The Alignment (Or Not) of Posture and Pain

"Stand up straight."

A quote you may have heard from your parents or grandparents as a kid, or may even have mentioned it yourself. The expectation being a posture mimicking that of a soldier standing at attention.

Or what am I often asked by clients in the gym and clinic: "Is my pain related to poor posture?". Often times, it is a result of a Google search or acquaintance mentioning that it is.

So what is the verdict?

To date, pain and posture are not well linked in research studies assessing posture. It is important to know that posture in these studies is generally defined as the amount of curvature of the spine in that region (upper back, lower back, and neck).

These results have been shown for low back pain and amount of lordosis(1), neck pain and global and segmental posture(2), and subacromial impingement syndrome and upper back posture (3). These studies tend to show a large range of difference among posture in both those in pain and those without pain, suggesting that the differences are natural differences among individuals.

So what does this all mean? If we think differently, what if a "posture problem" is actually a movement problem (or lack thereof)?

If you've ever been on a long-haul flight (cue flashbacks of economy class Vancouver to Sydney), put in shift in front of the computer, or been on your feet for hours at a conference, you probably noticed your body becoming fidgety. You start to move around, stretch, shift side to side. In short, you change your posture.

Often times, your body knows what to do if you listen. Try to avoid staying in the same spot for an extended period of time. Take periodic movement breaks (even if that means doing a little dance in the office!).

Hope this helps.

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References:

(1) Laird, R.A., Kent, P., Keating, J.L. How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain?. BMC Musculoskelet Disord17, 403 (2016). https://doi.org/10.1186/s12891-016-1250-1

(2) Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007 May;16(5):669-78. doi: 10.1007/s00586-006-0254-1. Epub 2006 Nov 18. PMID: 17115202; PMCID: PMC2213543.

(3) Lewis, J.S., Green, A., Wright, C. Subacromial impingement syndrome: The role of posture and muscle imbalance. Journal of Shoulder and Elbow Surgery, Volume 14, Issue 4, 2005, p385-392