Wednesday, November 21, 2012

Ideal Posture, Spinal Health and Psychological Well Being

The posture that we hold is the ultimate factor in deciding how much of our spine we use and how strong our spine is. Having good posture while standing, sitting, sleeping and exercising is very important and helps to ensure that the spine is resilient and hearty. Bad posture leads to weak points in the spine that can limit mobility, worsen appearance, make you susceptible to injury and also cause stress and mental hardship. Poor posture is a physical as well as an emotional problem. Poor posture has been documented to decrease approachability and as a key aspect of body language it dictates how one is viewed by others. It affects mood, confidence, and through interactions with a number of neurological systems it affects our subconscious appraisals of the environment. To gain good posture it is imperative to practice spine and core strengthening exercises, and in my opinion these are the most important exercises one can engage in. I have spent the last year working on my spinal posture and it has slowly transformed me into a happier, calmer, more outgoing person.

Weak Points in the Spine
The human spine is made up of a complex chain of ligaments, fascia, bone, and inter-vertebral discs, and their health is dependent on the tone and strength of the surrounding spinal muscles. There is a whole system of muscles that runs up and down your spine and sits in between your vertebrae. By pushing and pulling against individual vertebral bones, and other surrounding bones, spinal muscles help your core bend, twist and turn and when they are strong they help you to move nimbly and gracefully. Envision an “inner snake” that wants to stretch out, move, slither and squirm in all directions. Your normal posture is like a straitjacket that restricts its movement. A snake’s body is composed of vertebrae and vertebral muscles (and ribs) with no limbs – just like our spine. There is a metaphorical, limbless snake that makes up your spinal column. This is your true core, and this is what you want to make flexible, coordinated and strong. For most people the spine is inflexible, restricted, clumsy and debilitated. It is very difficult for any athlete to perform properly without a strong and balanced spine because the neck, shoulders and hips are actually anchored in the spine, where they provide a base for the head, arms and legs. Joseph Pilates called these core body segments the “powerhouse” of the body and insisted that they are integral for a stable foundation for all movements. Most yogis insist that “you are only as old and decrepit as your spine.” A weak spine is probably the primary limiting factor for people trying to build strength in their arms and legs. For this reason, the first thing I would recommend to an aspiring body builder is yoga and Pilates. You may not have noticed it but your spine has strong points and weak points, and the weak points may be affecting you more than you know. In fact, many of the weak points themselves are very difficult to notice.

We all underuse certain muscles in our trunk. Holding your back, neck and shoulders in firmly upright positions probably feels tight, and kind of intense. It’s a brittle, aching pain almost as if the muscles are asking you to leave them alone – warning you that excessive use will lead to injury. These are signs of muscle weakness, but these areas can be opened up with prolonged practice, and are best explored during a hot shower or bath, or in “hot” yoga. At one extreme these weakened areas can be responsible for spinal deformities and at another they can lead to mildly uncomfortable dislocation (subluxation) of vertebrae. This happens because the spinal muscles are not strong enough in certain areas to hold the vertebrae in an ideal posture relative to the force of gravity. People go to a chiropractor in order to have these dislocations aligned. The dislocations or subluxations can be very slight but still cause discomfort. When a chiropractor performs an alignment the spine becomes neutral again but because this does not actually strengthen the muscles in the back, the vertebrae fall quickly back out of alignment, sometimes within hours. The cracking associated with chiropractic is often a sign of degenerative activity stemming from disuse and muscle atrophy. Traumatic accidents to the spine often cause disuse of injured spinal segments and these areas are more likely to crack, become weak and painful and are susceptible to recurring injury. The cracking does produce endogenous morphine, temporarily relieving pain and brining patients back for future adjustments. Most chiropractors do not insist that their patients exercise the “opened” areas after adjustments and this is why there is no solid evidence for the efficacy of chiropractic and why it has not been shown to be better than physical therapy. Any joints in your spine that feel tight, weak or that crack should be attended to. I don’t think it is necessary to crack these joints, but cracking them gives you a good idea for where the weakness is, and what areas need to be targeted. Once you can locate where the cracking or tightness is coming from, try to hold that posture so that the adjoining muscles can be exercised. You will be surprised by how quickly these tight and sore muscles “open up” in response to exercise.

Spinal medical experts have noted that segments of the spine, from the bottom to top (coccyx to atlas), that go underused resemble, and have many of the same physiological properties of cadaver spine. I believe that the main reason that some segments of the spine go into disuse is because we have lost conscious control of them. This is another side effect of disuse and happens because the muscles do not receive signals from or send signals to association cortex. Basically, the only time these muscles becomes active is when they are signaled by subconscious motor systems. Whenever we fail to use muscles in our body the muscles shrink and go through a process called muscle atrophy. Unfortunately we are forced compensate for these weak muscles by becoming tense in other areas. The muscles that we use to compensate become excessively tense and tight and go through a process called “muscle shortening.” I realized that muscles throughout my spine, and my shoulder girdle (pectoral, scapular, collar bone, and rotator cuff) had become weak, stiff and painful. We engineer the use of the weak muscles out of our lives and find ways to get around having to use them and this leads to a physique that is poorly balanced and ungainly. Because of muscle atrophy and muscle shortening they can become dangerously weak and contribute to both diffuse bodily discomfort and psychological angst. My own anxiety is much improved from attending to my posture and stretching and strengthening the many postural muscles in my back and shoulder girdle.

