Getting the Story Straight: Posture Isn’t Just About Stature

Utter the word “posture.” Then watch most people instinctively yank their shoulders back. They puff out their chests, lock the knees and go as ramrod straight as possible. And they probably think about a parent or teacher who once admonished them about slouching.

Lawrence Wayne doesn’t do any such things. He winces. And most certainly doesn’t repeat the word. “Talking to someone about posture can be insulting,” said Wayne, a personal trainer and owner of the Fitness Companion workout studio in Chicago. “Most people know they would benefit from improved posture. Calling attention to it can put them on the defensive.”

What’s more, posture is probably the most misunderstood word of fitness. We think of posture as something we don’t do right. It doesn’t occur to most of us that posture could change our bodies and our lives.

“Posture is empowering,” said Jim Lal-Tabak, a yoga teacher who conducts classes in the Chicago area. “I have one student, a woman, who regularly ran 30 floors of stairs in her building. But she was always hunched over, sort of closed. She started taking classes and two years later seems like she grew 3 inches. She got a new hairstyle. Her life is different.”

Best of all, we can improve our posture at any life stage. It’s never too late. “Even patients with mild osteoporosis [a bone-degenerative condition that can lead to deformity] can make dramatic improvements with series of posture exercises,” said Dr. Pauline Camacho, director of Loyola University’s Osteoporosis and Metabolic Bone Disease Center.

One exercise she recommends is the midback posture correction. To do it, sit on a chair with your chin in but not up. Keep the stomach tight, chest forward and feet together flat on the floor. Place your arms in a “W” position with the shoulders relaxed, not hunched and the elbows bent. Bring the elbows back, gently pinching the shoulder blades together. Hold for a slow count of 1-2-3, then relax for a slow count of 1-2-3.

Start with three repetitions every day, Camacho said, and gradually work your way to two sets of 10 each day. She recommends visiting the National Osteoporosis Foundation at www.nof.org for information and suggested exercises. Wayne said the best posture exercises to help anyone’s alignment focus on the middle or center back and the lower abdominal muscles.

“Most people are contracting their upper chest and lower back muscles whether they are lifting weights or hunched over a computer,” Wayne said. “If you make time for posture work, you can’t help but feel more erect.” Wayne isn’t asking for much time. He routinely suggests shoulder rotations to his clients. It is a three-step exercise that takes seconds. First, feel for the bony protrusions at the top of your shoulders; raise them up slightly. Second, gently bring the shoulder blades toward each other. Third, drop the back slowly a half-inch to an inch total.

“You want smooth, gentle movement,” said Wayne. “No yanking, pulling or jerking your shoulders back.” Physical therapists, yoga teachers, dance instructors and personal trainers who focus on posture have long recommended imagining the crown of your head or breastbone is attached to a string on the ceiling. Proper posture keeps that string straight but not overly taut. Wayne said that image is a good one but might be difficult to follow while walking, especially if we are moving briskly to make a train or appointment. His alternative is to keep your earlobes squared with those bony protrusions at the top of the shoulder.

In either case, pausing to be aware of your posture will serve you fruitfully during times of stress. Wayne said that getting up from your computer work or other activity every 20 minutes will do wonders for your energy level.

There are some myths about proper posture. For instance, it’s probable your grade school teacher was wrong about sitting up straight. Rather than concentrate on making the spine erect, physical therapist Jodi Skrzypek said, we should have a small curve forward in the lower back and keep the shoulders lined up with the ears and hips.

Standing requires a similar relaxed yet efficient position that doesn’t overstress the muscles or joints. “It’s certainly not about balancing a book on your head,” said Skrzypek, who is part of the outpatient physical therapy department at Rush-Presbyterian-St. Luke’s Medical Center in Chicago. “When you stand, always keep a slight bend in the knees. Be aware of when you stand for a long period. You can avoid too much tension on the knees by placing one foot up on a step.”

Skrzypek said she regularly works with people to avoid the “middle-age effect” of back, neck and shoulder pain. Leaning forward at the computer and slouching while driving or surfing the Internet are behaviors she gently nudges patients to avoid. She said a rolled towel on the back while driving or sitting at your desk can help avoid discomfort while reminding you to keep your ears, shoulders and hips aligned.

Daily Stretches

Another effective strategy for maintaining healthy posture is daily stretches for the hamstring (back of the thigh) and hip flexor muscles. Skrzypek favors a wall slide in which your back and buttocks are flat against the wall and feet a few inches away. Tuck in your chin so your head is as close to the wall as possible. Flatten your stomach, then slide up and down the wall. Keep your back and stomach flat while bending the knees and never go lower than a 90-degree angle (which might be too far at first for some beginners).

Taking a yoga class is bound to improve your posture. Lal-Tabak teaches hatha yoga, which can be characterized as gentler than some forms (such as ashtanga or power yoga) and is a good version for novices.

For his part, Wayne said several of his clients have referred daughters, sons or spouses to him because of poor posture. Sometimes the loved ones in your life recognize your inevitable hunch or slouch long before you ever will. “Your attitude about life reflects through posture,” Wayne said.

“Just ask people you trust. They will tell you. Improving your posture will give you a boost of confidence in a short time.”

Preventing a Humped Back

The worst-case scenario of bad posture is what doctors call kyphosis, or a humped back. It is a gradually occurring deformity that begins with weakened abdominal muscles and declining posture or stature.

“Poor posture is often overlooked by physicians,” said Camacho, of the Osteoporosis and Metabolic Bone Disease Center. “I have seen 80-year-olds who have lost so much height but only in the last year were sent for bone-density tests.”

Early detection can avoid big problems, she said. “When I compare two people with osteoporosis”--a bone-density loss that affects more women under 65 and men and women equally in later years--”the one with good posture won’t get the deformity.”

Kyphosis typically occurs when the rectangular-shaped spinal vertebrae collapse from fracture in the front or back of the bone. The results are wedge-shaped vertebrae. The spine compresses together, and the hump develops. Once the vertebrae reach the collapsing fracture stage, it is difficult to reverse the condition with exercise or medications.

Doctors recommend weight-bearing exercises (except when osteoporosis is so severe the workout itself will cause fractures) plus calcium and vitamin D supplements for anyone with early symptoms or a family history of osteoporosis.

One promising trend is the emergence of vertebroplasty, an outpatient procedure in which special body cement is injected into the vertebrae to reinforce the bone and avoid future collapsed vertebrae. The procedure has up to now been more closely linked to patients with severe fractures. Camacho said it could be used to help at earlier stages of osteoporosis and prevent years of chronic pain for some people. It is not used for people with disc disease but holds great potential, especially for the 25% of American women older than 50 who will suffer spinal fractures.

*

Bob Condor is a writer for the Chicago Tribune, a Tribune company.