What do you think about when someone says “POSTURE”?
The first thing that comes to mind for many is appearance, either “bad” slouching or “good” standing straight and tall. However, the effects of posture go much further than our appearance. Posture can make a tremendous impact on appearance, but it can make as much or more impact on our health!
It may be more apt to think of posture in terms of “strong” and “weak” or “healthy” and “unhealthy”. A healthy posture begins with proper spinal alignment and extends to the extremities, regardless of the position that the body is in or activity being done.
Today, some of the most common threats to posture involve the use of electronics. Whether it’s lounging while binging TV shows, slouching while playing video games, having the computer workstation not set up at proper height or the constant forward head tilt associated with handheld games and phones, failing to maintain a healthy posture for extended times can wreak havoc on the human body.
Consider these potential costs of unhealthy posture and rewards of maintaining a healthy posture.
- Effects on Breathing
The National Heart, Blood and Lungs Institute compares the lungs to sponges. They do not change size on their own. Instead, surrounding muscles in the chest and abdomen contract to create a vacuum around the lungs allowing air to flow in. When they relax, the body exhales and the lungs deflate. Muscles used for breathing include the diaphragm, muscles between the ribs, abdominal muscles, along with the muscles of the face, mouth, pharynx, neck and collarbone areas. When a person slouches or has their head tilted forward, it can reduce the space that the lungs and surrounding muscles can move, thereby negatively affecting breathing.
A 2018 study published in BioMed Research International reported that simply sitting with forward head posture had an “immediate negative impact on respiratory function” compared to sitting with an upright posture. This correlates with a 2014 “Pulmonary Function of Patients with Chronic Neck Pain” study which measured neck muscle strength, endurance of deep neck flexors, cervical range of motion, forward head posture, psychological states, disability, and pain intensity of subjects who reported chronic neck pain and compared them to healthy subjects. They found that patients with chronic neck pain also had “significantly reduced vital capacity, FVC, expiratory reserve volume, and maximum voluntary ventilation.” (Vital capacity, or VC, is the “maximal volume of air that can be expired following maximum inspiration…The FVC is similar to VC, but it is measured as the patient exhales with maximum speed and effort)”. These deficits led them to conclude: “Patients with chronic neck pain do not have optimal pulmonary function.”
- Effects on the Heart
As we age, natural wear and tear on the body contribute to a gradual loss in height. Unhealthy posture contributes to greater stress on the body and thereby increases the risk for height to decline. A study published in the “Archives of internal medicine”, now “JAMA Internal Medicine” investigated the impact of height loss on health outcomes. After following over 4000 men for over 20 years, they compared mortality risk of those who experienced a height loss of 3cm or more to that of subjects whose height loss was less than 1 cm. They discovered those with greater height loss also had an increased risk of all-cause mortality. Specifically, they noted that the “excess deaths were largely attributable to cardiovascular and respiratory conditions and other causes but not to cancer.”
- Effects on Digestion
Posture can have a similar effect on the digestive system. In the case of digestion, not only does healthy posture allow the muscles to work as they should, it also allows gravity to help assist in moving food through the body.
Harvard Health lists unhealthy posture as a cause of heartburn caused by acid reflux, and slowed digestion. “Slouching puts pressure on the abdomen, which can force stomach acid in the wrong direction,” explains Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital. “And some evidence suggests that transit in the intestines slows down when you slouch…” Additionally, research has shown that an upright body posture is associated with reduced intestinal gas retention and faster clearance of intestinal gas compared to lying down.
- Effects on Energy and Mood
Often a person’s mood is reflected in their stance, so much so, that a hunched over posture is listed as a diagnostic symptom of clinical depression. A 2014 experiment evaluated subjects completed a psychological stress task while seated with either a slumped or upright seated posture. Researchers found the subjects who completed the task while seated upright reported higher self-esteem, more arousal, better mood, and lower fear, compared to slumped participants. The upright subjects also used less negative emotion words.