Spinal Weakness and Psychological Stress

Bad posture is a social signal that communicates defeat. Slouching forward, bowed head, rounded shoulders and looking down constitute a mode of operation for many mammals (especially monkeys and apes) to signify their inferiority and to defer or subordinate themselves to the dominant or alpha animals. I believe that subordination goes hand in hand with anxiety for evolutionary reasons. Acting anxious keeps you from being perceived as a threatening competitor. If we adopt this syndrome of defensive postures we will inevitably develop the concomitant psychological symptoms too. In other words, if we do not attend to and improve our posture we are conditioning our nervous system to operate on nervous energy and forcing it to assume that our environment is oppressive and hostile. All in all, monkeys use poor posture to keep from getting attacked. They are sending a signal that they are already defeated (possibly handicapped) and are not trying to challenge others. It can be the same with humans. When I first went out on long walks exaggerating my posture, standing tall and looking upwards, I could tell that other pedestrians questioned my motives and were even moved to suspicion and anger. My posture looked fake because I was standing straight without the postural musculature that should accompany it. The point is – you can’t develop this musculature unless you work on it. Some people got genuinely angry seeing me standing erect and looking upwards. This is why I chose to walk and stretch after dark, outdoors, by myself at first. Once the postural muscles become stronger, standing erect looks genuine and people aren’t offended by it and don’t question it. I believe that in classrooms, in the workplace and even within families we are constantly sending each other nonverbal feedback, practically bullying each other into slouching. When someone else stands straight we have a natural inclination to be offended. We feel we must either stand straighter, or try to pull them back down. What we should do is applaud and support them while being reminded to monitor our own posture.

I personally think that vertebral subluxations interfere with the proper functioning of the parasympathetic nervous system which is responsible for calming various organ systems and “resting and digesting” in general. In fact, many parasympathetic nuclei are closely integrated with the spine. It has been shown that most calming drugs and neurochemicals such as opiates and oxytocin act on receptors in regions of the spinal cord that regulate the autonomic nervous system, especially the parasympathetic branch. An explicit link between spinal weakness and inactive spinal parasympathetic nuclei has not yet been established, but I believe it is there. There is solid evidence to link spine weakness to stress though. It has been well-documented that poor posture raises the diaphragm preventing the lungs from being able to take a full breath. Shallow breathing activates the other branch of the autonomic nervous system, the sympathetic branch, which is responsible for “fight or flight." For this reason bad posture puts us in a continual mode of defensiveness, and anxiety. Slumping posture is also known to impede the ability of the lungs to expand and inflate fully. Shallow breathing is a cause of anxiety and it exacerbates other psychological disorders. I think that well-researched and well-produced programs or regimens of postural exercises should be readily accessible to psychiatric patients and to the broader community at large so that people can open up their breathing passageways and experience more calmness. I am currently developing such a program using stretches and exercises that I think are best using anatomical and “psychoneuroendocrinological” criteria - so stay tuned.

Types of Poor Posture that Promote Spinal Weakness

An ideal posture is normally defined as one where the body’s segments are aligned so that the least amount of energy is required to maintain a desired position. A “neutral” or properly aligned spine shows three curves from the profile:

 1) A backward curve (convex anteriorly) in the neck region known as “cervical lordosis.” To reduce excessive cervical lordosis, make sure that your head is pushed backwards and your chin is tucked down toward your chest. You don’t want your head hanging forwards and your jaw jutting out.

2) A forward curve (convex posteriorly) in the upper back called “thoracic kyphosis.” To reduce excessive thoracic kyphosis pull your shoulders back, and then lean backwards instead of slumping forwards. Proper neck posture complements and reinforces this curve.
3) A backward curve (convex anteriorly) in the lower back called “lumbar lordosis.” To reduce lumbar lordosis tilt your hips backward and tighten your buttocks, rather than tilting your hips forward and sticking out your butt.

These curves can be excessively pronounced, or not pronounced enough. For most people, they are excessively pronounced. Viewed from the front or back the spine should be totally straight, any curvature to the right or left side is called scoliosis. Scoliosis is rare, but side bending is important to strengthen the lateral spinal muscles. Look at your posture in a mirror and look for the three curves in your profile. Do any look unnatural or excessively pronounced? A neutral spine with no excessive curvature is likely a healthy spine but not necessarily a strong one.

The two main types of poor posture are:

1)      Rounded and elevated shoulders and a jutting-forward head position.

2)      Forward tilting of the hips, increase curve of the lumbar spine and protruding of the stomach.

