The Importance of Posture to Musculoskeletal Health

Posture directly affects musculoskeletal health [2,4].  Harvard Health Publishing defines posture as “the way you hold your body while standing, sitting, or performing tasks like lifting, bending, pulling, or reaching” [2]. They go on to describe good, or correct, posture as “keeping the cervical, thoracic, and lumbar curves in balance and aligned, with weight distributed evenly over the feet” [2]. While exercise and nutrition habits are indeed important contributors to leading a healthy life, sometimes the path to a fitter, safer, and more pain-free lifestyle begins with maintaining good posture [2].  

Developing good posture, however, may not come so easily, as it often requires breaking old habits that the body has become used to, such as slouching with hunched shoulders, carrying objects on one side of the body, slumping forward while sitting in a chair, and sleeping on a mattress that does not provide proper support [8]. Failure to correct posture, over time, may result in long-term adverse effects on the musculoskeletal system [9]. For example, Harvard Health Publishing notes that “repetitive activities at work or home, such as sitting at a computer or lifting and carrying, may produce tension and muscle tightness that may result in a backache” [2]. Other factors, such as “sports injuries, accidents, or congenital conditions” (ex. scoliosis), may also inhibit the ability to develop good posture [2]. 

During movements that involve lifting, bending, reaching, or carrying an object, poor posture can cause imbalances, and place great stress on the muscles and spine, which could result in injury. Other side effects of bad posture may include sprains, strains, tears, carpal tunnel syndrome, hernia, and jaw pain [1,4].  

So, what does good posture look like? The views may differ slightly, but for walking, the general consensus is to stand upright, with the head level (chin parallel with the floor), shoulders relaxed, and a balanced gait, shifting weight evenly from one foot to the other [2,4]. Wearing comfortable shoes with proper support is also advised [2,4]. For picking an object up from the ground, Mayo Clinic recommends starting in a safe position—not from a standing position, but either squatting or kneeling down [7]. The object should remain close to the body, with its weight centered. While performing the lift, it’s suggested to “maintain the natural curve in your lower back,” and engage the core muscles [7]. Equal weight-distribution through the feet and remembering to use the legs, as opposed to the back, and to avoid twisting, are also tips to ensure good posture when lifting and carrying an object [7].  

Paying attention to posture is also important when the body is at rest. Standing or sitting in one position for extended periods of time (known as static posture) has been shown to be deleterious to the musculoskeletal system [3,5,6,8]. In some studies, experts report that “people with the most sedentary time are more than twice as likely to have cardiovascular disease than those with the least” [5,6]. Because fewer muscles are being used when sitting down, remaining sedentary can lead to muscle degeneration, particularly in the abdominals, hips, and glutes [4]. In an article concerning the importance of posture among patients in nursing homes, Swann writes, “If poor sitting posture develops, it can have an adverse effect on chest capacity and respiration as well as on a resident’s musculoskeletal structures” [9]. Furthermore, since sitting slows blood circulation, it can sometimes produce swelling, often in the legs [5]. Other problems from sitting too long can range from “swollen ankles and varicose veins to dangerous blood clots,” as well as to damaged spinal discs [5].  

To insure good posture while sitting, several studies suggest not leaning forward, to relax the shoulders, keep the arms close to the sides of the body, have elbows bent at ninety degrees and feet flat on the floor [2,5]. For standing, it’s recommended to keep the knees slightly bent (avoid locking), looking straight ahead (as opposed to the ground), all the while holding the shoulders neither too far forward nor too far backward, but rather down and relaxed [2,5]. “When a person is standing,” Swann adds, “it should be possible to draw a straight line from the earlobe, through the shoulder, hip, knee, and into the middle of the ankle” [9]. If having to stand in one position for several minutes on end, it’s suggested “to shift weight from one foot to the other, or rock from heels to toes, [to help] with circulation and balance” [5]. For people who are often sedentary, simply taking a break to stand is insufficient to help correct posture; instead, it’s encouraged to take short walks every twenty or thirty minutes [3].  

While the criteria of “good posture” may vary from study to study, most agree that it’s beneficial to one’s health to be mindful of posture. Certain exercises like sitting on a physio-ball, gentle stretching, yoga, lifting weights, or simply taking a brief walk, have all been found to help correct posture, and thus improve the strength and flexibility of the musculoskeletal system [2,4,5]. Of course, as noted in Harvard Health Publishing, “bodies vary” [2]. If a person is concerned or has doubts about their posture, it’s suggested that they consider making an appointment with a professional, such as a physical therapist or a certified personal trainer.   

References 

1. Center for Disease Control and Prevention. Work-related musculoskeletal disorders prevention. Atlanta: CDC; 2013 [updated 2013 Oct 23]. Retrieved September 27, 2020 from https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-disorders/index.html 

2. Harvard Health Publishing. Posture and Back Health. Retrieved September 30, 2020, from https://www.health.harvard.edu/pain/posture-and-back-health 

3. Hedge, A. Cornell University Ergonomics Web. Sitting and Standing at Work. Retrieved September 27, 2020 from http://ergo.human.cornell.edu/CUESitStand.html 

4. Hein, J. T. Posture. Align Yourself for Good Health. Mayo Clinic. Retrieved September 29, 2020 from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/posture-align-yourself-for-good-health/art-20269950 

5. Levine, J. A., Matthews, C. E., Dicharry, J., & Amasay, T. Don’t Just Sit There! (2014, March 17). Richmond Times-Dispatch (VA). Retrieved September 27, 2020 from https://www.washingtonpost.com/wp-srv/special/health/sitting/Sitting.pdf 

6. Matthews, C. E., George, S. M., Moore, S. C., Bowles, H. R., Blair, A., Park, Y., Troiano, R. P., Hollenbeck, A., & Schatzkin, A. (2012). Amount of time spent in sedentary behaviors and cause-specific mortality in US adults. The American Journal of Clinical Nutrition, 95(2), 437–445. DOI:10.3945/ajcn.111.019620 

7. Mayo Clinic. (2016). Proper Lifting Techniques. Retrieved September 27, 2020 from https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076866 

8. Sizer, P. S., Cook, C., Brismee, J.-M., Dedrick, L., & Phelps, V. (2004). Ergonomic Pain—Part 1: Etiology, Epidemiology, and Prevention. Pain Practice, 4(1), 42–53. DOI:10.1111/j.1530-7085.2004.04006.x 

9. Swann, J. (2009). Good Positioning: The Importance of Posture. Nursing & Residential Care, 11(9), 467. DOI:10.12968/nrec.2009.11.9.43734