5 Exercises to Improve Posture

Lindsey Rose, PT, DPT, ART-Cert.

There are several ways that posture is being negatively affected in our daily lives. Desk jobs, heavy school backpacks, texting, and overall increased screen time have all contributed to this widespread problem. More frequently we are seeing patients of all ages with back and neck pain due to poor posture.  Years ago, we took more frequent breaks and allowed ourselves more vertical time for our head, neck and upper spine to be aligned.

Posture’s effects on us are mental (confidence), communication (perceived confidence), injury prevention (poor posture leading to many potential issues), and diagnosis-based (scoliosis, impingement, referred pain in neck and arms, etc.).  Having proper alignment leads to people not only feeling better about themselves, but portraying this feeling to others in non-verbal communication as well- whether in the workplace, personal relationships, or others.

There are many factors that are associated with proper posture, originating from the head all the way to the ankles. Any sort of deviation can put excess stress on one part of the body, leading to overuse and, ultimately, pain. In this article we have chosen to highlight a few specific corrective exercises for rounded shoulders and forward head posture, whether these issues stem from increased screen time (reading on a tablet or texting), or from poor desk setup in the workplace.

The average human head weighs between 10 and 12 pounds. Anytime the head is tilted forward - either while slouching at your desk or looking down at your cell phone - the muscles, tendons, and ligaments must adjust to support the head in a forward tilted position (remembering back to simple physics and lever arms!). Even the discs in our necks are involved in distributing and absorbing the forces being placed on the neck. As the head is tilted forward the shoulders move to an anterior position, which may lead to poor postural habits. As demonstrated in the figure below, the greater the angle of the head tilting forward, the more weight and stress is placed through the spine.

To start - here is a quick anatomy review of what is affected with forward shoulder/forward head posture.  Forward shoulder posture is sometimes referred to as “Upper Crossed Syndrome” with tight pectorals, tight upper trapezius (top of shoulders, shrug), tight levator scapulae (lifts shoulder toward ear and tips head), weak deep neck flexors (front of neck, important in chin “tucking”), and weak posterior shoulder musculature (muscles between shoulder blades that “open” the chest).  Think about the parts to slumped/poor posture:

• ●The shoulders are rolled forward causing tightness in the front of the shoulders, as they are adaptively/over time shortened
• ● Increased stretch and weakness in the upper and mid back
• ●In general, the action of the middle trapezius and rhomboids is to retract or “adduct” the scapula. When they are overstretched, they are unable to pull the shoulder blades back and get really tired from trying so much
• ●If your head is forward, you are going to be looking at the ground!  Then, because you are looking down, it places stress on the muscles that insert into the base of the neck holding up the head to try to “lift” you up to see (think elderly, hunch-back posture)
• ●The upper trap (top of shoulder) is tight, leading to headaches, tight shoulders. You will “shrug” your shoulders to try to eliminate or reduce the tightness, making them tighter

In addition to the increased frequency of texting and using tablets, another way that poor postural habits can be formed is at the workplace, specifically with desk jobs. Desk ergonomics are an important tool to decrease the likelihood of developing poor posture while at work. A few quick fixes in chair and desk height along with proper computer placement will assist in correcting posture to create a more productive work day and decrease the likelihood of back pain developing.

At one point or another we have all heard a parent or physical therapist say: “Stand up straight!” We should all want to stand up a little taller and squeeze your shoulder blades back (but not up!) a bit after seeing the negative effects of poor posture. The good news is that there are ways to reverse the effects of poor posture with a few stretching and strengthening exercises:

1. Chin Tucks

• ●Stand with your spine against the wall, pull the upper back and head back until the back of the head touches the wall. It is important to make sure the chin is down so the head is pulled straight back and it is not looking up. This is in general a small motion, think ears over shoulders. Hold head back for 5 seconds, Repeat 10 times.
• ●Note: If you have extreme forward head posture, you may not be able to pull you head all the way back to the wall, in that case, pull the head back as far as you can without pain.
• ●Importance: This exercise helps to strengthen the muscles that pull the head back into alignment over the shoulders. 

   

1. Wall Chest (Pec) Stretch

   Option #1

• ●Stand next to a wall, extending your arm along it. Rotate your body away, until you feel a stretch across the front of the chest. Hold 30 seconds, Repeat 3 times.

  Option #2

• ●Stand in a doorway, lined up with the opening. Place your arm shoulder height in the doorway at a right angle (see picture below). Slightly rotate body downward and away, until you feel a stretch across the front of the chest. Hold 30 seconds, Repeat 3 times.
• ●Note: Start slowly to feel a gentle stretch in the chest to avoid pulling in the shoulder joint itself.
• ●Importance: As mentioned above, with excess forward shoulder placement, chest muscles (pectoralis major and minor) tend to be very tight; this stretch will help decrease muscle tightness.

   

1. Trigger Point Ball to Chest

   Option #1

• ●Starting at the armpit, move slightly medially (toward breast bone), with both hands use the trigger point ball and massage your chest muscles (pectoralis major and minor), when you find a spot that is sore or has increased restriction, stay there until you feel a release. Hold for 30 seconds, Repeat as needed.

  Option #2

• ●Lay on trigger point ball, starting at the armpit, move slightly medially (toward breast bone) into your chest muscles (pectoralis major and minor), move around slowly until you find a spot that is sore or has increased restriction, stay there until you feel a release. Hold for 30 seconds, Repeat as needed.

• ●Importance: As mentioned above, with excess forward shoulder placement, chest muscles (pectoralis major and minor) tend to be very tight and trigger points develop which can refer pain into the shoulder. In addition to exercise #2, the use of a trigger point ball to release the pecs will be beneficial to patients with poor posture.

    

1. Theraband Rows

• ●Place the knot of your Theraband in a closed door. Determine the appropriate resistance by pulling more or less on the theraband. Keep back straight. Start with elbows slightly bent, thumbs facing upward. Pull the cord all the way toward the chest. While pulling the Theraband, the elbows should be drawn along the side of the body until the hands touch the lower ribs. Slowly return back to the starting position. Complete 10 reps, Repeat 3 times.
• ●Note: It is very important to not let upper trapezius (top of shoulder and neck) hike during this exercise.
• ●Importance: As mentioned above, it is the posterior shoulder musculature that is weak, from being over stretched and inhibited in a forward shoulder posture. This exercise will help to strengthen to promote proper posture.

    

1. Front, Side, Back Lifts (Add light weight per your tolerance)

• ●Start lying on your stomach on an exercise ball (For beginners: use a stable gym bench). Start with arms down to side. First, with thumbs facing up, lift arms front, keeping elbows straight, so arms are shaped like a Y. Second, with palms facing down, lift arms side, keeping elbows straight so arms are shaped like a T. Third, lift arms back, keeping elbows straight so arms are shaped like an inverted V. Complete 10 reps (each direction), Repeat 2-3 times.
• ●Note: Keep your neck in proper alignment throughout the exercises. Also it is very important to not let upper trapezius (top of shoulder and neck) hike during this exercise.

• ●Importance: To strengthen/stabilize the rhomboids, middle trapezius and lower trapezius, all of which are important postural muscles.