You’ve probably heard people say, “sit up straight, keep your shoulders back and don’t slouch.” Children usually get that advice from their parents, and like all good advice it should last a lifetime, because poor posture can lead to a painful condition called postural syndrome.
Postural syndrome can cause physical changes to the body and painful side effects. Most people with the condition notice their shoulders are rounded and tend to droop forward. Muscles that connect the shoulders and the back of the neck to the head then tend to pull the head forward, and the resulting position can cause constant, aching pain, stiffness and even burning in the upper and middle back areas, as well as in the shoulders, neck and head. Over time, poor posture can also lead to the development of trigger points (tight muscle fibers), which can refer pain throughout the back and neck, as well as cause headaches.
Poor posture usually develops gradually in people who sit improperly for long periods. Think about how much time you spend sitting. You probably sit in your car, at work, when you’re eating meals and when you’re watching television. And if you’re like most people, you probably tend to sit with a forward bend, which causes your shoulders to become hunched over. This is the opposite of good posture, which is a state of musculoskeletal balance that involves a minimal amount of stress or strain on the body.
Over time, poor posture can cause a muscular imbalance in the body. Normally, there are balanced tug-of-war games happening between the chest muscles (pectoralis) and the upper back muscles (rhomboid, middle trapezius and inferior trapezius) and between he muscles that bring your chin to your chest (anterior scalene and sternocleidalmastoid) and the muscles in the back of your neck (upper trapezius). No muscle group wins, because they all have equally strong players.
The impasse ends, however, when chronic poor posture gives the chest muscles the advantage. The chest muscles then become tight and short, tugging or pulling the shoulders forward. Chronically tight chest muscles cause the muscles behind the shoulders to become relatively weak. At this point, the stronger muscles pull the spine out of its normal alignment, causing postural changes. Now the shoulders are slouched forward and the head, because of its connection, must follow. In an effort to hold the head up to compensate, the muscles in the back of the neck then become tight, ending the other tug-of-war and causing the head to jut forward.
If you have postural syndrome or just poor posture, it’s important that you see your healthcare practitioner as soon as possible. Postural awareness and adequate care can help restore muscle balance and joint health, but since it may have been many years since you started ignoring your parents’ advice, it may take some time for you and your healthcare practitioner to fix the problem.
If you take a look at people with good posture, you will notice several curves that are part of their spine. Their neck and lower back will curve inward, and their shoulder blade area will bend outward. These are the normal curves in people whose bones, joints, ligaments and muscles are healthy. The way the muscles and ligaments connect to the spine and the way the vertebrae are aligned determine this good posture.
Normal spines have an S shape, which consists of three main sections: the cervical at the top, the thoracic in the middle and the lumbar at the bottom. All three sections support the body by holding it in an upright position.
Four major muscle groups that interact with the cervical and thoracic spine help provide this support (although there are several smaller muscles that also play a role). The first is the pectoralis, which comprises two powerful chest muscles that allow you to bring your arms across your body, as if you were squeezing a large ball. The second is the rhomboid, which comprises the muscles between the shoulder blades that allow for rowing movements. The third is the scalene and sternocleidalmastoid (SCM) muscle group, found in the front of the neck, which allows you to bring your chin to your chest, rotate your neck and bend your neck to the side. The fourth is the trapezius muscle group, which is at the back of your neck and allows for neck extension, rotation, side-bending and pulling the shoulders up.
Normally, all these muscles work as a team and stay balanced with one another. They’re playing tug-of-war, but no one is winning. The pectoralis, scalene and SCM in the front pull with equal force to the rhomboids, trapezius and suboccipital muscles in the back.
When you have postural syndrome, however, it disrupts this balance. The anterior chest muscles become so big and so tight that it’s difficult for the weaker muscles in the front of the neck and back of the shoulder blade to support the spine. These weaker muscles become tired, yet still try to hold their position. It becomes uncomfortable for them, however, and they give in again. The battle also places stress on them, and over time they can develop pain that leads to tension in the shoulder, neck and head regions.
Because it takes so long for this imbalance to develop, it’s very common for patients with postural syndrome to get discouraged when they first try to fix their posture. That’s why it’s important for you to see a chiropractor if you suspect you have the condition. You and your chiropractor can work together to fight the syndrome that’s putting you in a slump.