Freeze.

Check your posture. How are you sitting or standing right now? Is your body neatly aligned with your spine, joints stacked squarely on top of one another, head in a neutral position?

Or are your shoulders and back rounded, head jutting forward to see your screen, chest caved in?

One of the most important things we can do to eliminate pain, avoid doing damage to our bodies, and exude a confident, vibrant air is fix our posture.

Back, shoulder, neck, hip, knee, foot, and pelvic pain, plus incontinence and prolapse can all be caused or made worse by chronic poor posture. But fixing it is hard; as soon as we stop being aware of how we’re standing or sitting, we revert back to our slouches, leans, and locked knees.

To learn what proper posture is and how to improve our standing (so to speak), we turned to our awesome DPTs, Brianna from Four Pines Physical Therapy and Meagan of Orthopedic & Spine Therapy.

The posture problem

What does poor posture look like? According to Meagan, the problem starts, literally, from the ground up.

When you’re standing, where are you bearing most of your weight? How you stand translates all the way up, so it’s important to be sure your body is in proper alignment.

“I find a lot of people hang out on their heels, and that sets up a cascade for lazy standing,” Meagan says. “When we do that, we’re not relying on active muscles for support but instead locking our joints. When we stack up locked ankles, knees, hips, and spine, it passes the burden of holding us upright to our ligaments and skeletal structure. At some point, we can’t get away with that anymore, and things start to hurt.”

She went on to describe the posture of someone who isn’t stacking their body correctly: “Typically, the most common crummy posture I see is weight on the heels, knees locked and slightly hyper-extended [bending the wrong way], pelvis thrust forward with hips locked, bum tucked under into what we call a posterior pelvic tilt, and then, because we know we should have good posture, shoulders thrown back. Or they’ve given up on good posture and are hunched in a forward slouch.”

When we try to “fix” our incorrect posture, we tend to do it “from the rib cage up,” she says. “But just squaring our shoulders and keeping our head straight really only contributes to the neck and back pain.”

And posture problems are increasing in younger folks too, thanks to a screen-saturated culture, Bri adds. “I’m working with three teens right now who have that forward-head posture with their chin jutting at their screen, looking at phones or tablets which are down low on a desk or in their lap. Their heads are forward, chest caved in, shoulders rounded. A gentle mid-back cue to push things up and forward is all they need, but pretty soon they get tired and sore and go back to slouching.”

“Of course, when your muscles aren’t used to stabilizing you, they get tired,” she says. “But if you keep at it, they get stronger, just like any muscle you exercise.”

Check you out

A big part of fixing your posture is being aware of how you’re standing and sitting, and correcting what’s wrong.

So, check in with yourself. How?

According to Bri, one great test for those with breasts is to check out your personal … um … trajectory. “Physical Therapist Julie Wiebe suggests you check yourself out in a mirror or a window as you pass by, and notice where your boobs are pointing. Are they pointing at the ground, or up above the horizon? Or are they nicely horizontal, stacked neatly over your ribs, and leading you straight ahead? It’s an easy, quick way to connect with your posture and be aware of how you’re aligned.”

Another check, Meagan says, is to stand with your back against a wall. “Be sure your heels, hiney, the backs of your hands, and back of your head all come in contact with the wall. Keep your nose and ‘headlights’ (for those with headlights) level. If you can’t rest your head against the wall, you might want to talk with a PT for help to get that range of motion back. But this is something you can do several times a day, just to remind yourself what ‘straight’ feels like.”

There’s a sitting version of this too, for those long car commutes: “Don’t be a floating head over the steering wheel,” Meagan says. “Use your headrest, check in with it, press your head against it, use the supports for your back, and get a lumbar roll for longer trips. The support is there for a reason, so use it!”

And speaking of range of motion, when your body is in a healthy “neutral” stance, you should have range of motion available both forward and back. Can you tilt your pelvis forward and backward? It doesn’t have to be a big move, just small shifts, but you should have “room” to go both forward and back. If you can’t move one way, chances are you’re already too far in that direction.