Five years later, a similar study was published that evaluated the differences in walking posture. Subjects completed a number of baseline tests walking in their usual posture and again after walking in either an upright or slumped posture. They were subjected to a psychological stressor during the experimental walking phased. Researchers found that the group instructed to walk upright showed “less sleepiness, less pain and marginally greater feelings of power” as well as lower systolic blood pressure compared to the slumped walking group.
- Effects on Musculoskeletal System
It is obvious that unhealthy posture puts the musculoskeletal system in potentially awkward or stressed positions that can cause pain. But there is more to it than that. According to the Mayo Clinic, “Good posture supports good health. Proper body alignment can help prevent excess strain on your joints, muscles and spine — alleviating pain and reducing the likelihood of injury.”
In a study published in Surgical Technology International’s 25th edition, New York spine surgeon Kenneth Hansraj conducted a study which found “bending your head to look at your mobile device held in your hands can put up to 60 pounds of pressure on your neck.” He compared what happens when subjects bent their head at 15, 30, 45 and 90 degrees to view their devices. In the neutral position, ears over shoulders, the average human head weighs about 10 pounds. However, with every inch, the head is tilted forward, the pressure on the spine doubles. Looking down when texting can easily create 20 or 30 pounds of pressure on the spine.
And it isn’t just the neck and spine! Harvard Health Publishing lists stress incontinence as a risk of poor posture. The same slouched posture that constricts the respiratory and digestive systems puts pressure on the bladder and decreases the function of the pelvic floor muscles. In fact, the National Association for Continence advocates for a healthy posture as one of the best ways to improve pelvic floor health!
The good news is that posture is something that you can work on practically anytime and anywhere. Just being mindful of your posture will likely help you develop better habits. If your posture needs some work, your chiropractor can assist you determine your current posture as well as ways to improve your posture to benefit your overall health. This may include spinal adjustments, treatment modalities, specific stretches, targeted exercises, and changes to your workstation. If you don’t already have a regular chiropractor, you can find a TCA doctor near you at www.tnchiro.com/find-a-doctor.
“The Posture of Happiness” http://posturemonth.org/posture-break/ May 1, 2018
“The True Cost of Bad Posture” https://www.shechangeseverything.com/blog/why-it-is-important-to-correct-forward-head-posture May 15, 2019
“HOW THE LUNGS WORK” https://www.nhlbi.nih.gov/health/lungs
Pulmonary Function of Patients with Chronic Neck Pain: A Spirometry Study Zacharias Dimitriadis, Eleni Kapreli, Nikolaos Strimpakos, Jacqueline Oldham Respiratory Care Apr 2014, 59 (4) 543-549; DOI: 10.4187/respcare.01828
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Dainese R, Serra J, Azpiroz F, Malagelada JR. Influence of body posture on intestinal transit of gas. Gut. 2003;52(7):971-974. doi:10.1136/gut.52.7.971
“3 surprising risks of poor posture” Harvard Health February 15, 2021 https://www.health.harvard.edu/staying-healthy/3-surprising-risks-of-poor-posture#:~:text=Heartburn%20and%20slowed%20digestion.,wrong%20direction%2C%22%20explains%20Dr.
Nair S, Sagar M, Sollers J 3rd, Consedine N, Broadbent E. Do slumped and upright postures affect stress responses? A randomized trial. Health Psychol. 2015 Jun;34(6):632-41. doi: 10.1037/hea0000146. Epub 2014 Sep 15. PMID: 25222091.
Jessie Hackford, Anna Mackey, Elizabeth Broadbent, The effects of walking posture on affective and physiological states during stress, Journal of Behavior Therapy and Experimental Psychiatry, Volume 62, 2019, Pages 80-87, ISSN 0005-7916, https://doi.org/10.1016/j.jbtep.2018.09.004.
Why good posture matters https://www.health.harvard.edu/staying-healthy/why-good-posture-matters
Back Health and Posture https://my.clevelandclinic.org/health/articles/4485-back-health-and-posture
Posture: Align yourself for good health https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/posture-align-yourself-for-good-health/art-20269950
“Why Good Posture Is Our Favorite Way To Improve Pelvic Floor Health” National Association for Continence