THE MISSING LINK TO HEALTH AND FITNESS
Most of us have experienced an episode of back pain or neck and upper back discomfort some or the other time in life. Our back works constantly to keep us erect under an array of stresses and strains. We can get a back pain sitting long hours in the office to by just bending down to pick up a baby. The pain can be due to extreme muscle tightness or spasm, wear and tear of the spine, joints and the disc, due to popping out of the disc or due to irritation of the nearby nerves. Sometimes even a trivial sneeze can precipitate low back ache.
When the subtle curves of the spine get straightened, reversed or exaggerated with poor posture, imbalance in the strength of complementary muscle groups and inefficient movement habits, many neck and back problems are created.
We all want a resilient, pain-free, smart and an injury resistant back, but unknowingly, we tend to misuse this gift of our body! Our head wants to lead not just functionally but position-wise too! It projects in front as if it wants to win a race with the entire body. Then the body also decides to lean forward as if catching up with the head. We slouch, we collapse into our chairs and hunch over our tables. More of us are looking rounded, crooked and out-of-line! It is so common to see young professionals with rounded shoulders, protruding heads, upper back humps, protruding belly and waddling feet.
Not only do we look like wounded soldiers but we are also in pain! Despite sitting on ‘ergonomic chairs’ the pain doesn’t leave! Not just the office chair, we misuse our bodies even while standing, walking, lifting, driving and while performing various activities in a variety of postures. We keep using it to our comfort and advantage till it starts groaning with pain.
Exercise of any type cannot always help in alleviating pain. For many who exercise regularly, the back still continues to hurt, the neck and upper back feel sore by the end of the day while the knees seem to get wobbly. Unless we do something to correct our natural alignment, the problems will continue. Lack of awareness about our posture in daily activities will wash out the effects of proper exercising too!
WHAT IS POSTURE
Posture does involve appearance but posture is more connected with functions – what we should and should not be doing physically. The design of our body is not a flaw. Our spine, shoulders, head, knees and feet are not randomly placed in the body. They are well-thought of mechanisms, very intricate and sophisticated to keep the body functioning – standing erect against gravity, performing all day to day activities with minimal stress and strain.
Posture is not only an erect spine and back. Posture involves correct alignment and proper functioning in every external part of the body including the feet, the knees, the hips, the shoulders, the chest and rib cage, the shoulder blades, the neck and the head. Mere wrong placement of the feet can be the cause of knee and back pain.
In proper posture, the bones are properly aligned with the help of muscles and the force of gravity is evenly distributed through the body with the muscles working optimally and effortlessly – length and strength wise –thus supporting the skeleton efficiently.
The way beams and pillars have to be aligned to give a strong frame to a building, our bones and joints too have to be properly lined up for proper functioning with no wear and tear and minimal use of energy. Lack of alignment would produce undue tension on joints and muscles and we will have to spend more energy to stay upright. This is with the help of muscles working in the state of proper balance. Muscular imbalances are the cause of mal-alignment and postural imbalances.
We overuse certain muscles which eventually become short and tight or we underuse some muscles which loose function, tone and strength. If the muscles on one side are stronger than the counterpart, the joint will get slightly tilted or rotated. Just a small degree of misalignment is enough to drastically alter the tension inside the joint. This will then lead to wear and tear, a destruction of the structure of the joint and its contents – and we get labeled with an array of radiological diagnoses which begin with postural mal-alignments.
Our postural mistakes
Sitting - We have become professional sitters and we literally punish our backs with prolonged chair-sitting. We usually sit with the lower back bowed or rounded back behind us. This puts lot of pressure on the front part of the discs, making the disc more prone to get prolapsed in the front. People with existing disc problems feel more pain when sitting with a convex lower back. Even sitting straight on a chair for long is not healthy, as this disengages or does not let the body use the core postural muscles. The superficial back muscles then have to work hard to keep us erect. This puts enormous strain on the bones and the discs like a compressive load on them. There is a 40% increase on the pressure on the discs when we sit as compared to standing. Even when we are relaxing say watching the TV or reading the newspaper, we are suffocating our discs.
Standing - Standing with knees locked back, abdomen protruding forward, increases the curvature of the lower back – increased lordosis or a sway back. The lordosis further weakens not only the muscles of the abdomen, but also the muscles of the legs, back and the hips.
Muscular imbalances tilt our pelvis forward. Pelvis is the bony basin that forms the lower part of the trunk and the zone where the lower limbs begin. To understand the proper positioning of this basin, visualize it being filled with water, level, so that the water cannot slip in front or at the back. It is common to see pelvis tipped too far forward with an overarched lower back and then the belly too comes beyond the line of the belt. The abdominal muscles are weak in such people and this leads to a forward pull on the abdominal organs and the lower back as well.
Driving - Sitting while driving is different from sitting on the office chair as the body has to face many varying positions, vibrations and impacts of accelerations and decelerations. The feet are actively being used and they cannot be used to support and stabilize the lower body as normally happens when they are placed on the floor during normal sitting in a chair. The design of the car seat itself, can increase the chance of back problems for some people. If the posture is wrong, car driving itself can be the cause of back ache.
Sleeping - We all rest in various sleeping posture for 5-8 hrs everyday! That means 25 – 33% of the day we give to sleeping to charge our batteries! Considering this, we are spending one third of our life time sleeping and the position we sleep can make a big difference in our posture and health.
Certain sleeping postures do increase the tendency to a sway back while others give rise to neck pain. We usually blame the mattress or the pillow for the pain and stiffness but it usually is the wrong positions in which we sleep that give rise to the pain.
Sleeping on the belly can never be symmetrical as the head has to turn to one side or the other and this pressurizes the neck. Even the low back can get extremely curved as the lower back sags into the mattress.
Sleeping on the back places less pressure than sleeping on the stomach. As the weight gets evenly distributed across the widest surface of the body, this minimizes pressure points and ensures proper alignment of the internal organs. Adding a medium firm pillow under your knees and lower legs for a relaxed back will stretch the back, reduce the lordosis and the pressure from the spine and the discs. A thin pillow to keep the neck will permits a neutral position – neck in level with the spine.
Sleeping on the side with the top leg folded more than the lower one twists the body as if the top hip is trying to race with the lower one! At some stage, the back starts feeling stiff on awakening in the morning. Placing a pillow between the thighs can prevent this twist thus keeping the back more neutral in the side sleeping position.
Even the head, neck and spine alignment can suffer with pillow body mis-match as sleeping on the side, creates a significant gap between the neck and the mattress due to the width of the shoulders.
Thus the pillow used should be a wide one, spanning from the ears to the shoulders.
Is it possible to undo the effects of wrong posture on the body? Yes, most of the times it is possible. The answer lies in -
Aligning all the joints of the body so that we can do away with the slump, stand erect, feel and look taller and overcome our posture associated aches and pains. This is done individually after a methodical posture assessment following which corrective measures as to how one needs to stand, pick up objects, walk, get up from a chair, climb up and down the stairs, etc are shared.
Proper focused exercises that-
· Increases the flexibility of the back
· Strengthen the postural muscles
· Stretch the overused and shortened muscles of the neck and back
· Strengthen the underused and weak muscles of the abdomen
In the process of improving the posture, one can get rid of the array of aches and pains and also look better! Whatever the age, postural alignment will definitely improve the appearance and people will start noticing the difference in the way we look and move. It is just matter of becoming aware! Let us give high priority to postural alignment to stay functionally active and preventing disability.
