Posture has always been a hot topic of conversation in the physical therapy world. When I mention that I’m a PT, people often ask about their posture and what exercises will make it better. To be honest, this is a loaded question. There’s no one simple answer. If you asked 10 physical therapists, you’d probably get 10 different answers. Some might say to focus on the core because if you aren’t strong in your mid section, it will cause you to slouch. Others might say to focus on the upper back (thoracic region) because if you can naturally keep your shoulders back with little effort, this is the best way for good posture. While others might say that you need to get a good chair and have your workstation evaluated by an ergonomic specialist. These are all valid ways to help improve your posture, but they can be overwhelming and take up a lot of time that we don’t always have.
When it comes to posture, I prefer to take a different approach that emphasizes motor control of the neck. This approach primarily stems from a research study entitled Effect of Neck Exercise on Sitting Posture in Patients with Chronic Neck Pain. I frequently talk about this study when explaining posture to my patients. Likewise, when I teach Redcord education classes to physical therapists, I will reference this study.
I find that neck stability is a good place to start when tackling just about any posture problem. You get a lot of bang for your buck with a simple approach that can be done without buying any props or equipment.
So let’s first talk about the authors. Deborah Falla, Gwendolen Jull and Paul Hodges are three of my favorite scientists when it comes to motor control research. Trevor Russell and Bill Vicenzino round out the five contributors to this article. They are all neuromuscular gurus that teach at the Department of Physiotherapy at the University of Queensland in Australia.
Published in 2007, the purpose of the study was twofold: 1) to look at changes in sitting posture in the neck and upper back when distracted by playing a computer game in people with neck pain and people without pain; and 2) to compare the effects of two different neck exercises on their ability to maintain sitting posture with neck pain. 58 people with neck pain and 10 controls were asked to play solitaire sitting at a computer for 10 minutes and were photographed every 2 minutes to look at changes in sitting posture at their neck and upper back. They found that people with pain had a harder time maintaining their posture during the task compared to people without neck pain.
Next they had the 58 participants with neck pain try two neck exercises to see which was better at helping them maintain their posture. One group was asked to perform a craniocervical flexion test which is the gold standard test to strengthen the deep muscles of the neck. They performed this exercise by placing a blood pressure cuff under the middle of their necks and asking them to push their necks into the blood pressure cuff at a standardized range of pressures from 20mm Hg to 30mm Hg. This is performed by asking them to lightly nod their heads like when gesturing yes to someone. They used the gauge on the BP cuff to hit the appropriate pressure or effort needed to train the deep muscles of the neck. They were instructed to hold each level of pressure or effort for 10 secs and repeat 10 times.
The second group of neck pain people were taken through an endurance strength training regimen that progressively got harder over the 6 week intervention. They were asked to raise their heads off the table and move it through a pain free range of motion 12 to 15 times and progressed to 3 sets of 15. They even used weights strapped to their heads to make it harder for them.
The results of the two different exercise routines showed that the group that just focused on the blood pressure cuff exercise had an easier time maintaining their neck and upper back posture while playing solitaire at the computer. Compared to the group that focused more on strengthening the outer muscles of the neck. This tells me that we should all focus on strengthening the smaller deeper muscles of the neck because those are the muscles that get shutdown when you have high levels of pain. Not only does it improve your neck posture but it also improves your mid back posture as well.
It’s like a two for one deal because you can do one exercise and get twice the benefit. This is not saying that you don’t need to do any other postural exercises but it is a good place to start and does not take much time or effort to reproduce this exercise. You can lie down on your pillow in the morning, tuck your chin slightly towards your chest and slightly push your head into the pillow with little effort. You can progress the push down progressively but still with not a ton of effort. If you're looking for an exercise at work you can place one of your hands on your forehead and resist yourself pushing your chin towards your chest again with little effort and progress the effort as well. These exercises are easy but can go a long way and you can do them multiple times per day.
So if you are feeling overwhelmed about your posture, give this exercise a try. Or you can contact me at Activcore Princeton for a full postural evaluation.
Disclaimer: The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.