Posture, Babies, And Bathwater

Posture is a controversial topic. It’s relevance for pain has been properly questioned by fans of “pain science,” biomechanically-minded crowd has worried that a baby is getting thrown out with the bathwater. In previous posts I’ve written about the very dirty bathwater that does indeed need to be thrown out. In this post I’ll provide a few thoughts on taking care of the baby (assuming there is one under the dirty water.)

Extensive research shows that objective measures of postural alignment correlate very poorly, if at all, with pain. But this doesn’t mean that posture is irrelevant to health and especially performance. Posture is a fundamental part of coordinated movement, one of the first skills that a baby learns. We need a well-organized trunk and neck to see the world, coordinate movements of the arms and legs, protect vital structures from injury, and maintain balance. We can barely do anything without a minimum level of postural skill, and that skill must elevate to an elite level if we want elite level athletic performance.

In the context of pain, common experience makes clear that posture is sometimes a dominant cause. For example, I have noticed that standing in the same place for long periods of time at a cocktail party or museum will sometimes make my lower back stiff. It feels better almost immediately when I sit for a few minutes. A slumped position works best, and is also my most comfortable way to rest over long periods of sitting. I have clients with literally the exact opposite set of preferences, which is why they use a standing desk at work and lumbar supports while sitting..

Nothing about these anecdotes is inconsistent with the research on posture and pain, which does not imply that people are equally comfortable in all positions, or that they don’t benefit from tinkering around with different options. Adjusting your posture to be more comfortable is not rocket science, and most people will do it unconsciously. But our natural tendency to self-organize can get stuck in a bad groove if we don’t give our bodies the feedback it needs, in the form of variable postural challenges. And we can really get stuck if we decide that certain postures that feel natural are wrong and to be avoided. Consciously trying to mold posture to some assumed ideal is probably a bad idea, as it tends to encourage stiffness..

So how do you get unstuck from a bad postural groove and make progress? One way is to play with the different constraints around which your posture tends to self-organize. I’ll review five: coordination, strength, mobility, social context, environment, and pain.

There are many common exercise methods that focus on training postural skills. For example, yoga, Pilates, or tai chi develop are very much about maintaining a specific postural alignment in a variety of functional contexts. Do you need that specific alignment to be functional and healthy? Probably not. But trying to maintain it under variable conditions is a way to build coordination.

Locomotive activities all challenge the ability to coordinate alignment of the spine with movements of the arms and legs. Therefore, improving your performance in activities like crawling, walking, running, climbing and swimming are likely to improve your posture as well.

Postural skill is also about helping to maintain balance, and therefore we might expect it to be improved through activities that challenge balance, like gymnastics, dance or skateboarding.

Strength