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Poor posture is the posture that results from certain muscles tightening up or shortening while others lengthen and become weak which often occurs as a result of one's daily activities. There are different factors which can impact on posture and they include occupational activities and biomechanical factors such as force and repetition. Risk factors for poor posture also include psychosocial factors such as job stress and strain. Workers who have higher job stress are more likely to develop neck and shoulder symptoms.
Poor posture can present in several ways:
- It can present with rounded and elevated shoulders and a pushed-forward head position. This position places stress on the spine between the top of the neck and skull and the base of the neck and upper shoulders. There is a reduction in the stability of the shoulder blades resulting in changes to the movement pattern of the upper extremities.
- It can present with a forward tilting of the hips, an increase in the curve of the lumbar spine, and a protruding stomach. This position places stress over both the hip joints and lower back.
Poor posture is the result of musculoskeletal distortion in the neck, and lower and upper back. Most people think of poor posture as simply slumping over, but that is not necessarily the case. Due to the variety of body types, incorrect posture differs from person to person. One person's proper posture can be incorrect posture for someone else and vice versa. Nevertheless, there are ways to determine poor posture. Some of the classic signs of poor posture include having a pot belly, rounded shoulders, and a jutted out neck and chin. Pot bellies result when the lower back experiences an exaggerated curve, thus pushing the internal organs, in the abdominal region of the body, toward the anterior of the body. Rounded shoulders and postural neck problems result from the excessive anterior curve of the cervical and thoracic spine.
There are numerous risks associated with poor posture. Poor posture can impede the ability of the lungs to expand. Posture, when correct, helps to increases one's ability to breathe, and allows muscles to work at optimum capacity. When slumped over, the lungs have less room to contract and inflate, therefore, decreasing its capacity to obtain the maximum amount of oxygen needed.
Poor posture is also a main risk factor in many injuries. Many athletic injuries are the result of poor posture. For example, the Journal of Athletic Training; May 2009 Supplement, states that "many overhead athletes suffer from shoulder pain due to poor posture." According to Segen's Medical Dictionary the term overhead athletes refers to amateur or professional athletes who participate in overhead sports and are thus at risk of traumatic or degenerative injuries to the shoulder girdle. Overhead athletes are not the only ones at risk. Poor posture injuries can be found everywhere.
Weight lifting, if not done correctly, can be detrimental to posture, and causes a lot of the neck and shoulder problems in countless athletes. Vern Gambetta, in his article Perfect Posture, states; "Overemphasis on the bench press can [hinder good posture], as it causes a round-shouldered posture." The rounding of the shoulders can cause pain as stated in the University of California at Berkeley Wellness Letter; November 2000, "Increase in neck and shoulder pain may be due to the postural problems in the upper body including rounded shoulders and jutting the head forward. Although the thoracic and lumbar spines are crucial factors in postural problem, they tend to overshadow the head or the cervical spine. An article in the February 2006 Consumer Reports on Health remarked that "Research has found, for example that letting your head jut forward is associated with neck, back and even jaw pain." Some headaches are the result of poor head posture. The decrease and even loss of shoulder movement along with chronic pain, neck-related headaches and the decline in the ability to exercise as well as many other problems stem from poor posture. Injuries and pain caused by poor posture span a wide variety of people. All areas of the spine are equally important when it comes to posture. Poor posture is a physical as well as an emotional problem. It affects mood, confidence and how one is viewed by others. In the January 1999 issue of Vegetarian Times, Karin Sullivan in her article "Perfect Posture" states, "Someone with collapsed or withdrawn body posture doesn't invite the same kind of interaction [as someone with good posture.]" Most communication is associated with body language. Posture is a key aspect of body language. Slumping over closes one off to others. Someone who is already depressed can fall farther into depression because no one will come up to them because their posture indicates they don't want to be disturbed.
After a time, poor posture feels normal and continues to regress further from correct posture. Sullivan says this is "a [vicious] cycle where slouching and slumping pull the spine's vertebrae out of alignment, which in turn leads to muscle tension that can cause even more slumping and slouching". When poor posture feels normal it becomes harder to correct because the muscle memory now stores the information needed for poor posture, and disposed of the memory for correct posture. Some ways of correcting poor posture do more damage than good. The old standard of soldiers with their shoulders thrust back, heads up while standing at attention causes the back to tense up and is extremely hard to sustain for long periods of time. Posture is somewhat of a precision based practice. If one is not in correct alignment, poor posture is the consequence. If not amended correctly, one's posture can be further harmed and can lead to increasingly painful experiences. Any distress in the spine, as well as other parts of the body can be increased due to prolonged periods of poor posture. Poor posture will continue to digress the longer it is left uncorrected.
Who is at risk
Studies have shown that drivers of trucks and public transport vehicles are at a greater risk of lower back and neck pain syndromes as well as other musculoskeletal disorders than clerical workers, partly because of their poor sitting posture and lack of breaks. Clerical workers who use a computer for extended periods are at greater risk of upper extremity and neck pain, especially on the side where the mouse is used. Further studies have implicated poor sitting posture in the development and perpetuation of neck pain syndromes. Sitting for long periods without interruption with poor posture has been shown to cause postural backache. Ergonomics assessments showed that taking poor (awkward) posture is common in almost all working situations. Even dental students do not use a favorable working posture. So, they are at an intermediate to high risk of developing musculoskeletal disorders symptoms.
