EXERCISE PLAN FOR HEALTHY BONES: POSTURE

An often overlooked component of good health and fitness is proper posture. Posture is the balance struck between the unrelenting force of gravity pulling down on you and the valiant effort of your body structure to hold you up. The path of least resistance between these forces is what we call posture. Good posture causes no pain or problems and helps you use your muscles, tendons, and bones optimally. “Bad” posture actually uses more energy, though it is often thought of as laziness. That’s a mistake, because poor posture may indicate an underlying structural problem that is not your fault at all. And if you try to correct a structural problem without knowing exactly what it is, you will probably exacerbate the situation.Say you have one leg that is significantly shorter than the other. To compensate, in an attempt to keep your eyes level (a real priority for your brain), you’ll probably hold your shoulders unevenly, creating a scoliosis in your spine. Your mother’s advice to “straighten up” will be useless—you literally can’t. A doctor without appropriate training might advise you to do some back-strengthening exercises to even out your shoulders, but getting stronger while you are still uneven will just exaggerate the tilt. If you made an appointment with me, your checkup would reveal the different lengths of your legs as the cause of your problem, and I’d prescribe a gradually adjusting series of heel lifts and several sessions of osteopathic manipulation to fix the cause of your problem. Now you have a physical support to help keep you level, and your muscles and bones will no longer have to contort themselves. Of course, this is a very simplistic explanation and an exaggerated example, but I think you get the idea: address the cause of the problem, not the result.Your posture is your posture, and you can’t will it to be different. If your shoulders are rounded, no amount of throwing them back or thrusting your chest out is going to “fix” them. You can make your posture work as well as possible for you, but you can’t make it into something it is not. So make sure your posture is maximally efficient, and get any permanent “bad” posture evaluated to discover if there is a correctable underlying problem. You’ll need an appropriate therapy program to make any changes necessary for optimal body positioning.Simply maintaining good posture no matter what you are doing in the course of your day is an excellent defense against kyphosis, the spinal curve commonly called “dowager’s hump” or “hunchback” that is a hallmark of osteoporosis. Keeping the head, shoulders, spine, and hips in alignment protects the spine, so you need to be conscious of how you walk, stand, sit, lie, climb stairs, sleep, drive, type, and everything in between. Stick with the natural curves of your back. If you stand against a wall, your heels, buttocks, upper back and shoulders, and back of your head should touch the wall. With a side view, you should be able to draw a straight line from your ear to your shoulder to the middle of the curve of your lower back to your hip, knee, and ankle. From the front, it should be clear that your eyes, shoulders, chest, and hips are all level and parallel to the floor.That is the alignment you should strive for at all times. If this is not your normal or comfortable posture, you may have a structural problem that should be evaluated by a professional. I recommend an osteopathic structural evaluation, as most nonspecialists tend to recommend strengthening exercises that may be good for posture in general but will actually exacerbate a structural problem. But for most people, conscious effort and increased strength will be able to help posture, barring a medical issue.A major pitfall to good posture is working at a desk. Proper alignment is crucial when typing or working at a computer in order to avoid carpal tunnel syndrome or other repetitive motion injuries to nerves and joints—and just to eliminate the achiness you feel at the end of a long day at your desk. When you’re at your desk, not using your computer, prop your work on a stand at an angle in front of you, so you don’t have to hang your head forward over flat papers to read them. Use a footrest, especially if you need one in order to keep your thighs parallel to the floor when your chair is otherwise adjusted to the proper height. Your chair should support the curve of your lower back, and if it doesn’t, use a pillow or rolled-up towel to do the job. When you are driving (which puts you in much the same position as sitting at your desk), use the headrest.Lifting anything without injury also requires proper posture: bend at the knees and hinge at the hips, not the waist, so your legs, not your back, are taking the heavy load.Sleep on your back or side, as sleeping on your stomach places a strain on your lower back.The first key is to be aware of your body position no matter what you are doing. It may require conscious attention at first, but eventually you’ll develop good habits and will align yourself properly automatically. The second key is to build your flexibility, balance, and strength (particularly of the front of the thighs, buttocks, and stomach), all of which are important to support good posture.*121\228\2*

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