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The Best Exercises To Improve Posture And Get Out Of Chronic Pain

Written by: Nick Jack
Category: 2014
on 12 October 2015
Hits: 5349

Understanding the importance of posture and how to assess and correct faults should be the priority of every rehabilitation program. To take it one step further this also should be the priority of every sports and strength program because a person who moves in close to perfect posture moves most efficiently. Apart from injury prevention, improved performance is the secondary gift of improving posture. Unfortunately this type of training is completely ignored or misunderstood by most people resulting in poor response to rehab programs or sports performance. Often multiple injury or new injury can and does occur when postural problems are not addressed much to the frustration and despair of the person in pain. This article we will show you some of our simple assessment methods, why and how you to correct your posture and some of the best exercises that produce significant results to prevent injury and improve performance.

What Is The Perfect Posture?

Posture is defined as: "The position from which movement begins and ends."

Ideal Posture - That state of muscular and skeletal balance, which protects the supporting structures of the body against injury or progressive deformity, whether you are moving or not. It is during a state of ideal posture that the muscles will function most efficiently. In ideal posture, a line extending down the side of the body should run through the ear lobe, transect the shoulder, hip and knee joints and fall just in front of the ankle bone. We use an IPAD assessment tool called Posture Screen Pro to assess our clients and you can see an example of this below. This picture provides before and after photos over a 9 month period of postural correction.

This is an excellent example of a client who came to use for postural correction and made some significant change within a short amount of time. We needed to have a definitive assessment tool and this app is fantastic at providing this for us to evaluate the success of our program. Knowing where to start is important in designing the program because the exercises and stretches that can correct one postural dysfunction can exacerbate another! Understanding the different types of posture and the relationship they have with opposing muscles makes this so much easier.

Poor Posture

Poor posture not only takes away from looking good, it compromises how we were designed to function, eventually leading to pain and/or injury. The majority of people have very poor posture due to a number of different factors, such as working in environments that force us to sit too much, performing repetitive tasks with poor form, dysfunctional breathing, emotional disorders and even developmental dysfunctions evolved through childhood.
The following is a picture of common postural dysfunction.


The picture above shows the effects of imbalance between the trunk flexors (your abs) and trunk extensors (your back muscles). As the abdominal musculature become progressively stronger than the back muscles, the following postural aberrations may be seen:

  1. Short and tight upper abdominal musculature
  2. Depressed sternum
  3. Forward head
  4. Increased thoracic kyphosis, (a hump on the upper back)

This type of posture is very common and usually associated with lower back pain and disc bulges! This is due to the development of a "flat back" and loss of your spine's natural curve, often due to excessive time spent in a seated environment. This can progress to a C-shaped spine, and severely altered spinal mechanics. The C-curve posture encourages degenerative changes in the spinal column, not to mention that it increases your chances of neck pain to go along with your lumbar disc problem, and a lifetime of Chronic PAIN.

The most concerning issue arising from postural faults and imbalance is not just the area in pain but the risk of further more serious injury in other areas in the body and loss of balance. This is due to the loss of stability and balance. The body will use many protective methods resulting from instability that in turn creates loss of balance and rotation. For example a forward head posture will increase the thoracic spine kyphosis restricting your ability to rotate, which in turn restricts your balance as you are now limited to correct yourself when you need it. As mentioned earlier this is very common in golf and lack of rotation for a golf player is a disaster and severely destroy your handicap, and also your body. See the video below of an example of this.

What Is Dynamic Posture?

So far we have looked intensely at Static Posture which is the position of your body at rest. But what about the way you hold yourself when you move? This is quite interesting as I have seen many people present terrible results in a static assessment yet when they move they are almost perfect, and funnily enough more times than not they are pain free! This would be common with high level surfers, snowboarders, some dancers and even gymnasts to a degree. This would be due to the fact that they have taught themselves the necessary skills and abilities needed for their sport or hobby that requires a perfect body position to compete at a higher level. The common theme  to all of them is a close to perfect posture in order to maintain optimal balance and fluent movement. Training balance skills with poor posture is a waste of time as you will never learn to surf or snowboard to elite levels if you cannot maintain the optimal body position.

How Do You Correct These Faults?

As part of the correction of these cases of faulty alignment, the long weak muscles must be shortened and strengthened, while the short tight muscles must be stretched. The stretching should take place first. It is very important to stretch only the tight muscles and apply a consistent approach. This is why we spend so much time on designing a stretching program at the start of our rehabilitation programs and even sports programs to ensure these tight muscles are taken out of the equation. On the other side of having tight muscles is weak muscles. We all have certain muscles prone to lengthening and weakening. When a muscle group becomes angry and tight, it will try to take over the function of weaker opposing muscles, resulting in continuation of muscle imbalance and often overuse injury to the tight muscles. An example of this would be tight hips, now inhibiting the weak glutes (your butt).

This is a concept first explored by Vladimir Janda and also later by Paul Chek and where the terms Tonic muscles versus Phasic muscles and also Lower Cross Syndrome and Upper Cross Syndrome developed. Not all muscles are designed the same way. In Vladimir Janda’s book “Assessment & Treatment of Muscle Imbalance” he explains great detail how this system works, but in simple terms tonic system muscles are prone to tightness or shortness, and the phasic system muscles are prone to weakness or inhibition. Janda determined this from clinical findings working with his patients, and you can see this yourself if you watch a person with cerebral paulsy move, the tonic muscles become completely dominating while the phasic muscles become almost completely non existent. I have witnessed this myself working with some brain injury clients and disabled clients. This is very important to know when designing our program for stretching and strengthening, as we need to make sure we are only stretching the TONIC muscles, and not the phasic. The Phasic muscles are commonly recognized as the muscles that are mainly responsible for movement, where as the Tonic muscles are mainly responsible for stability, posture and stabilization. Muscles prone to weakening are commonly lengthened too much in relation to their ideal resting length and the relative length of their opposing muscle.

