Poor postural habits are something that most of us, as humans, are guilty of from time to time. But do we ever really stop and consider the consequences our bodies suffer as a result? With the addition of smartphones and tablets to our lives, most of us spend more time in a hunched position that we realize. These sustained postures can have detrimental effects on our spine and surrounding joints and soft tissues.
When you look at a picture of the spine from the side, you will notice that is not straight up and down. In fact, it has several curves that create an “S” shape, which is important for absorbing the stress that is placed on our bodies. When we lose those normal curves due to continued use of poor posture, pain can manifest due to abnormal stresses on our muscles, ligaments, and spinal discs. The lower back (lumbar spine) and the neck (cervical spine) has a normal backward curve called lordosis, whereas the upper back has a forward curve called kyphosis. Postural dysfunction occurs when the normal curves increase or decrease, leading to pain in and around your spine. It may also contribute to other joint problems.
A common postural deviation seen in physical therapy is a Forward Head Posture. When viewing the body from the side, normal posture is considered when you can draw a line straight down from your earlobe, to the tip of the shoulder, the bony prominence on the side of your hip, outside of the knee and to the back of the arch of your foot. A forward head posture is noted when the earlobe sits in front of the tip of the shoulder, often with a straightening of the curvature of your neck, and an increased curve in your upper back.
Over the long term, this posture causes the following problems that are common reasons for patients to seek physical therapy:
1. Headaches
When you lose the normal backward curve of your neck, and your cervical spine straightens or ever begins to curve forward, the face will ultimately be directed toward the floor. In order to see where you are going or to look forward, your spine compensates by extending the head on the upper neck. This will cause shortening of the muscle under the back of your head, as well as shortening of your SCM on the front of your neck. When placed under stress, these muscles can contribute to headaches. Additionally, the nerves and joints in the upper neck can be compressed, causing pain in the neck and into the head as well.
2. Neck Pain
Loss of the cervical curve will place increased tension on the ligaments along the back of the neck and the back wall of your cervical spinal discs. This increased tension can lead to the formation of bone spurs where these ligaments attach, as well as an increased chance of tears in your discs leading to herniated discs. Bone spurs and herniated discs can affect the nerves that run from your spinal cord in your neck to your arms causing pain, numbness, tingling, and weakness.
3. Shoulder Impingement
When the forward curve of your upper back increases, your shoulder blades sit more forward and higher on your back. When raising your arms overhead, your shoulder blade must rotate in a particular way to allow full shoulder motion. When the position of your shoulder blade on your trunk changes, this rotation can decrease and you are now at an increased risk of pinching of tendons in your shoulder when you raise your arm overhead. This is called shoulder impingement and it can lead to pain and break down of these tendons and increase your chance of tendon tears.
4. Jaw Pain
Pain in and around the temporomandibular joint (TMJ) can be common with forwarding head posture due to abnormal stressed places on the mandible (lower jaw bone) and the soft tissues around your TMJ. If you compensate for the loss of your cervical curve with head extension, the muscles that open your mouth are placed on stretch and your mouth will rest in an open position. In order to keep your mouth closed at rest, the muscles that close your mouth will work extra hard which can cause pain in the cheeks, head, and jaw. Additionally, increased stress on the soft tissues around the TMJ can cause pain and clicking/popping.
5. Respiratory Dysfunction
In order to take a nice deep breath, the lungs need room to expand inside a mobile and flexible rib cage. When your posture is hunched forward, your ribs have less ability to move and expand causing more shallow breathing patterns and excessive use of your accessory breathing muscles in your neck. This type of breathing pattern can further contribute to neck pain and can have serious effects on people with underlying respiratory disorders.
We’re Here to Help
All of these problems may sound scary but the good news is that physical therapy can help reverse these dysfunctions. Physical therapists are trained in manual therapy techniques to stretch and mobilize your tight soft tissue and joints and will instruct you in exercises to strengthen your weak muscles to improve your overall posture and movement. To request an appointment with one of our highly-trained physical therapists, click here!
By Kelly Letellier, DPT, MTC, CMTPT
