Good posture is the elusive element that everyone covets but few laypeople can pinpoint exactly what it entails. Most people will state that it is merely a matter “I know it [good posture] when I see it.” However, chiropractors are taught in their schooling how to analytically breakdown what exactly is ‘good posture.’ A chiropractor would observe a patient from a sagittal view (profile) with either a literal plumb line or more often an imaginary one that passes through the ear, the shoulder, the hip, the knee, and finally the ankle. This would be for an ideal patient with proper posture. For most patients, these points of contact would be either anterior or posterior to the plump line, indicating areas for correction.
The problem with modern-day living is the sedentary lifestyle. It is inevitable, after sitting for hours, to lose one’s composure due to fatigue — no matter how ergonomic one’s chair is. Eventually, the chin will start to jut forward, the cervical lordosis (concavity) becomes more kyphotic (convexity), the thoracic spine becomes more kyphotic than is normal, and there is a reduction or loss in the lumbar lordosis as well. Slouching for a short period of time, infrequently, is not worrisome. However, prolonged poor posture day-in and day-out leads to maladaptation of soft tissues, including musculature and ligaments, and in some cases, even the skeletal structure. There is a process called ‘creep,’ which occurs after a sustained posture of 20 minutes. The tissues adapt to this sustained posture, for better or worse.
It isn’t just sitting but also computer work and texting that compound this maladaptive process. Texting, in particular, leads to prolonged cervical flexion (looking down), which strains the neck and upper back as well as leading eventually to a reduction of cervical lordosis in the cervical spine.
If the head is held properly over the spine, it is stacked and there is an optimal amount of pressure placed on the spine and the body. However, with ‘forward head posture’ or ‘anterior head carriage,’ which often occurs with prolonged texting or computer work, the amount of strain placed on the cervical musculature and ligaments increases. Over time, this means that cervical musculature and upper back musculature become hypertonic (tight) and fatigued/strained. The most common muscles affected are the levator scapulae, sternocleidomastoid muscle, anterior/middle/posterior scalene muscles, and upper trapezius muscles. If they remain hypertonic for long, they will develop contractures, known as ‘trigger points.’
When these muscles are hypertonic or develop trigger points, they often refer pain, causing cervicogenic headaches, TMJ pain, cramps, etc. The straightening of the cervical spine or loss of lordosis also leads to muscle imbalances, ligament laxity, and early degenerative problems in the cervical spine.
The good news is that a skilled and experienced chiropractor will be able to address these issues, using a combination of soft-tissue manipulation and chiropractic adjustments. Since these problems did not develop overnight, it will take a series of treatments over time to fully rectify the situation. Often, home care exercises and stretches coupled with in-clinic treatments will be necessary to resolve the problems associated with ‘anterior head carriage.’
Dr. Kyle Yu, DC, MS
Seattle Chiropractor