Correct and Incorrect Posture

If you're like most people, in all probability your posture could use some improvement. Due to increasing addiction to technology, postural deficiencies have increased alarmingly among younger children and youth because of their constant hunched forward position. Since athletes are no exception, obviously physical and technical skill learning - along with sport performance - have been profoundly affected.

What Is Good Posture?

Schloder (2013) defines posture several ways, …Ideal or correct body posture means the pull of gravity is evenly distributed over the base of support with maximum biomechanical and physiological efficiency and minimum stress and/or strain on the body…Others define posture as follows:… Posture is based on the position of the spine and all the joints in the musculoskeletal system, i.e., the relative arrangement of body parts…In 1947, the American Academy of Orthopedic Surgeons defined posture as,… the relative arrangement of the parts of the body… … Good posture is the state of muscular and skeletal balance, which protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, stooping) in which these structures are working or resting…

What Is Bad or Poor Posture?

Poor posture is defined as, …faulty relationship of the various parts of the body, which produce increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support…(cited in Whitehead, July 17, 2014; Peterson-Kendall, Kendall-McCreary, Geise-Provance, McIntyre-Rodgers, & Romani, 2005, p. 51).Poor posture reflects, and is frequently interpreted as, a negative ‘bodily attitude.’ More importantly, it has potentially detrimental effects on the individual’s health and tends to impact, of course, physical activity and sport performance. According to research, incorrect or ‘poor’ posture puts stress on the spine, which can induce neck, shoulder, back, hip and pelvis, knee, ankle, and also foot problems. If this is prolonged and the condition becomes chronic, the spinal discs, especially in the mid and lower back, may be structurally affected leading to disc degeneration and bulges. If the spine is held in hyper-kyphosis shoulders hunch forward, the condition pulls the shoulder blades wider apart and away from the spine. This interferes with efficient shoulder function, and is linked to shoulder impingement pain.

The Impact on Sport Performance

Many sports, such as swimming, hockey, etc. engage in predominantly forward and very repetitive movement. Therefore, athletes tend to experience thoracic mobility restriction and shoulder injuries. A loss of the natural hollowing in the low back and backward pelvic tilt can also inhibit movement patterns of the legs, and result in developing various lower limb conditions. Furthermore, reduced rib and spinal joint can affect normal breathing; reduce tidal Volume and Vo2 max uptake as the ribcage and spine stiffens. Alex McKechnie, well-known athletic performance director of the Los Angeles Basketball Lakers attributes chronic injuries to poor posture. He believes that,…Muscles do not work in isolation; they work collectively to produce strength, power, and coordination because functional strength is the key. Leg muscles (quads, hamstring, and gluteus muscles, i.e., all muscles tied to the thigh) have pelvic control and any lacking of such affects the knees as well (cited in Ogden, 2010, The Telegraph, London, UK)Postural deviations are not only perceived as aesthetically unpleasant, but more importantly, influence muscle efficiency adversely. If body segments are out of alignment for extended periods of time, muscles come to rest in a shortened or lengthened position. Over time, this may result in long-term adaptive changes.Strong muscles are often tight, placing opposing muscles in a lengthened and weakened position, ultimately having an influence on postural alignment. It has been proposed that adaptive muscle shortening may occur as a result of muscle overuse, particularly in shortened ranges of motion, which is likewise believed to cause postural deterioration (Novak & Mackinnon, 1997; Hrysomallis & Goodman, 2001). Postural training therefore enhances proprioception and kinesthetic awareness, and is therefore crucial not only to maximize sport performance but also for general health and well-being, and the prevention of injuries. Several factors may contribute to ‘poor’ body carriage, which is linked to postural control. The latter is the result of the brain’s assimilation of neurological feedback from our sensory receptors (vision, touch, kinesthesia-awareness or sensing the location of muscle and joint movement, and balance, vestibular function of the inner ear). Sensory organs within the muscles, tendons and joints (proprioceptors) provide feedback to the spinal cord and brain about joint angle, muscle length, and muscle tension in limbs, which is then integrated to increase awareness of body position and movement, and to enhance reaction time in response to a change in joint position. Remedial/corrective exercises are promoted as a means to correct postural dysfunction, to improve muscle balance and neuromuscular coordination directly relevant to the functional and dynamic position of the respective activity. Three vital principles are involved: a) stretching the front of the body; b) extending the back; and c) strengthening the back. McKechnie is a firm proponent of re-educating movement and adjusting posture by having athletes exercise in front of mirrors to monitor positional alignment. This is indeed one of the most valuable aspects of ballet training. Since acute and sub-acute shoulder syndromes are common musculoskeletal disorders remedial exercises need to be included in daily workout programs.

