Posture and Mid-back Pain

The last post addressed "swayback" posture and its effects on the lower back.  Given that the lower back serves as the "base" of the spine, altered posture in this region must be compensated for somewhere else.  The next "link in the chain" is the mid-back or thoracic spine.

Referring back to the picture from the last post; as we move up from the lower back, you can see the accentuated outward "C" curve in the mid-back or thoracic region.  Notice how this increased "kyphosis" causes the shoulders to move forward.  Note also how this posture tends to collapse the chest and bring the head forward (We will address this in the next post).

The increase in kyphosis in the mid-back can cause lengthening and weakness of the paraspinal muscles in this area.  This allows the chest muscles to become tight and pull the shoulders further forward which can lead to shoulder issues.

If allowed to remain or even progress over time, this type of posture in this part of the spine can start to cause the vertebrae to become wedge shaped (See picture below).  Once this occurs this posture is very difficult if not impossible to reverse.

How do we prevent it from getting to this point?  A colleague of mine shared this quote with me many years ago and I have used it often.  "Extension equals function".  This increase in kyphosis or worsening of the outward "C" curve is what we refer to as a flexed posture.  Imagine trying to do overhead tasks or maintain good balance if you looked like the picture above on the right.  Trying to do things in a flexed posture tends to set us up for injury.  Being in a more erect, extended posture allows the muscles that support the shoulders and spine to work more effectively and normalizes the pressure on the discs.

How do I improve my posture if I look like the picture above?

1.  As mentioned above, extension equals function, so extend, extend, extend -- within reason.  Do not push into pain or be overly aggressive but a nice way to help reverse this over flexed curve is to lay on an exercise ball.  This helps improve mobility in the spine to achieve a more upright posture.

Don't have an exercise ball?  Roll up a couple of towels forming a "log" and lay over that.

2.  Strengthen the supporting muscles.  The two exercises below are great for improving strength of the muscles that support the shoulder blades and the muscles that help keep your spine supported in good posture.  Don't have a theraband?  Use a towel and make it an isometric exercise.

3.  Stretch out those tight pecs.  The exercise below not only stretches the pecs, but by pressing your arms back into the wall as you are moving up and down you are also strengthening the spinal muscles and scapular stabilizers.  This is also a great exercise to do during the work day to get us out of the flexed posture we tend to adopt at our desks.

Next post we will take a look at how poor posture can affect the neck.