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​​Does Exercise have an Effect on Posture?

Definition of Posture: The position of the person's body or body parts.

Every person positions their body differently. If we spend a life-time in the same posture, soft tissues can lose their flexibility and mobility. Imagine being in a "bad" posture. For instance, sitting with your hips bent, lower back and shoulders rounded, and your neck bent back just so you can look at your computer/TV. The soft tissues of your muscles and tendons, ligaments, and even your nerves in the back of your hips, thoracic and lumbar spine are constantly being stretched as well as the soft tissues in the front of your neck. On the flip side, the front side of the hips, lumbar and thoracic area tighten up, as does the back of your neck. Poor posture puts your body in "uneven stress.”(1)

As therapists, we often base our treatment on the posture presented by the patient. If someone were to present with poor posture, the logical treatment would be to strengthen, or stiffen, the areas that are stretched, or loose. In turn, we would stretch the areas that appear to be tight (or stiff). The patient must then be trained to utilize this new available range of motion to achieve proper positioning and posturing in static positions and in active motions.

A review of recent articles has shown success in improving various postures with exercise.

A) Lumbar posture--should it, and can it, be modified? A study of passive tissue stiffness and
lumbar position during activities of daily living

Scannell JP, McGill SM
Phys Ther 2003; 83(10): 907-917

18 Subjects (between the ages of 18-25) with hypolordosis (decreased Lumbar curve), hyperlordosis (increased Lumbar curve), and a control group with normal Lumbar curve participated in the study. The hypolordosis group received abdominal and erector spinae strengthening to increase lumbar curve. In the hyperlordosis group, the subjects received abdominal and gluteal strengthening to reduce the excessive curve. They found the Hyperlordotic group were able to decrease their calculated passive tissue strain through exercise.

B) The effect of pectoralis muscle stretching on the resting position of the scapula in persons
with varying degrees of forward head/rounded shoulder posture

Roddey TS, Olson SL, Grant SE
J Man Manipulative Ther 2002; 10(3): 124-128

38 subjects with mild, moderate, and no forward head posture with no current complaints of neck pain were measured for forward head/rounded shoulders posture (FHRSP) using a plumb line. FHRSP can be determined with the person standing with the line at the side. Scapular distance us measured from the acromion (edge of the shoulder) to spinous process of T3 (the
edge of the bone at T3 in the back). Subjects with either mild or moderate FHRSP performed  
pectoralis stretches once daily for 14 days. Subjects had a reduction in scapular distance (rounded positioning) after treatment.

C) Effects of an adapted physical activity program in a group of elderly subjects with flexed
posture: clinical and instrumental assessment

Benedetti MG, Berti L, Presti C, Frizziero A, Giannini S
J Neuroeng Rehabil 2008; 5(32): -

28 elderly subjects 65 years and older with flexed posture were studied. One group was given exercises specifically to improve their postural alignment while the other was given generalized exercises to improve joint mobility, muscle strength, and flexibility. Exercises adapted for patients with flexed posture improved postural alignment more effectively than a generalized
exercise routine. Exercises included back extensor strengthening, pectoralis stretching, and hip and hamstring stretching.

With the support of recent articles to provide evidence for the inclusion of physical exercise to help in changing posture, it validates the need to include specific exercises to address posture change into the treatment session. Unfortunately exercise by itself does not actively change our posture. In reality, to change posture, we must consciously act to change
our form. Change in body position can be localized to a specific body part or joint position or as comprehensive as altering multiple joint segments to allow for maximal positioning of the overall body. Also, with any injury there may be a physical change to the soft tissues that can make it difficult for the person to achieve optimal posture.

Your physical therapist can provide the right treatment exercises, manual therapy, and postural education to not only return to level of function but also prevent and manage possible future injury.

-- Duffy Chan, PT