As we get ready to head back to school, it’s a great time to talk about posture. Whether we are sitting or standing it is important for our bodies to be in alignment. So, this week we are going to take a deeper look at posture including what defines good posture, what can cause poor posture, and what we can do to improve our posture. So, let’s dive in.
What is good posture?
To understand posture, we need to familiarize ourselves with the anatomy of the spine. Our spine is made up of a group of bones called vertebra. These specialized bones stack on each other to create a protective column for the spinal cord known as the vertebral column. The vertebra in the column are categorized by section. The first seven are the cervical vertebra, the next 12 are the thoracic vertebrae followed by the 5 large lumbar vertebra. And last, but not least, are the sacrum and the coccyx with 5 and 4 vertebra respectively.
The vertebral column is not a perfectly straight tower like you would build when playing Jenga. It has three important curves in it. If you look at the spine from the side, you will see a curve at the neck and low back that appear to curve into the body (which is defined as a lordotic curve) and one curve in the mid back which appears to curve out and away from the body (which is defined as a kyphotic curve). These normal lordotic and kyphotic curves in our spines allow us to center our weight and move efficiently.
In the standing position, correct posture viewed from the side would mean the ear, shoulder, hip, knee, and ankle all line up. In this position, the three curves of our spine are equally balanced allowing our weight to be centered over our feet for efficient movement and the least amount of wear and tear on our bodies.
In the sitting position, good posture follows the 90-90-90 principle: 90 degrees at the hip (between the trunk and thigh), 90 degrees at the knee (between upper and lower leg), and 90 degrees at the ankle (between lower leg and floor). Of course no one can maintain this perfect position for long durations of sitting, especially a child who just wants to wiggle! If the child is using a computer at a desk, an additional 90 degree angle should be seen at the elbow.
What causes poor posture?
The alignment of our spine is affected by the length and strength of the muscles surrounding it. Muscle length is how much range of movement the muscle has, and muscle strength is how much force the muscle can produce. When the muscles in and around our spine cannot move within their normal range and/or produce the appropriate amount of force our alignment can be affected.
There are many factors that can lead to changes in muscle length and strength causing poor posture. Here are some examples:
- Spending too much time being sedentary can lead to generalized weakness (loss of the muscle’s ability to produce force) which includes the muscles that control posture.
- Spending prolonged amounts of time in poorly aligned positions (ie. hunched in front of a computer) can cause changes in our muscle length and strength.
- Many neurologic and orthopedic conditions affect the muscles’ ability to relax and or generate force which impacts alignment.
Poor posture can have long term implications. Small changes in posture can often progress and become larger issues over time, especially during periods of rapid growth. And, changes in posture that persist can become permanent.
Simple ways to improve posture
Believe it or not, there are some very simple changes that can be made to support better posture:
- Encourage children to be more active. Play moves the body helping muscles to stretch out and get strong.
- Check your child’s backpack. Backpacks should be worn with the straps snug. I’m sure you will hear the same “It’s not cool!” complaints I do, but it’s very important. The heaviest items should be in the back of the pack, closest to the body. The pack should weigh no more than 10-20% of the child’s weight. https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Back-to-School-Tips-Getting-the-Year-Off-to-a-Good-Start-from-the-AAP.aspx
- Make sure kids are not spending too much time in front of screens. And if they are going to play:
- Make sure they are in a good position.
- Try having kids play laying on their stomach (prone).
- Make sure they take frequent breaks and move around.
- If your child uses adaptive equipment like a wheelchair, check to ensure the equipment fits properly. Remember that obtaining alignment in these devices is impossible without using the straps and supports. Check with your therapist or medical provider if you are not sure how to use these items.
- Try some simple stretches and strengthening activities to help improve posture.
Stretch It Out
Head Tilts
- Get in a comfortable sitting or standing position.
- Slowly lower your ear toward your shoulder making sure to not to let your opposite should come up.
- Relax in this position for 15-30 seconds.
- Repeat on the other side
Chin to Chest
- Get in a comfortable sitting or standing position.
- Slowly lower your chin toward your chest
- Relax in this position for 15-30 seconds.
SuperHero Stretch
- Stand in the middle of a doorway.
- Lift your arms above shoulder height and place your hands on either side of the doorway.
- Slowly lean forward. You should look like your favorite superhero flying through the air.
- Hold the position for 15-30 seconds.
Cat and Cow
- Get in a hands and knees position.
- Slowly round your back up like a cat.
- While rounding your back, tuck your bottom and bring your head down like you are trying to look at your belly button.
- Slowly come back to the start position.
- Slowly arch your back with your belly moving toward the floor.
- Gently bring your head up so you can see the sky.
- Slowly come back to the start position.
Turtle in the Shell
- Lay on the floor on your back.
- Bring your knees to your chest
- Wrap your arms around your legs and hold the position like a turtle trying to stay in their shell.
Adapted Stretches
If a child has good head control, try the head tilt and chin tucks in supported sitting.
Prone on Extended Arms
- Lay the child on the floor on their stomach.
- Have the child place their hands on either side of their chest.
- Then ask them to push up onto their hands and bring their head up.
Prone Prop
- Lay the child on the floor on their stomach.
- Have the child bring their forearms under them
- Then ask them to push up onto their forearms and bring their head up.
Supported Prone Prop
- If the child is not able to prop on their forearms independently, use a firm cushion or wedge under their trunk.
- Move their arms in front of the wedge.
- Ask them to bring their head up.
Get Strong
Marionette
- Stand with your back against the wall.
- Pretend someone is pulling on a string attached to the top of your head.
- Bring your head up and back until the back of your head touches the wall.
- Hold the position for 5-10 seconds.
What Time Is It?
- Stand with your back against the wall and your arms at your side touching the wall.
- Have your partner call out times on a clock.
- Move your arms into the correct time position with the back of your arms touching the wall.
Shoulder Blade Squeeze
- Get in a comfortable sitting or standing position.
- Have your partner place their hand on your mid-back between your shoulder blades.
- Squeeze your shoulder blades together trying to touch their hand.
Core Muscles
- Check out these posts/videos on ways to improve core muscles which are an essential part of posture.
Adapted Strengthening
Adapted Marionette
- Sit in your adaptive device with a headrest.
- Pretend someone is pulling on a string attached to the top of your head.
- Bring your head up and back until the back of your head touches the headrest. *Use a small stuffed animal behind the child’s head to help them determine where pressure should be.
- Hold the position for 5-10 seconds.
What Time Is It
- If the child has good upper body/arm strength, try this game in a wheelchair or regular chair. Make sure their back stays in contact with the back of the chair during the activity.
- If that is too difficult:
- Have the child bend their arms at the elbow.
- Keeping their back against the chair, have the child lift their elbows so there is a 90 degree angle at their armpit.
- Demonstrate as needed to assist.
Adapted Shoulder Blade Squeeze
- Sit in your adaptive device.
- Bring upper arms next to the side of your trunk.
- While keeping your back against the seat, try to push your elbows back into the backrest.
The alignment of our spine is soooo very important. If you have any concerns about alignment and posture, please seek the advice of your medical professional. Their input is essential and invaluable.
Thanks so much for stopping by today!
– Heather
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