Your mom told you to always stand up straight…and she was right.  Poor posture can lead to many problems including head, face, neck, shoulder, upper back, and arm pain. One study demonstrated that a forward head, increased thoracic kyphosis (rounded upper back), and rounded shoulders increased the incidence of cervical (neck), interscapular (between the shoulder blades) and headache pain [1]. Another study demonstrated that an increased angle between the head and neck (forward head) increased the incidence of TMJ (jaw) pain, and increased the incidence of chronic tension headaches [2].

How does technology play into all this?  With the increased use of computers and cell phones (texting and e-mailing from smart phones) we spend a good portion of our day with our head, neck, and upper back in a rounded, forward head position.  The more time spent in the forward head position, the greater the chance for the muscles to become adapted to this position. Eventually this position will increase tightness and tension which can cause vasoconstriction (restriction of blood flow) to these muscles and put increased pressure on nerves in that area.  On average, the human head weighs about 12-15 pounds and when you have a forward head posture you put a great strain on the muscles in the back of the neck.  When you compound the forward head posture with rounded shoulders then you compress all the structures that run through the front of the shoulder and place a great strain on the muscles of the upper back. Porterfield and DeRosa demonstrated that lengthening (by rounding your shoulders) and inevitable weakness of the muscles between the shoulder blades can also be a product of weak abdominal muscles.  When we sit for long periods of time, lack of strength in the abdominals can cause the low back to round out, the chest to descend, and the weight of the upper trunk to shift anteriorly.  As this shift happens, the collar bone compresses the rib cage and the bone in the upper arm (the humerus) becomes rotated inward [3]. 

All of the shifts and changes in the body structures can result in an increased strain on the postural muscles which in turn puts stress on the nerves that run through these structures.  Compression of the nerves that come out the back of the neck can result in facial pain or headaches.  These nerves are responsible for sensation in the back and side of the head, face and jaw region.  Poor posture can also compress the nerves into the arm because they exit the neck between the rib and collar bone.  This can cause numbness, tingling, or pain into the arms.

So what's the answer?  Listen to your mom and sit or stand up straight!  This sounds easy, but you have to constantly remind yourself to do so.  Sarah Meeks, PT, GCS states that 50% of the postural problem is mental and that simply reminding yourself to sit or stand up helps tremendously [4]. You may, however, need an ergonomic assessment of your workstation along with some exercises to stretch the tight muscles and strengthen the weak muscles. At this point, a physical therapist is invaluable.  Physical therapists can be very resourceful for tips on how to set up your workstation, sleep, stand, and sit properly.

If you are experiencing any of the symptoms above, it would be a good idea to consult a physical therapist. At Sports Physical Therapy we perform one hour evaluations to assess your full musculoskeletal system guided by your subjective complaints.  A thorough evaluation can give a wealth of information regarding muscular tightness and weakness.  The physical therapist can give postural recommendations based solely on your specific findings.   If you tackle your symptoms early on, sometimes within a few sessions, you could be given enough alterations to your posture and proper stretching and strengthening techniques that those symptoms go away.  All without the use of medication!!

 

[1] Incidence of Common Postural Abnormalities in the Cervical and Thoracic Regions and Their Association with Two Age Groups of Healthy Subjects. Physical Therapy/Volume 72 Number 6/June 1992.

[2] The Relationship Between Forward Head Posture and TMJ Disorder. J. Orofac Pain 1995 (Spr); 9(2):161-167.

[3] Porterfield JA, DeRosa, C., Musculoskeletal Neck Pain Perspectives in Functional Anatomy PA; WB Saunders Co. 1995.

[4] Meeks, S. Walk Tall: An Exercise Program for the Prevention and Treatment of Osteoporosis. Triad Publishing. 1998