Do You Know How to Stand? Chances Are You're Doing it Wrong.
Every time I have a new patient, the first thing I do during the exam, after taking a history, is look at my patient’s posture. What I’ve realized after 15 years of looking at posture is that most people don’t know how to stand. We shove our hips forward, collapse into our low back, round our shoulders, and jut our chins forward. I find myself teaching almost 100% of my patients how to stand.
Dr. Kelly Starrett on Posture
Dr. Kelly Starrett, a physical therapist, has written an impressive book about body mechanics, exercising safely, and self-care called, “Becoming a Supple Leopard.” In it, he very concisely describes the best standing body mechanics. The below is adapted from his book.
According to Dr. Kelly Starrett, “prioritizing spinal mechanics is the first and more important step in rebuilding and ingraining functional motor patterns.” Getting the spine into what is called a “neutral” position through a movement called bracing will allow your muscles to move with greater efficiency and provide better stability throughout your spine so that you don’t injure yourself. By prioritizing good spinal mechanics you save yourself from major bouts of pain. This is because your body will be more prepared to handle moments of relapse than if you didn’t practice good spinal mechanics.
Practicing good form with regularity is important to building spinal stability because the more you are training your body to have good form, you are also rebuilding neural connections that tell your brain where your body is in space (called proprioception). Practice doesn’t just make perfect, it makes permanent.
Neutral Spinal Position V. Flexion or Overextension Faults
There are two main faults in most people’s spinal mechanics. The first is called a flexion fault and the second is called a an overextension fault. Both occur from poor posture and lack of spinal bracing. A flexion fault occurs when you regularly roll your shoulders forward either sitting at a computer, phone, or carrying a backpack. This position puts pressure on the spinal discs in your mid-back and rolls your shoulders forward. An overextension fault occurs when you bring your chest too far out and draw your hips down, which can happen when you sit for long periods of time. This position places too much pressure on the spinal discs of your low back and creates too much rounding of the lumbar spinal curve. Both of these positions will reduce your range of mobility and create instability in your spine.
A braced, neutral position is where all of us should be to achieve optimal spinal health. What I mean by a neutral spinal position is that your ribcage is in line with your pelvis, your ears are in line with your shoulders, and you are engaging your core muscles to stabilize your position in space, allowing force to be transferred evenly down your spine.
Achieving A Neutral Standing Position (See Fig. 1):
- Position your feet directly below your hips and parallel to each other. Rotate your hips externally and “screw” your feet into the ground. You do this by keeping your feet straight and torquing the feet (pushing through the right foot in a counterclockwise motion and the left foot in a clockwise position).
- While you are screwing your feet into the ground, squeeze your butt muscles to set your pelvis into a neutral position. You don’t need to use full tension at all times - initiate the tension, then reduce it. Continue bracing your abdominals at about 20% tension to maintain a braced position.
- Use your abdominal muscles to lock your pelvis and ribcage in place. Do this by taking a deep breath in, allowing the air to reach the bottom of your belly. This is called diaphragmatic breathing.
- As you exhale, stiffen your abdominals again to pull the ribcage down and balance your it over your pelvis. This creates a force of pressure that will hold up your spine more rigidly.
- Rotate your shoulders externally by opening your arms and drawing your hands out so that the palms face the sky. While you do that, draw your head back towards your chin to align your ears over your shoulders.
Fig. 1: The Bracing Sequence
Achieving a Neutral Sitting Position (See Fig. 2):
Sitting is generally not good for the body, but there are some things we can do to minimize the ill effects of prolonged sitting. The easiest and best way to minimize the effects of sitting is to take standing breaks every 15-20 minutes. When you do have to sit, follow the below bracing technique:
While you’re sitting it’s important to maintain a braced neutral position. Keep an eye out for leaning forwards or backwards. If you notice yourself doing this, it’s probably time for a break.
Fig. 2 & 3: Braced Neutral Posture and Correct Texting Posture
Correct Texting Posture
Texting is something that we all do, and it’s something the vast majority of us do without any attention to our spinal health. The correct texting position starts with your spine in a neutral standing or seated position. (See Fig. 3)
- Bring your phone up to your eyes.
- Roll your shoulders back and then let off just slightly to keep from overextending your midback.
- Draw your head back so that your ears are in line with your shoulders.
To help bring awareness to the bracing sequence, Dr. Starrett has some tips to highlight the position of your spine and help you identify when you are losing good form. (See Fig. 4)
- Take one thumb and put it on your sternum. Splay your fingers out and face your palms perpendicular to your body
- Pin your other thumb on your pubic bone, creating two parallel planes.
The goal is to keep your hands on the same horizontal plane as your pelvis and ribcage so any changes in them will be reflected in the hand position. If your hands move further apart, you are overextending. If your hands move closer together, you are rounded forward or flexing.
Are you concerned about your posture and body mechanics? Are you feeling pain from extended periods of sitting or standing? Call us at 510-922-1579 or text us at 510-692-9948 to schedule your next appointment.
- After you have followed the bracing standing position, assume a squatting stance by screwing your feet into the ground to create torque, squeezing your butt, and setting your shoulders into a neutral position.
- Keeping your shins vertical and your back flat, sit your hamstrings back and hinge forward at the hips.
- Lower your butt into the chair, maintaining tension in your hips, hamstrings, and back as you sit.
- Keep at least 20 percent tension on your abdomen when you sit to keep the spine stabilized. It’s nearly impossible to keep your abdomen contracted for more than 20 minutes, so take a standing break when you feel that you can’t contract your abdomen any more.
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