Your Posture Matters

Ladies and Gentlemen, I am hoping that you are staying well, and that by now you have been fully vaccinated to protection you and others from the COVID-19 virus.  Also, I hope that your life is returning to a more normal routine for daily living.

During these past months, you probably spent more time sitting, communicating, and socializing on computers, iPads, and phones.  Shoulders were rounded, heads were titled forward, chins were tucked downwards.   Necks and backs are strained and maybe even painful; hip and leg muscles are maybe a bit weaker.  As I paint the scenario of the health effects with a more sedentary lifestyle, more than ever expected, these changes in activity may have contributed to poor posture.   My question to you is:  Have you noticed a change in your posture over this last year?

Good posture is so important to your health, function and fall prevention.  When you stand up, do you stand straight, shoulders back, and head lifted so that your chin is parallel to the floor?  If not, your posture can be improved.  To maintain good posture takes work, but also posture changes do occur with aging.

Good posture is directly related to the musculoskeletal systems, an interaction of   bones, muscles, and joints.    If you have posture changes, is it due simply to slouching (Picture A) or aging changes that results in kyphosis and hyperkyphosis (Picture B).

     or               

Picture A                                                               Picture B

The spine is made up of bones referred to as vertebra, muscles, and sponge-like disc between the vertebrae.    With aging, changes occur to all three anatomical features, which is why over time the backs of aging adults tend to curve, as seen in Picture B.

The major factor in spine curvature, is not slouching, rather occurs due to aging changes in the intervertebral discs.  The intervertebral discs harden over time, lose flexibility, compress the length of the spine, which then tilts forward – referred to as kyphosis.   As the degree of kyphosis increases to hyperkyphosis (hyper-curvature), physical performance changes, fall risk increases, and quality of life may decline (Katzman, et al., 2010).  According to Katzman, et al., reports estimate that 20-40% of older adults have hyperkyphosis.  The greater the severity of kyphosis, the greater the odds of falls in older adults (McDaniels-Davidson, et al., 2017).   Muscle mass also changes with age.  Loss of skeletal muscle mass and function is referred to as sarcopenia (Santilli, et al., 2014).  Muscles shrink, which also contribute to the curvature of the spine.

Osteopenia and osteoporosis, loss of bone density, also results in changes in posture and height.  The loss of calcium in bones produces loss of density, which produces a slight reduction in the size of bones result in slight changes in height and curves of the spine – both change erect posture.  Osteopenia and osteoporosis are risk factors for injury when you fall.    Medical treatment exists that can correct your posture and reduce your fracture risk.   Your Harmony Team wants to protect you from injuries when you fall.

As with all other topics we have discussed over the last couple of years, strategies exist to help prevent, delay and/or treat these changes and diseases.  If you notice changes in your posture, you should tell your Harmony Team.  Your Harmony Team wants to work with you to reduce your fall risks and improve your posture.   You can reduce your risks and implement actions that can help improve your posture.   You can pay attention to and maximize your posture – stand up straight.   You can avoid slouching, slumping or fall asleep in a chair.  You can exercise.

Exercise

Ladies and Gentlemen, Exercise is by far the most important factor for maintaining posture and is so important because exercise improves bone and muscle functions, both essential to maintaining musculoskeletal health.   So many people are sitting, spending lots of time on computers, maybe even falling asleep in a chair with heads falling forward.   This can cause neck pain, back pain, and poor posture.    Knowing that exercise is the primary intervention, talk to your Harmony Team and primary provider about a possible referral to physical therapy for a prescribed exercise program.

I would like to share with you a couple of exercises prescribed to many ambulatory patients who attended my Falls Clinic that involved standing against a wall inside their home.  One is called a Wall Stretch Angel and the second is the Stand Straight Supported, both which my patients valued.

Wall Stretch Angel

You can see this exercise demonstrated here.

Here is a diagram of your body position against a wall.

Here are the steps:


Stand with your back against a wall (your body should be touching the wall).


Place your hands at your sides, with palms up.


Raise your arms up to shoulder level, bend your elbows to look like a right angle.


Slowly raise your arms, keeping your elbows against the wall as you lift, then slowly lower your arms just down to your waist…Repeat 5-10 times, and if you can, complete this exercise again in the day, especially after sitting in your chair for long period of time while, at a desk or a computer.   You will sense how good this feels for your back and shoulder muscles – both needed to improve your posture.


Stand Straight Supported


Stand in an open corner in a room, clear and obstructed by furniture.  Back-up into the corner until you feel the support of the connecting walls against your shoulders and your body – you should feel supported.   Next, lift your head up and back until your head touches the walls in the corner.    Appreciate how good it feels to have your head lifted high, to look straight head.   Hold that position for 10-15 secs, then relax the position.   Repeat 5-10 times.   If you don’t have any issues with vertigo, you can also add slowly turning your head from side-to-side, until your chin reaches your shoulder and reverse from left to right.  These exercises will stretch and strengthen your neck muscles.


Straight posture is essential to visually scan your environment, anticipate and navigate your environment, maintain normal balance and walking, and reducing your fall risks – reduce your falls.


I hope this message is helpful to you and provides easy strategies for your safety.   If you have concerns, remember to talk to your Harmony Team.   Open communication with your healthcare team as you adjust to this changed way of living, helps you to maximize your health and function, essential to reducing your fall risks.


Your Harmony Team is committed to reducing your fall risks, to help you prevent falls, and promote your function and independence.


Your Harmony Team is here to help you!


Thank you for reading this message.

Pat Quigley

03/08/21

References:

Katzman, W.B., Wanek, L., Shephard, J.A., & Sellmeyer, D.E.  (2010). Age-related hyperkyphosis: Its causes, consequences, and management.  J. Orthop Sports Phys. Ther., 40(6):  352-360.

McDaniels-Davidson,  C., Davis, A., Wing, D., Macera, C., Lindsay, S.P., …  Kado, D.M. (2017).  Kyphosis and incident falls among community-dwelling older adults.   Osteoporosis International, 29, 163-169.

Santilli, V., Bernetti, A., Mangone, M., & Paoloni, M. (2014).   Clinical definition of sarcopenia.  Clin Cases Miner Bone Metab, 11(3), 177-180.

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