In a common postural injury like piriformis syndrome we see the tightening up of the Hip Flexors and Quads ( rectus femoris) creating a reduction in glute strength during basic movements like walking and running. This lengthening and weakening of the Glutes & VMO occurs due to their Phasic nature. The tonic muscles being the hips and in this case the Piriformis muscle, begin to develop a method of overworking and dominating all movements and in essence “shut down” the phasic muscles completely. The longer this stays this way the further the imbalance becomes and reaches a point of chronic pain that can lead to nerve impingement and all types of leg and back problems. Which is why we MUST approach a muscular imbalance by identifying these tight muscles with tests and putting a plan in place to weaken their overworking nature. To strengthen the weak muscles first without weakening the tonic muscles is a waste of time, as the tonic muscles will “steal” the workload and continue to become short and tight.
Refer to chart below of examples Tonic and Phasic muscles.

Lower Cross Syndrome and Upper Cross Syndrome

Here is two videos to watch that demonstrate these postural concerns and you will also see what it looks like after it has been corrected.

What Are The Best Exercises You Can Do At Home?

Firstly make sure you have identified where your postural problems may have begun and make changes to this before starting an exercise program. For example change your workstation set up, buy a new bed, go for a walk at lunchtime instead of sitting on the couch, change your running technique. These are just some of the things you need to look at to see what caused your problems in the first place. An exercise program is a waste of time as long as these problems remain. As mentioned, make sure you have completed a thorough stretching assessment to identify any muscle length tension imbalances that need correcting. Watch our video on how to do this by going to our Sports Assessment video. Watch the video from the 6:47 mark to see the exact stretches we use. Once you know what your KEY STRETCHES are you can combine with the stability exercises I am going to show you. Before getting straight into the exercises it is important you understand how to breathe correctly and engage your core using some simple tips and body mechanics. This allows your weaker muscles to remain engaged but more importantly work in the correct timing and sequence. I suggest reading our article on CORE STRENGTH here to see this in full action.
Complete your key stretch first and then follow up with the exercise as per the instructions below.

Prone Cobra

Without a doubt the best exercise to use for correcting the Kyphosis or hump on the back. Very easy to do, needs no equipment and can be done almost anywhere.

Instructions:
1. Lie face down with your arms at your sides.
2. As you inhale pick your chest up off the floor with the neck in neutral alignment simultaneously squeezing your
shoulder blades together and rotating your arms out so the palms face away from your body.
3. You should feel the muscles between your shoulder blades doing the work. If you feel stress in your low back
squeeze your butt cheeks together prior to lifting your torso.
4. Hold until you need to breathe out and exhale as you lower.

Make sure you hold this for 10 seconds and complete 6 repetitions before having a rest. Complete 2 more sets and your job is done

The 3-minute Time Under Tension Rule:

The reason I asked you to hold for 10 seconds and repeat 6 times over 3 sets is so we could achieve a total time of 3 minutes. Research has shown that the longer you can hold a postural correction exercise, the better your postural improvements will be, as your muscles begin to relax and form a new resting position. The postural tonic muscles will respond more to time than load. Start with small exercise holds of about 10-15 seconds and gradually increase the time to 3 minutes as your posture and ability to hold the exercise becomes stronger. Watch this video for a full explanation of this concept.

Horsestance

Instructions:
1. Kneeling on all fours with good spine alignment horizontal to floor dowel on back with elbows bent.
2. Drawing your belly button in towards your spine raise one arm 45° in front to shoulder height with thumb upwards and the opposite leg straight back to hip height moving the rest of your body as little as possible.
3. Hold for 5 seconds and complete 10 reps before completing on the opposite side.

Swissball Neck Flexion

A great exercise for teaching you how to hold your posture in a standing position. Remember the postural assessment we did at the beginning? Well this exercise is actually training your brain and your muscles to feel what it is like to be in "ideal posture". We use this a lot with Golf players to help them with addressing the ball better and also to provide more explosive rotation. Also anyone with neck pain or upper back pain this is a fantastic exercise to use. Once again the 3 minute time under tension rule applies here as for this posture to become your new position you need lots and lots of time.

Instructions:

  1. Stand with a swissball against the wall and your forehead touching the ball
  2. Engage your deep abdominal muscles and slowly walk towards the wall
  3. You will feel some tension in your neck as you try to maintain a perfect tall posture
  4. Hold for 10 seconds and rest
  5. Repeat 6 more times before completing a stretch

Watch the video below of other more Functional Strength Training exercises that can enhance your posture. Technique is everything and trying to execute perfectly will do more good than just trying to get a few more reps.

Conclusion

I hope this article sheds some light on what is often a difficult and boring topic to come to terms with. If you are injured or suffer from repeated injuries or pain, I highly suggest you undertake a postural corrective program for a while until your issues resolve. If you play sports then this type of training must make up some part of your conditioning to firstly avoid injury but secondly improve your performance. Lastly always remember to look for the original cause with postural problems which in most cases is from sitting too much, poor workstation set up and various other repetitive tasks. To get long term success you must identify these areas and change them. An exercise program can only do so much while you continue to do the things that caused your problems in the first place.

If you enjoyed this article and would like to know more about our programs fill in a form below to schedule a Free Postural and Movement assessment. I will get back to you within 24 hours.