When discussing posture, most people think about how they sit or stand. That is only one type of posture, what we call static posture. Static posture is how the body is aligned while not moving.
Postural problems are often first noticed with static posture, such as someone slumping while sitting.
There is a second type of posture to consider and that is dynamic posture. Dynamic posture is how the body is aligned during movement. Problems with dynamic posture may be noticed with sports. A swimmer may notice one shoulder doesn’t stroke like the other or a yoga practitioner may find one hip doesn’t move like the other.
Since both static posture and dynamic posture involve joints and muscles, a problem with one can lead to a problem with the other.
Both static and dynamic postural faults create imbalances in the muscles of the human body. There is a carefully choreographed pull and counter pull relationship between opposing muscles in the body. An imbalance in this tug-of-war between opposing muscles can lead to injuries involving the muscles, joints, tendons and ligaments.
Poor dynamic and static posture can both lead to injury creating a vicious cycle of further injury and pain. This cycle starts with either repetitive motion (dynamic posture) or poor prolonged positioning (static posture) that leads to injury.
Depending on the degree of injury there will be varying degrees of inflammation, pain, muscle spasm, muscle trigger points (knots) and tissue adhesions. These muscle changes will alter the muscle function, both in its ability to move and stretch. The altered muscle function goes on to create distortions in muscular balances and movement patterns, setting the stage for more injury.
A classic example is someone who has had their elbow in a cast for a few weeks and then cannot straighten their arm when the cast is removed. The bicep muscles have shortened and are now too tight to allow the arm to straighten.
However, the functional balance of movement between the bicep and the triceps muscles is also lost creating problems with any controlled elbow movement.
The most common muscle imbalances are due to static posture, as so many people spend a large percentage of the day sitting. Sitting creates a very well known pattern of muscle shortening and tightening.
Perhaps the biggest and most important muscles affected due to prolonged sitting are the hip flexors (Iliopsoas muscle). The hip flexors job is to pull the knee up towards the chest. While sitting (static posture) the hip flexors are placed in this position for prolonged periods and then shorten to this size.
When people attempt to stand upright with shortened hip flexors, several movement patterns (dynamic posture) are affected.
People with tight hip flexors stand and walk with excessive pelvic tilt, creating a sway-back posture. This excessive arching of the lumbar spine causes the thoracic spine to round forward creating a hunching upper back posture. Over time, even the cervical spine can be affected with straightening and forward head carriage.
Tight hip flexors also means that the balance between the hip flexors and the abdominal muscles is lost. The hip flexors, being tighter, will activate during most abdominal exercises. Meaning all the crunches in the world won’t do anything for your abs, but will further aggravate the hip flexors.
The hip flexor muscles also need to work in balance with both the hamstrings and gluteal muscles. When this balance is lost, buttock tightness and hamstring injury will often follow.
Hip flexor tightness will affect most sports activities. Swimmers and runners are the two groups of athletes that find tight/shortened hip flexors to be particularly detrimental to their performance.
Another easily identifiable postural fault is forward rounded shoulders. Forward shoulder posture is greatest with those who spend prolonged time sitting at a desk or computer (static posture). For many, this posture is learned while a student and then continues on in professional life.
Forward shoulder posture can also result from poor exercise selection (dynamic posture). Over-development of the chest and back muscles that cause the shoulders to round forward while avoiding those exercise that pull the shoulders back can create this posture. It is common to see in all athletes, but swimmers in particular typically exhibit this posture.
The muscles responsible for pulling the shoulders back (trapezius and rhomboids) over time become lengthened and weak. Correspondingly, the muscles in the front (pectoral and anterior deltoid)become tight with trigger points.
Internal rotation of the shoulders creates greater stress on the rotator cuff setting the stage for tendonitis or greater injury. Stress and injury are also common in the neck, upper shoulders and upper to mid back.
Correction of postural faults takes time and effort. Muscle changes that were created over months and years are not easily reversible.
Be patient and work at your corrections. If these faults have been present long enough to create injury or other movement distortions, you may require treatment from a healthcare provider trained in sports medicine or movement patterns.
Dr. Jemal Khan is a chiropractor based in the Cayman Islands.