How to Achieve Correct Posture

The requirement to stand up straight, ‘stand tall, sit straight, and move correctly at all times’ means the following:

Appearance is ‘regal’ – standing and walking ‘lifted and tall’ (pulling-up)
Body is always balanced over base of support (feet)
Head is always held straight, fixated in center, eyes focus forward unless different head position is needed
Shoulders are lowered naturally and resting downward
Abdomen is always slightly drawn in and diaphragm is always lifted
Hip muscles and pelvis are always centered, not tipped forward, sideward

Correct Positioning of the Body and Body Alignment

Maintaining correct posture is an active process not a passive one. Individuals should always ‘feel energized’ while being ‘cognizant or conscious of personal postural habits’ since all action originates from a starting posture (Schloder, 2013). Correct posture is best observed when someone is standing ‘tall’ or ‘pulling up’ with shoulders back. The ‘good or ideal’ posture is identified by using the ‘imaginary’ straight line, starting from the earlobe, passing through the cervical vertebrae, the acromion (tri-angular projection part of the shoulder blade that forms the point or tip of the shoulder), the lumbar vertebrae, the center of the hip, just in front of the mid-line of the knee, and slightly to the anterior of the ankle bone.

Good Posture Includes:

Straight line from the ear through shoulder, hip, knee, and ankle
Shoulders, hip muscles, knees equal in height (balanced): head is centered

Most Common Postural Flaws:

Forward protruding head
Rounded shoulders
Arched lower back
Excessive anterior pelvic tilt (protruding backside)
Scoliosis- Spine curvature from side to side – may be rotated – typical scoliosis has S-shape or C-shape rather than a straight line
Lordosis- Condition commonly referred to as ‘swayback, saddle back’ or lumbar hyperlordosis – inward curvature of a portion of the vertebral column
Rounded Shoulder- ‘Slouch’ syndrome – common in activities with prevailing forward motion and/or the result of excessive time spent in forward position

Postural Assessment and Tests

Posture assessment should be carried out at the beginning and finish of each season, andcontinued throughout in intervals; especially for younger children and youth due to sudden growth spurts, which usually alters posture. Based on assessment and personal needs, medical experts need to design remedial/corrective exercises, which are incorporated into Warm-up and Cool-down phases of each training session. Athletes carry out these exercises at home as well to advance their progress. The most common test tool is the plumb line test, usually administered by an orthopedic specialist, qualified physician, or fitness expert. When viewing posture in the standing position, the plumb line represents the line of reference to the only fixed point in the standing posture, the base where contact is made with the floor as the foundation of the body. Based on the results, remedial (corrective) exercises are then pre-scribed and performed daily.

Plumb Line Test – Stand upright against plumb line string (attached to ceiling) with small weight fastened at bottom of string, feet together, arms extended alongside body – assess degree of deviation from correct upright posture (see picture)
Free-standing’ Test – Stand upright, feet together, arms extended alongside body – draw imaginary straight line from ear through ankle – assess degree of deviation from correct upright posture (see picture)
Standing Wall Test – Stand upright, feet together, arms extended alongside body, back against the wall, heels touch baseboard – assess degree of back curvature against the wall (arching away from wall)
Prone Test on floor – prone position on floor, arms extended in front of head, legs extended in back – assess degree of elevation/curvature (trunk, not flat) from floor
Supine Test on floor – supine position on floor, arms extended in front of head, legs extended in back – assess degree of elevation/curvature of back (back not ‘flush’ on floor) from floor

Remedial Exercises

It is very important to pay close attention to body alignment and posture when performing daily routines, when exercising, and during training. Tight chest and weak back muscles frequently cause and/or contribute to the forward head position or so-called ‘rounded shoulder’ syndrome. If an excessive backward pelvic tilt is evident, corrective stretching for the hip muscles and back as well as strengthening of the abdominal muscles is needed. These exercises need to be carried out at home as well because poor posture can only improve through daily maintenance. Squat slide against wall - Sliding up and down against wall. Progress from standing, to half squat, to standing flush against the wall.Upright 'L' - Sitting upright with legs extended, assistant pushes back until straight. Body bridge - Start in supine position on floor, elevate trunk with arm support on floor. Body bowl - Begin in supine position on floor; raise head, shoulders, upper back, and legs off floor; arms extend over head. Round/Flat back - Standing upright, bend hips to round back. Standing upright bend trunk forward with a flat back. Cat/Cow - Begin sitting, folded over legs, with arms extended out. Push up by straightening arms, curve back, return to sitting on heels.