Poor posture can result in spinal and joint dysfunction as a result of muscle changes. Poor posture can result in short term but more likely long term pain or damage.
Poor posture can stem from many sources; one of the most significant sources deals with repetitive motion without frequent breaks. If one spends a substantial part of one's day in a certain position without frequent reprieves, the spine tends to orient itself to that movement. For example, if someone is constantly leaning over to pick up objects, gradually the spine will start to develop a more exaggerated forward curve of the thoracic spine. Sullivan comments on poor posture saying; "These problems [poor posture] are often the result of chronic muscle tension, physical injuries or even emotional trauma, such as grief or depression. Conditions like these throw the musculoskeletal system out of alignment, and if not corrected, poor posture eventually feels normal." Emotions, as well as physical activities, affect the state of one's posture.
Other causes include sustained immobile posture for long periods of time. Taylor, Consmüller, and Rohlmann in their article "A novel system for the dynamic assessment of back shape" in the Medical Engineering & Physics journal, say: "Low back pain is an increasing problem and can be aggravated by prolonged static posture. Sitting for prolonged periods is a great hindrance to good posture. Poor sitting posture is hard to rectify. Jenny Pynt in The Physiotherapy Theory & Practice journal states, "In sitting there is no one ideal posture, nor should one posture be sustained. Healthy sitting posture therefore, is best thought of as an active not static phenomenon." There are ways to improve your posture such as rolling your shoulders back and down, making sure your ears are aligned with your shoulders, and strengthening your core muscles. Poor posture is affected by prolonged periods of repeated motions, or remaining fixed in one particular position.
Warnings concerning backpacks and computer use
Backpacks and computer use are associated with spinal distortions. The Sept/Oct edition of American Fitness in their article "Get in Straight: Simple Steps to Improve Your Posture" quote Dr. Thielman who "cautions against carrying backpacks that weigh more than 20 pounds, attempting to lift object that are too heavy and repetitively making the same moves without taking frequent breaks. Any one of these activities encourages the forward leaning motion that causes poor posture and back problems." Computer use and backpacks both favor the anterior leaning of the upper portion of the body. The weight of the backpack causes the shoulders to slump forward to compensate for the extra weight. The posture used while carrying a backpack affects one's unloaded posture. In the article "Adolescent standing postural response to backpack loads: a randomised controlled experimental study" in the 2002 edition of BMC Musculoskeletal Disorders 3 Grimmer et al. notes; "Unloaded posture that habitually deviates from gravitational alignment has been associated with spinal pain." When one becomes accustomed to slumped shoulders when carrying a backpack, the action affects normal unloaded posture. Alternative backpack designs may help, such as non-flexible straps that prevent the backpack from shifting around.
Computer use is also problematic concerning posture. An article in Consumer Reports on Health states, "The journal of electromyography and kinesiology found that poor posture among computer users is an independent risk factor for musculoskeletal disorders of the neck and shoulders." Prolonged computer use with poor posture can deform the thoracic and cervical spine. Steve Marshal in his article "Oh, My Aching Back!" in Occupational Health & Safety journal observes; "we do not as a whole, sit with proper posture when using our computers.' 'We slouch, we hunch over and perhaps we sit cross-legged or curl our legs under our seats." This computer posture may cause people to bend forward when not using the computer.
There is growing evidence supporting the implementation of an alternative sit to stand workstation and ergonomical desk adjustments that yield positive effects reflected on computer workers and employers, studies by Thorp et al. for example  found up to 32% reduction in pain and discomfort in lower back, and Pronk et al. showed a combined reduction of upper back and neck pain by up to 54% in office workers compared with pre-intervention data findings.
- Neutral spine (good posture)
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- Movahhed, T., Dehghani, M., Arghami, S., & Arghami, A. (2016). Do dental students have a neutral working posture?. Journal of back and musculoskeletal rehabilitation, 29(4), 859-864.
- "6 tips to improve your posture". 2016-07-22. Retrieved 2016-07-27.
- "Get in Straight: Simple Steps to Improve Your Posture." p.47.
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- Marshall, Steve. "Oh, My Aching Back!."p.118
- Thorp, A. A., B. A. Kingwell, N. Owen, and D. W. Dunstan. 2014. “Breaking up Workplace Sitting Time with Intermittent Standing Bouts Improves Fatigue and Musculoskeletal Discomfort in Overweight/Obese Office Workers.” Occupational and Environmental Medicine 71 (11): 765–771. doi:10.1136/oemed-2014-102348.
- Pronk, N. P., A. S. Katz, M. Lowry, and J. R. Payfer. 2012. “Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-stand Project, 2011.” Preventing Chronic Disease, 9: E154. https://doi.org/10.5888.pcd9.110323.
- Ventelite Kenmore Physiotherapy: Improving posture through the implementation of a sit to stand workstations - a review of current journals and evidence-based literature in 2019.
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