One of the first things I do with a new client is to evaluate their standing posture. They may feel like they are standing straight, but injuries and life habits force us into adapting postures that may not be ideal.
As one client noticed, optimal standing posture can feel awkward at first:
Dustienne evaluated my balance and posture as part of her initial examination. I stood upright thinking I had pretty good posture. Apparently, I had become accustomed to postural accommodations. My normal posture morphed into something quite different than it should have been while recovering from an injury. Dustienne gave me cues to get my rib cage over my pelvis. It was incredible because the “normal” upright position felt so awkward and unsustainable. Honestly, it felt like I was leaning way forward over my toes like a skier taking off on a ski jump. It took a while of doing my home program and working with Dustienne, but I can now achieve normal upright posture and it feels great!
Your proprioceptors, which are sensory receptors, are responsible for telling your brain where your body is in space. When postural adaptations occur after an injury or pregnancy, your brain needs to retrain and relearn what neutral standing is.
The body’s plumb line
In construction, there is a way to determine whether a line is perfectly vertical by using a pointed weight called a plumb. This vertical line is called a plumb line.
The body also has a plumb line.
Florence Kendall was a pioneer in the field of physical therapy. Her most popular and highly regarded book, Muscles: Testing and Function, is a cornerstone of physical therapy testing and evaluation. In this book, Kendall discusses how optimal posture can be measured on a plumb line.
Ideally, the plumb line would intersect the middle of the ankle, knee, hip joint, rib cage, shoulders, and ears. We see deviations from the plumb line alignment due to weakness, myofascial tightness, and adapted postural habits. This might present as the head forward past the plumb line, the ribs behind, etc.
For instance, for my client above, her ribs were behind her pelvis so far that she needed to lock out her gluts to balance, which decreases the function of the abdominal muscles and can lead to pelvic and back pain. Her head needed to come forward past the plumb line to accommodate for the ribs coming forward (hence why she felt like she was falling forward at first).
Two common postural habits that I see in the clinic are a postpartum postural adaptation and chronic pelvic pain postural adaptation.
Postpartum postural adaptation
When you are pregnant, you spend somewhere in the ballpark of nine months getting used to learning where your new center of gravity is as the baby grows and gains mass. The learning process is gradual over roughly 40 weeks and your proprioceptive system adapts over time.
You experience a completely different center of gravity moments after you have your baby, but your proprioceptors haven’t had a chance to figure out where your body is in space.
If we look at a woman who is postpartum on a plumb line, we will likely see:
- her pelvis forward of the line
- ribs behind the line
- head either in line or forward of the line
As a result:
- The front of the hip joint is in an overly lengthened position, making the gluts functionally weak and putting excess pressure in the hip joint capsule.
- The abdominal wall is overly lengthened, which will make the abdominals less efficient.
- The back aspect of the pelvic floor muscles grips around the anus, which could mean less activation in the front where some women have weakness and associated urinary incontinence.
Chronic pelvic pain
The pain combined with myofascial adaptations might cause you do adopt a posture where your rear end is tucked under and your ribs are collapsed down in the front. You may find yourself stuck in lumbar flexion, unable to achieve a neutral spine.
Lumbar flexion shortens the abdominal wall and prevents full diaphragmatic excursion.
How do you change this? Sometimes you need to ride the storm out and wait for the bladder, menstrual, or abdominal pain to cease.
Once you are feeling like you are able to be upright again, try my extension progression flow for extending your back again. Be sure to only try for the amount of extension that feels good, without forcing it.
When we are able to keep our shoulder blades back on the ribs, it doesn’t pull our shoulders and our head forward. This helps decrease the amount of weight the spine is supporting in the front. It helps to strengthen around the shoulder blades and the back muscles.
In order to achieve this we need both awareness and the strength to pull our shoulder blades back.
It’s also important to know that we are not supposed to maintain a stiff rigid upright shoulders back posture like we may have been told when we were little kiddos.
How to improve your standing posture
Imagine that you are a ki