Postural dysfunction is a broad term used to describe the state of your body when it doesn’t line up correctly with gravity. When your posture is off, it can lead to chronic pain and other health issues. We’ll explore different causes of postural dysfunction, and what you can do to help correct it.
Find out more about the causes and consequences of this dysfunction as well as possible treatments that can help alleviate these painful symptoms.
What is postural dysfunction?
Postural dysfunction is the inability to maintain proper posture.
For example, postural dysfunction occurs when you slouch or stay in an awkward position for long periods of time. Poor posture leads to a wide range of different health problems such as back pain, shoulder pain, headaches, and neck pain.
When the position or curvature of the spine is abnormal, this causes stress in the joints and soft tissues surrounding the area.
Types of posture
- Forward head: Head is in a forward position, where the ears are anterior to the shoulders.
- Kyphosis: Rounded upper back and shoulders.
- Swayback: Pelvis is posteriorly tilted but shifted anterior to the shoulders, causing more extension in the low back like you are slightly leaning backwards.
- Flatback: Posterior tilt of the pelvis with no curvature of the lumbar spine, which also leads to decreased lordosis curvature in the cervical spine.
What causes poor posture?
- Being desk-bound and slouching while you’re sitting
- Cradling or looking down/up at a cell phone
- Poor sleeping posture such as sleeping on your stomach or laying in a fetal position
- Stress which leads to tense muscles and spasms along the spinal column
- Poor lifting posture and carrying too much weight
- Advancing age
- Carrying extra or too much weight
- Side to side spine curvature
- Weak muscles or injury
Contributing factors to postural dysfunction
- Knowledge and awareness of good posture habits
- Inactive lifestyle
- Work related repetitive motions or lack of movement
- Stiff joints
- Lack of movement and consistent exercise
- Weak or tight muscles
- Weakened or poor core stability
What pains or afflictions does poor posture cause?
The most recent research shows posture does not cause pain or discomfort, but can be correlated to neck, shoulder, low back, hip, and knees pains.
Maintaining ONE posture for too long leads to an unhealthy posture. A phrase we’ve heard and like to use in our practice is “Your NEXT posture is your BEST posture”.
This means we are made to move and avoid static positions all day long which helps prevent postural related pain.
When a job or hobby requires staying in one position for a long time, find modifications and leave cues for yourself to change positions.
According to Harvard Medical School, poor posture contributes to poor balance, headaches, breathing difficulties, incontinence, constipation, and heartburn or slowed digestion.
As humans, we adapt and learn to tolerate incredible things such as power lifting, gymnastics and everything in between. We can tolerate different positions and postures. Consider a military tall, upright posture vs. the hunched over man who says he has no back pain.
Old fashioned understandings of posture have been shown to not be ideal. The stand up straight with a book on your head, methodology leaves something to be desired in today’s world.
With that being said, forward flexed posture and rounded shoulders often increase the bio-mechanical demand and stresses on muscles and joints. This overworks muscles which leads to decreased or inadequate strength. In turn, you end up with painful, adverse symptoms.
Weakened scapular stabilizers contribute to abnormal motion with overhead lifting. This leads to nerve impingement and pain into the shoulder.
Forward head can increase the pressure on the cervical spine. Often, this posture relates to localized neck pain or radiating symptoms down your arms.
Bad posture while sitting or standing can cause spinal changes
This leads to larger problems such as kyphosis or forward head posture.
Lengthy forward leaning posture through the spine and head/neck leads to the kyphotic and forward head postures. Severe cases of kyphosis can decrease lung expansion and develop respiratory complications.
Forward head posture takes the cervical spine out of it’s normal lordotic positioning. This can increase the strain on your neck joints. This causes joint or nerve pain.
As mentioned above, posture can be correlated, but has not been shown to be causative of pain.
How to have good posture
Awareness, strength and spinal mobility help attain “good” posture.
Attaining a better upright posture doesn’t occur overnight. In fact, better posture development can take extensive work.
Building good habits means understanding positioning and what causes you to have poor or static postures.
- Generally, stretching your pecs create an opening of the chest and decrease rounding of the shoulders and spine.
- Increasing strength in postural muscles can improve your ability to stay in an upright posture for longer periods.
- After an individualized evaluation, your therapist assesses tight tissues/joints and weak musculature while working to address them. You’ll get input on desk setup and postural cues/awareness to prevent a worsening of posture.
Developing an ergonomic work space
Ergonomics have evolved from the same chair, desk, etc. for everyone to understanding what works best for each individual.
If you’re not used to sitting up completely straight all day, but your desk fits that posture, you may experience pain too!
An ergonomic evaluation should take into account each person’s mobility and posture. Next, determine the appropriate desk height, computer height, mouse location and wrist/leg support.
The use of standing or raising/lowering desks helps, but you must understand how to set up each setting for you.
When standing, placing one foot on a stool or small step promotes a more active posture. As a result, you’ll prevent resting with hyper-extended knees and hip/lumbar extension.
When sitting, have appropriate monitor, keyboard and mouse positioning. This prevents reaching with the arms or poor wrist position. Having a foot support helps to prevent slouching and rounding of the spine.
Finding ways to maintain a more active posture decreases postural-related pain (and can even burn a few more calories! ) People using physioballs to sit on, with or without back support, increase muscular activity during a generally sedentary position. The more active and mobile you can be throughout your workday decreases your pain symptoms.
How Physical Therapy helps correct poor posture
Your therapist assesses the causes and contributing factors of your posture.
Then develops a personalized program:
- for stretching stretch tightened tissues (generally pectoralis major and abdominals)
- strengthens erector spinae, “core” muscles, scapular stabilizers
- provides education and information for maintaining your at home program
- advice on what equipment to utilize
The muscles that run along your back (erector spinae), are often overstretched with rounded shoulders and slumped posture. When in this lengthened position, the muscles aren’t in the appropriate position to stabilize at the spine.
This aspect of the core is often emphasized in addressing postural pains, but anterior and lateral structures must be addressed as well.
At times, taping and other tactile cues can be utilized to increase awareness of the position. Plus, we look at how much time a patient spends in that position, which can increase awareness and correction of kyphotic postures.