Thursday, June 01, 2023

When I was a physical therapy student, I did a rotation at a New York City hospital. As a Midwesterner, this was particularly exciting. I had the opportunity to work in THE CITY and the added perk of treating some of the feistiest elderly ladies Manhattan had to offer.

Part of my role as a physical therapy student was to evaluate their posture. Most days it would go something like this:  Me: “Mrs. Rosen (insert: berg, field, something...), please stand up straight.”

My patient: “But I AM standing straight!”

As I would look over at my patient, hunched over, with a rounded back, her neck craned upward like a turtle from its shell, I would wonder to my 20-something self, “How on Earth can she think that is standing straight?”

Several years and 12 hours of induced labor later, I caught sight of a woman hunched over, pushing a stroller down the street, and thought: “My, how can she stand with such poor posture, so hunched over?” It took longer than I care to admit, for my sleep-deprived mind to process that I was looking at my own reflection in a store window. “How could I be so hunched over?” I thought. “I have such fine posture; I thought I WAS standing straight!”

The answer is neuroplasticity. Simply put, our brain starts to accept adaptation in posture and physiology as the new norm. If you stand, sit, eat, read, commute, and work with poor postural alignment, eventually your brain starts to perceive that position as upright, and it takes conscious effort to retrain it back to a correct position. So yes, your mother may have been correct; if you make that face, it will stay that way.

We are constantly hunched over, craning our necks to view computer screens and devices, when driving, and of course while participating in our new favorite past time, snow shoveling. As care givers to babies, we hunch over to hold them, nurse them, carry them, chase them, and yes, push them in strollers. In these moments, we are often more preoccupied with the task at hand, with where we need to get to or the safety of the other children tagging along, than we are conscious of our own posture.

Our beloved adolescents are, unfortunately, some of the worst culprits of poor posture. They are burdened by their heavy (what in the world have you got in there?) backpacks and are slouching under the six inches they grew...this week. Ever self-conscious of their own miraculously developing bodies, standing with their shoulders rolled inward and backs hunched over. We find them hiding under their own shoulder blades, hoping no one will notice that their bodies are undergoing a beautiful metamorphosis. Parents, help them get a clue. Guide them to proper posture, because they are never too young to start bad habits that will accompany them into adulthood.

As for many of my elderly patients, there was a limit to how much could be done to help correct their posture, as they were often frail, and very osteoporotic, by that point. For most people, though, it is not too late to retrain their bodies to attain and maintain proper posture. Good posture is not only a cosmetic issue, it can have a direct impact on one’s health and well-being. Poor posture can lead to fatigue, neck, shoulder, and back pain, problems with breathing, and tension headaches.

Correct your posture by looking at yourself standing sideways in a mirror. Notice where your back may be curving over, your shoulders elevated and rolled inward, and neck craning forward. Try to straighten yourself while using the visual feedback you see in your reflection to guide you. Lift your chin, roll your shoulders down and back. Squeeze your shoulder blades together, pushing your chest outward. Utilize your stomach and trunk muscles to support your upright position. Activate them by sucking in your stomach muscles (do not hold your breath), and by squeezing your gluteal muscles. During periods of prolonged sitting at work or when traveling, take frequent breaks to stretch and self-correct your posture.

Properly aligned posture may feel weird and be difficult to maintain at first, as your body is not yet used to being in this corrected position. When practiced over time, it will become easier, as your body relearns what upright looks and feels like. Developing a habit of regular exercise, including core muscle strengthening, and over-all flexibility training will facilitate muscle balance development and reduce fatigue of the postural muscles that support posture and activity. All of your efforts will surely help develop a healthier, stronger, and less hunched over you.

Rivki Chudnoff, PT, MSPT is a NY/ NJ licensed physical therapist with over 14 years of experience working in both pediatrics and women’s health rehabilitation. Her practice addresses the needs of women in areas related to pelvic pain, sexual dysfunction, prenatal and postpartum related pain, and incontinence. Rivki currently resides in Bergenfield with her husband and their children. She can be reached at [email protected]

By Rivki Chudnoff, PT, MSPT

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