Does Posture Matter? Episode 3: Revenge of the Slouch

This is the third installment in a series about posture and its significance in preventing pain and optimizing performance and function. In the first and second posts, we addressed the strengths and weaknesses of the current body of research on posture's relation to pain, and the significance of static posture with consideration to how it influences dynamic posture. If you have not yet, please read the first and second posts.


More Than Just Pain
As mentioned earlier, most all of the research on static posture and its effects on the body focus exclusively on pain, and therefore these studies do not tell the whole story. Among some health practitioners there is such an intense focus on pain-treatment that other important elements of wellness and performance are neglected or forgotten. This is an understandable trend—most people don't go to a physical therapist or doctor because they have trouble reaching their arms overhead without breaking into overextension, or because they suffer from dreaded "butt wink" syndrome when they squat, or because they feel tired, tense, and stressed every day and can't take a deep breath without great effort. Most people go to the physical therapist or doctor when something really hurts or when they've completely destroyed their tissues and need surgical intervention, and they ask to be put back together and have their pain alleviated ASAP. Obviously, pain treatment should be a primary focus in physical therapy and similar professions, but it should not be the only focus. Focusing only on pain at the exclusion of other important factors that contribute to wellness puts physical therapists, doctors, and other rehabilitation specialists about on par with a bottle of Advil (and a hell of a lot more expensive). 

Posture has dramatic effects on everything from the functioning of the heart and respiratory system to feelings of confidence and emotional well-being. Even if some people can get away with hunching over desks and cell phones and laptops day after day without any aches and pains, they are putting their bodies in suboptimal positions for maintaining basic bodily functions and are detracting from their overall health and well-being. 

Ah yes, it looks like a classic case of your posture sucks.  ¹

The performance of the respiratory system is hugely dependent on posture. Imagine trying to inflate a basketball while someone is standing on it. Not only will it be incredibly difficult, but you'll probably reach a certain point where you just can't inflate the ball any more. Something similar happens when we try to breathe in a crappy, compressed position. When we sit or stand rounded forward, we put additional resistance on the structures of our respiratory system and limit how deeply we can breathe and how much effort each breath takes. In suboptimal positions, the physical structures involved in respiration simply cannot do their jobs as well. Hunching over restricts the expansion of the ribcage (and thereby decreases lung capacity) and limits the action of the diaphragm (the muscular structure primarily responsible for inhalation). Over the long-term, thousands of hours in this position keeps all of the respiratory muscles of the chest and abdomen in a continually shortened and under-active state, which can cause adaptive shortening and weakening of the respiratory muscles. This, in turn, will limit the functioning and capacity of your respiratory system even when you are in an upright, neutral position. To make matters worse, your body will quickly get sick of putting up with your crap and will try to find a work-around to the limits you've placed on its beautiful and efficient respiratory engine. In order to do this, the neck muscles involved in breathing (the sternocleidomastoid and the scalenes) will be called on to work overtime. It won't be long before these muscles get tight and overworked, opening the door to a host of other potential unpleasantness: neck pain, shoulder pain, jaw problems, headaches—you get the idea. 

More or less what bad posture does to your breathing. ²

It is easy to see for yourself the detrimental effects of poor posture on breathing mechanics. First, stand up tall, with a neutral spine, shoulders back, looking straight forward, and take a few deep breaths, initiating from your diaphragm and allowing expansion in the abdomen (belly breathing). Feels great, right? Next, sit down in a chair and hunch over with your elbows on your knees. Get nice and rounded forward and try to take some deep breaths. Or, for a more exaggerated demonstration, stand up and then reach down to perform the classic reach-for-your-toes stretch (this is a terrible stretch, by the way), making sure to round all the way over, and try to take some nice deep breaths from this position. Spend an hour or two in these positions and you're going to be a tensed up, stressed, ball of under-oxygenated misery. With the recent mainstream popularity of yoga and meditation, we should all know by now the therapeutic and health-promoting effects of deep and controlled breathing. Yet so many of us still sit, stand, run, lift, etc. with our respiratory prime movers compressed and restricted. It's no wonder so many people have trouble feeling awake, clear-headed, and calm as they sit hunched over their desks all day. 

As implied previously, posture also has a profound effect on our mental and emotional well-being. Again, I do not intend to delve deeply into the psychological and psychosocial effects of posture in this post, but it deserves mentioning. It has been shown that, in addition to our posture being a form of non-verbal communication to those around us, it directly affects how we feel. Particular posture archetypes are associated with feelings of confidence, happiness, power, and well-being. A "closed posture," in which someone is rounded forward, taking up a smaller amount of space, and closing off/covering more vulnerable body structures (abdomen, genitals, and throat), is generally associated with feelings of submissiveness, malaise, and discomfort. On the other hand, an "open posture," in which someone is more erect with head held high, chest open, limbs spread, and vulnerable body structures exposed, is associated with feelings of confidence, power, and comfort and relaxation. 

As if that wasn't enough, posture can have both immediate and long-term positive (or negative) effects on our hormones and, in turn, physical and mental health. A 2010 study on "power posing" demonstrated that posing in a "power position" for even a few minutes can increase confidence, affect risk tolerance, and increase testosterone and decrease cortisol levels, whereas spending a short time in a "low power" position brings about the opposite effect. That's huge. Simply changing our posture habits can have a considerable effect on our attitudes, energy, stress levels, performance, and overall feelings of well-being. (Go here for an interesting TED Talk on body language and power posing.) 

Finally, our posture has an effect on our performance. For anyone who is at all interested in athletic performance, attention to good posture is a no-brainer. Just like a finely tuned Italian sports car, our bodies are designed to perform best under optimal conditions and in optimal positions. For the same reasons that no one in their right mind would take a Ferrari out on the track with its lug nuts loosened, alignment off, and a poorly functioning fuel pump and expect to perform well (or safely), humans should not be surprised when their bad posture habits bleed into their athletic life and they have trouble breathing when they run a 100m sprint, or can't overhead press a barbell without hyperextending their low back and losing stability, or can't perform a squat without their torso caving over. From optimal leverages and joint positioning to breathing mechanics to emotional well-being and confidence—posture affects it all. 

Good posture is not a magical life hack that's going to turn you from a desk jockey into a record-breaking athlete or cure you of all your ailments, present and future. And honestly, nothing is. Excellence requires lots of work. Posture is, however, a foundational piece of a healthy lifestyle, and merits attention and discipline. 

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Photo credits
1 Fuente: COM SALUD via photopin (license)^↩
2 Tsukioka Yoshitoshi [Public domain], via Wikimedia Commons^↩