Perfecting Your Posture to Relieve Chronic Pain

How long does your body hurt after your feet first hit the floor in the morning? Ten minutes? Sixty minutes? All day? If you have forgotten what it feels like to move without pain, then this information is for you! Chronic pain has become so prevalent in our society that we are beginning to treat it as a normal phenomenon instead of the alert system that it is. Most degenerative changes that occur in the body are a result of how we move. Not just how often we move, but how we move specifically.

But my posture looks good!

Because I always begin an assessment with standing posture, most body-conscience people are startled to see that although their standing posture is aesthetically excellent, the alignment of the skeleton is not. That often reveals issues hidden deep within the musculature of the body. Because posture is subjective, guidelines are usually passed from teacher to student or mother to child. We know the basics—hunching over is bad and keeping the stomach in is good—but there are many other things that your mother didn’t know, especially when dealing with chronic injury issues. While biomechanical concepts are often linked to the movements of the arms and legs, the same universal laws apply to circulation, blood flow, lung inflation and bone density. Important physiological functions such as cardiovascular and organ health are also dependent on the mechanical environment created by skeletal position.

For a scientist, it is much easier to work with alignment than posture. Alignment is objective and easy to quantify. It is also easy to teach individuals where their body should be in space, and more importantly, why. The best alignment is chosen to place the bony levers in the position from which the muscular system has the best control. Alignment from the muscular point of view means less of many things: less inappropriate force in the joints; less stress on cartilage, tendons and ligaments; and less neurological confusion. It can also lead to more oxygen flow, more support for the organs in the body, and more motor skill, which is essential for healthy cognitive function. The two misalignments I see most often are tucked pelvises and rib thrusting. Both of these actions are compensatory mechanisms to enhance posture when muscular strength or motor skill is missing.

Tucking your pelvis?

Many women tuck their pelvis because it flattens the belly or because they were instructed from a young age not to stick out their bottoms. Yet this movement actually decreases the function of the muscles in that area. A tucked pelvis can change the position of the pelvic floor muscles, making them inefficient at holding the organs with strength equal to their weight. That can increase pressure on the prostate in men and can lead to organ prolapse in women. A backward tilt can also result in weak posterior muscles and excessive tension through the low back, which can decrease circulation and loading to the hips—critical to bone and cartilage generation.

Rib Thrusting

Rib thrusting is a common mechanism to disguise kyphosis, a forward curvature of the middle and upper back. Excessive sitting restricts the ability to mobilize the vertebrae individually. Standing up straight has simply become adjusting the upper back as a whole unit, not the individual articulation that the spine is capable of. The result is shoulders that are back where they should be, but ribs that are displaced forward. Because the placement and mobility of the rib cage are essential for optimal lung inflation, this bony repositioning can have an instant effect on how much air enters the body and how much oxygen enters the blood. The abdominal muscles attach to the lower ribs as well, so thrusting the ribs leads to weak stomach muscles, poor spinal stabilization and excessive disk compression.

Are You a Rib Thruster?

Stand against a wall with your heels three to four inches away. Press your thigh bones back toward the wall, letting your tailbone relax. Next, bring your shoulders, arms and the back of your head against the wall. You should have a small space underneath your waistband, but your middle back should be firmly touching.

Katy Santiago shows bad posture with rib thrustingKaty Santiago shows good posture with a straight back

Notice the ribs thrusting away from the wall. Good alignment! Head, ribs and hips on the wall without tucking the pelvis (waistband off).

If your middle back is not touching, peel your head and shoulders away until your mid-back touches. This is the curvature of the upper spine. Ideally your head, mid-back and pelvis should be touching the wall at the same time (but not your waistband). If you can’t keep them against the wall at the same time, then your upper spine doesn’t have the mobility it needs for the optimal health of the tissues that live there.


Katy Santiago is a biomechanics expert, director of the Restorative Exercise Institute, and featured expert in Gaiam’s Restorative Exercise DVDs for Strong Bones, Spinal Alignment and Foot Pain.

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