Exercises that Helped Me:

My main problem is that I developed misalignments from sitting long hours in front of my computer keyboard. Keyboard use is a major cause and contributor to “shoulder impingement syndrome,” where the shoulders, shoulder girdle, neck and back can be significantly thrown out of alignment from sustained reaching for the keyboard and mouse. When poor posture begins to feel normal, the muscle memory for good posture can be lost. Thus awareness of my posture at the computer was the first major obstacle. I bought a new computer chair, pulled the mouse and keyboard to the end of the desk near my stomach and I stopped slouching down in the chair by adding pillow. I found a cylindrical pillow that I placed vertically to support my lower back that allowed me to push my shoulders back.

If I were to have targeted and engaged these muscles, such as my rotator cuff, during heavy weight lifting, I would have damaged them badly. In fact, the weakness in these areas made it uncomfortable to lift weights. Many people go to the gym to work out their biceps, chest and triceps, but they neglect the weakened core muscles that are far more important aesthetically and functionally. Case in point, I badly injured a scapular muscle and a collar bone muscle 3 years ago when wrestling a friend despite the fact that I had been lifting weights. The injuries kept me from exercising, and stretching further exacerbating the problem. When my posture was at its worst, lifting weights was so uncomfortable that it was outright stressful. I took the last 6 months off to work on strength, range of movement, and flexibility in my spine and shoulder girdle and now weight lifting is exhilarating. During those six months I focused on fluid stretching movements in specific, tight muscles, while lightly flexing closely connected muscles.

In order to strengthen the affected muscles, you want to use very light weights, or no weights at all. I chose to go on long walks, working on standing straight and often on keeping my arms in the air, forcing them to work against gravity. I was focusing on using the postural muscles that felt tight and uncomfortable. At first, the uncomfortable positions were everywhere. They take trial and error, and ingenuity to pinpoint. I also started yoga, pilates, gymnastics, martial arts and swimming and these exercises helped me better locate and target my weak points.

Probably the most significant weakness that I had was in between my shoulder blades. The core upper back muscles opposite my chest were severely atrophic and were painful every morning upon waking. A number of back exercises, and stretches in this area profoundly improved this. Pulling my shoulders back and pushing my chest out during walks contributed. Changing a two-decades old mattress that I slumped down into throughout the night helped as well.

· -I used to walk around with my shoulders elevated, continually using my trapezius to raise them. This is a terrible habit (and a symptom of shoulder impingement syndrome). Instead, focus on pressing the shoulders down as if you were carrying a heavy load in the hands. This is difficult and painful at first but it is truly a body builder’s posture. Significant chest, back and shoulder girdle strength can be attained by building these muscles into this posture. To kick start the posture walk around your block with a weight in each hand and focus on pulling the shoulders down and slightly rotating the shoulders flexing and incorporating all of the muscles in the upper torso (the entire back and chest). Eventually you will be able to flex all of these muscles tonically (all the time) simply by pressing down on the shoulders.

· -I had a loud cracking sensation whenever I laid on my back and pulled my head up, chin to my chest. After taking yoga I found out that weakness in the muscles of my lower cervical vertebrae were responsible. After class these muscles were always sore. Doing yoga once a week and targeting these muscles on walks, and before bed helped significantly. Walking with the head erect and the chin tucked to the chest helped as well. These exercises actually removed a hunch (an “s”) in my neck that I had for years. I had cervical vertebrae that stuck out of the back of my neck in a pronounced way that became straight again though strengthening. I thought that the hunched neck would have to be mechanically manipulated back into place; however, all that was needed was to strengthen the surrounding muscles.

 · - My lower back was also very weak. Watching television or reading while lying on the stomach, with the head and chest off of the ground is effective in strengthening the lower back (thanks to my Mom for this tip). Standing while placing the hands on the lower back and pushing the stomach forward is helpful. These stretches can cause the lower back to tighten up so it is very important to stretch forward after stretching backward. Tight hamstrings place a lot of pressure on the lower back and so it is very important to stretch and exercise these first. Buying a “foam roller” and doing the recommended exercises with it helps as well. Sleeping on the side while trying to curve the neck and feet backwards, forming the letter “c” helps as well – you do not want to sleep hunched over all night (another tip from my Mom).
-Strong abdominals help to build a strong back. Aside from sit ups and crunches, try walking around the neighborhood while flexing the stomach muscles. This should be done flexing all of  the abdominals - from chest to groin. Alternatively walk around with your gut sucked in, using Pilates’ navel to spine posture. After a few walks these muscles learn to remain flexed while walking and thus become stronger and burn more central fat on their own. Of course this is the idea with everything else mentioned here - to build the muscle memory and strength necessary to maintain proper and healthy posture without having to think about it.

Here are my 5 favorite books on posture, the ones that have helped me the most:


  1. I think that it is funny that some people neglect the importance of your spine to your overall health. Practicing good posture will help you immensely with your health. However, I didn't realize that walking with your shoulders up can be detrimental to your health. I'll have to stop doing that and start walking the way that you suggested.

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