And it’s not just standing and sitting when you need to be aware of your posture, Bri says. When you’re in the gym, take full use of the mirrors around you. Don’t lock your knees, don’t tuck your bottom up, don’t suck your stomach in. Find that nice, neutral position that allows your muscles and joints to do their job as stabilizers and shock absorbers.

OK, my posture needs work. What do I do?

Says Meagan, “When people say they get tired in the correct body position, that’s when I’ll go all the way to the floor. Yes, you’re clinging for dear life above, but if your pelvis is arriving to the room a full minute before your head does, you’re not lined up. Save your muscles by stacking your body correctly: shift your weight forward to the base of your big toe or the front of your foot’s arch. Bring your pubic bone over your shoelaces to unlock the joints below. Lift your sternum, don’t just shove your shoulders back. Open your chest and rib cage to straighten up from the slouch.”

Other suggestions include getting good shoes that fit your feet and your needs (probably NOT high heels). If you’re on your feet all day, consider inserts or custom orthotics, and get shoes that support your feet and ankles (or better yet, work on strengthening your feet and ankles).

Chest-opening exercises can make a big difference, Bri says: “If a motion of a joint is painful, it may take something as simple as fixing your posture to alleviate the pain. If you have shoulder pain, it may be because of a cramped, impinged posture that’s limiting your range of motion. Open up your chest with pectoral stretches. We do an exercise called the ‘open book’ that helps you rotate and open your spine and stretch your chest muscles, thoracic spine, and pectorals.”

Also, get a good foam roller. Even just lying on it can help open you up and loosen tightness in your chest and thoracic spine (the part of your spine that runs from the base of your neck to your abdomen).

Change your posture periodically. Both PTs like adjustable desks because you can sit for a while, stand for a while. But it’s important to do both correctly and stay in alignment. If you start to shift your weight to one hip, it’s time to sit again.

Just be aware of what your body is doing, what you’re asking from it, Meagan says. Try to be aware that most of us stand with our knees locked, and try not to do that. You don’t have to stand with bent knees, just don’t lock them.

What does good posture look like?

Imagine a little creature that stands on your head and drops a plumb line down the side of your body. The line should run straight from your earhole to the midline of your shoulder (and remember, that’s with the rib cage up and open, not just shoving your shoulders back). From your shoulder, the line should run to the bony part of your hip, to the bony fibular head on the side of your knee, to the bony part of your ankle. Fortunately, your body leaves a sort of topographical map of bony bits to guide you.

Stacking your body properly allows gravity to work for you. Think of cultures where people carry heavy loads on their heads. “If your body is correctly aligned, it’s possible to carry quite a lot of weight safely. Gravity compresses and stabilizes you in a good way,” Meagan says. “But if you’re all out of alignment like a Jenga construction, you’re asking your muscles to take too much of the load.”

Fixing poor posture doesn't happen overnight, especially when we've spent years hunched over our computers, books, or food, but as the PTs tell me, fixing your posture starts a cascade of so many other good things: better breathing, better sleep, less pain, reduced incontinence and prolapse risk, and more. Plus, consider the message your body language is sending into the world – do you appear withdrawn, isolated, and unwelcoming? Or confident, open, and ready for anything?

Go stand in front of a mirror and do the plumb line test. Pull your body into the best alignment you can manage. Really feel how straight and confident and strong you can be. Do this anytime during the day when your body hurts, when you're tired or feeling insecure, or when you've just been sitting or standing too long. Then come back here and let us know how the simple act of correcting your posture changed your world – even if, for now, it's just for a few minutes at a time.

Have you had help to improve your posture? How did you do it (other than joining the military...)? We'd love to hear more, so please feel free to comment here, or start a thread in our community forums. You can also reach out to us on genneve’s public Facebook page or in our closed Facebook group.



Shannon Perry

Shannon is a celebrated author and global educator. Whether she’s interviewing a physician or producing a podcast, her appetite for research, facts, and truth culminates in credible health education and programming that women can rely on. An avid runner, cyclist, and climber, Shannon knows a thing or two about thriving in midlife and lives in Seattle with her cat, dog and boyfriend.


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