports while sitting..
Nothing about these anecdotes is inconsistent with the research on posture and pain, which does not imply that people are equally comfortable in all positions, or that they don’t benefit from tinkering around with different options. Adjusting your posture to be more comfortable is not rocket science, and most people will do it unconsciously. But our natural tendency to self-organize can get stuck in a bad groove if we don’t give our bodies the feedback it needs, in the form of variable postural challenges. And we can really get stuck if we decide that certain postures that feel natural are wrong and to be avoided. Consciously trying to mold posture to some assumed ideal is probably a bad idea, as it tends to encourage stiffness..
So how do you get unstuck from a bad postural groove and make progress? One way is to play with the different constraints around which your posture tends to self-organize. I’ll review five: coordination, strength, mobility, social context, environment, and pain.
There are many common exercise methods that focus on training postural skills. For example, yoga, Pilates, or tai chi develop are very much about maintaining a specific postural alignment in a variety of functional contexts. Do you need that specific alignment to be functional and healthy? Probably not. But trying to maintain it under variable conditions is a way to build coordination.
Locomotive activities all challenge the ability to coordinate alignment of the spine with movements of the arms and legs. Therefore, improving your performance in activities like crawling, walking, running, climbing and swimming are likely to improve your posture as well.
Postural skill is also about helping to maintain balance, and therefore we might expect it to be improved through activities that challenge balance, like gymnastics, dance or skateboarding.
It’s hard to hold a safe and functional posture when lifting a heavy weight, running a distance at a brisk pace, or performing a powerful throw. You need strength to resist the forces pulling you out of alignment. Like Yoga or pilates, “good form” in most weight training exercises is usually about maintaining a long spine. Once again, the neutral spinal position is not absolutely necessary for safe and functional lifting, but the effort to maintain it is a challenge that may create beneficial adaptations.
It should be noted that any postural skills built lifting may be specific to context. Fitness and strength are not likely to be limiting factors for organizing posture in everyday activities, which require surprisingly little core strength.
Another potential constraint on posture is mobility. For example, you need pretty good range of motion in the hips to sit upright on the ground with the legs extended, or even crossed. If you don’t, the hamstrings or glutei will pull your pelvis into a backwards tilt, and you will therefore need to round your back to keep your head level. If you improved your hip mobility, your sitting posture would immediately reorganize to make your trunk more vertical, perhaps improving comfort and efficiency. But this change would probably be specific to sitting with extended legs and might not affect other postures.
Posture has a psychosocial dimension. Body language sends social signals about mood and confidence. Teenagers may slouch to look cool. Some people suck in their stomachs to flatten their belly, lift the chest to show dominance, or collapse it to be submissive. On vacation, body language might change to reflect a more relaxed and comfortable mind. I have noticed that my back gets tired after a formal social function where I have to wear a coat and tie. Something about the occasion inhibits my natural movement and literally makes me feel stiff.
Attention and environment regulate posture. One of the reasons you tend to slouch when you look at a computer screen is that it helps you get closer to the object of your attention. If you direct your attention to the wide world around you, to objects both far, near, up, down, left, right and even behind you, your head will naturally move into a more upright position. Next time you are hiking, imagine you are in untamed wilderness, and need to be aware of potential threats coming from 360 degrees. You will notice a spontaneous change in the organization of your trunk and neck.
Pain can be a major constraint on posture. We instinctively move away from positions that hurt us. Many people who have their backs “go out” will find to their surprise they have spontaneously adopted a very crooked posture. The postural system immediately reorganizes to protect a tender area. Any time you can get something stop hurting, you open up a new set of possibilities for postural alignment.
In summary, anything you can do to improve your general physical function might also improve your postural organization. Not in the sense of looking more vertical, but in the sense of having a body that is a more functional and comfortable place to live.
The preceding was an adapted excerpt from my new book Playing With Movement: How to Explore the Many Dimensions of Performance and Health, now available on Amazon and Barnes and Noble.