How to Improve Posture
I get visits in the clinic from people
who don't have pain, but simply want to know how to improve posture either in themselves or in their children. Do you feel like you
struggle to stay upright? Are your shoulders always pulling you
forward? Do you struggle to touch the floor because you have tight
hamstrings? Do you suffer from mid-back fatigue and burning? Most of us
are involved in occupations that involve work in front of us - sitting
at computers with our hips and knees bent, head and shoulders forward,
elbows bent and palms down. Alternatively we stand for long periods
with our hips forward, slouched often, working on something in front of
us. We tend to overuse some muscles and underuse others and this is
what causes postural problems. Maintaining proper posture can be a
struggle between the overused muscles and the underused phasic muscles.
Why
are Some Muscles Tight and Others Weak?
What
are Upper Crossed and Lower Crossed Syndromes?
How
Can We Use this to Improve Stretching?
Why are Some Muscles Tight and Others Weak?
One hypothesis
is that poor motor control causes poor movement patterning and
imbalance between phasic muscles and tonic muscles. Phasic muscles are
those that have a tendency to become weak and inhibited under
conditions such as those listed above. These phasic muscles typically
work eccentrically against gravity. We can improve posture by
increasing activity in these phasic muscles.
This theory of phasic versus tonic muscles was first
introduced to the medical community in 1979. Dr Janda, a Czech
physician pursued his interest in physiotherapy after he finished
medical school and was one of the first medical doctors to work in the
field of physical medicine and rehabilitation. His theories on muscle
imbalance and pain syndromes are used worldwide by physical therapists
and physiatrists. He identified muscles that are prone to becoming
tight, and short, and other muscles that are prone to becoming weak or
inhibited by pain, stress, poor positioning, etc.
His tonic muscles are those that are involved in repetitive
activities and are dominant in a child shortly after birth. The phasic
muscles develop as the child works against gravity and become stronger
as the child's nervous system matures. In people that suffer
a stroke or cerebral palsy the flexor/tonic muscles dominate movement
suggesting that muscle imbalances may in part be due to central nervous
system influence - not just changes in the structure of the muscle and
shortening of connective tissues.
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Tight Tonic Muscles Upper Trapezius Pectoral Muscles Sternocleidomastoid Levator Scapulae Suboccipital Muscles Subscapularis Scalene Latissimus Dorsi
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Weak Inhibited Phasic Muscles Rhomboids Hyoids Serratus Anterior Deep Neck Flexors Infraspinatus Teres Minor Supraspinatus
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Tight Tonic Muscles Rectus Femoris Hip Flexors Hamstrings Erector Spinae Hip Adductors Tensor Fascia Lata Piriformis Quadratus Lumborum
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Weak Inhibited Phasic Muscles Rectus Abdominis Vastus Medialis Vastus Lateralis Glutes Transversus Abdominis
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How to improve posture
Stable posture
requires a balance in activity of the phasic
and tonic muscles otherwise pain and instability results.
Muscle imbalances result in a predictable manner. Janda classified
these imbalances as "upper crossed syndrome" and "lower crossed
syndrome".
What are Upper Crossed and Lower Crossed Syndromes
The
upper crossed syndrome involves facilitation of levator
scapulae, the upper fibres of trapezius, sternocleidomastoid, and
pectoral muscles, and inhibition of deep neck flexors,
serratus anterior, and lower fibres of trapezius. The lower crossed
syndrome involves facilitation of rectus femoris, the thoracic and
lumbar extensors, and the iliopsoas muscle, and inhibition of
abdominal muscles and the glutes. These muscles prone to tightness have
a lower threshold for activation so can become hypertonic.
These tight tonic muscles pull your head and shoulders
forward forcing muscles that control your shoulder blades to weaken
resulting in shoulder impingement issues. Tightness in the suboccipital
muscles cause headaches. Weakness in the deep neck flexors cause neck
instabilities. You can see how a series of muscle imbalances can alter
your movement patterns create poor posture and cause pain and injury.
Because of the reciprocal inhibition of muscles, the tight
muscle inhibits its antagonist. For example, the pectoral muscles work
with the rhomboids and middle traps to control scapular positioning on
the thorax. If the pectoral muscles are tight, their muscle spindles
fire excessively which causes a reflex inhibition to the rhomboids and
middle traps. This constant inhibition results in weakening over the
long term. As the pectoral muscles become tight, the scapulae assume a
new forward position. this is the rounded shoulder posture we see in
many people that work at desks all day.
Tight muscles limit mobility causing pain and weak muscles
fail to support joints leading to premature degeneration. So while it
is important to stretch what is tight, it is also important to
strengthen what is weak. Good posture and ease of movement is achieved
by stretching tight tonic muscles allowing their antagonists to respond
to strengthening exercises.
How Can We Use this knowledge to Improve Stretching?
You can
imagine the sensorimotor system is like a radio with controls for bass
and treble. You require a balance between the bass and treble to get a
sound that is harmonious. By toning down the bass we hear more treble
and vice versa. Likewise if we are able to tone down the tonic group of
muscles we bring our muscles more into balance allowing the tonic
muscles to stretch and improve posture. We can attempt this using the
Bruegger exercise.
The Bruegger
exercise activates the phasic group of muscles. By using
these muscles, through reciprocal inhibition we force the tonic muscles
to relax so we can get further into a stretch lengthen the tonic group
of muscles and improve posture.
Poor posture can be aggravated by sensory input that
affects muscle tone:
- Stress
- Pain
- Joint dysfunction
- Central nervous system disorder/injury
- Prolonged postures or repetition of the same activity
- Overwork or over-training
What is posture? To think all you need to do to correct your posture is do a few stretches and strengthening is foolish. Our posture and how we perceive our position in space is dependent on the development of the postural reflex system as an infant, how we learn to activate sets of muscles (muscle synergies)during our life time to control posture, sensory input, and responses from the higher centres of the brain to this sensory input. Part of a good postural correction program should also include proprioceptive and balance exercises.