Posture Archives - MelioGuide

Perfect Posture Guide

Margaret Martin — Mon, 17 Jul 2023 18:45:39 +0000

July 17, 2023

This guide is your introduction to the fundamentals of posture and identify resources on this site to help you develop a perfect posture. Before we get into how you can get the posture you want, we need to identify the roadblocks in your path.

Benefits of Perfect Posture

A perfect posture provides our:

Muscles in their best alignment. They can function with the least amount of effort, reducing the risk of sprains, strains, and neck and back pain.
Lungs with more capacity. Great posture improves rib cage alignment. Voice projection improves. You can breathe better when walking, running, or playing sports.
Musculoskeletal system with its most efficient alignment. You will run faster and throw farther. Function improves when chopping, lifting, and carrying.
The stomach and digestive system function at their best. Good posture reduces the incidence of heartburn, acid reflux, indigestion, and constipation.

What’s Stopping You From Getting the Perfect Posture?

Want perfect posture?

A good posture is important, but there are several impediments you might need to address. Let’s discuss them, one at a time.

Every day, you need to maintain your body’s alignment against the force of gravity. You must use muscular effort to maintain perfect posture.

If we give in to gravity, we slouch forward and could develop a Dowager’s hump.

Before the 1970s, healthy individuals sat and stood tall throughout the day. Several trends have reversed the emphasis on perfect posture.

Posture and New Technology

The first trend was the introduction of new technologies.

The use of computers, smart phones, and tablets (such as the Apple iPad), has led people to drop their heads and shoulders forward.

As you can see in the illustration below, the forward lean of your head increases the load placed on the muscles responsible for holding your head upright. These muscles were not designed to work for prolonged periods in this manner.

Raising your phone rather than dropping your head significantly reduces the strain on your neck and upper back muscles. This is especially true when it comes to iPads. The use of a stand for the iPad can make a significant difference in both your posture and neck and shoulder pain.

Posture and Furniture Design

The second trend is the change in furniture design. Soft, deep couches and recliners have made our postural muscles lazy.

This guide will provide you with new ways of looking at furniture and reconsider how to sit in the world around you.

Remind yourself of the many benefits beyond looking more confident. It will keep you motivated to have perfect posture.

How to Have a Perfect Posture

Many people wonder how to have a perfect posture. Let’s takes the first steps to improve your posture and do this posture exercise together.

Success starts from the ground up. I encourage you to follow me in the video demonstration below.

Perfect Posture When Standing.

Follow these instructions as you look at the video:

Close your eyes after reading each step to heighten your sensory awareness.
Begin by standing with your feet hip-width apart. Bring attention to how you distribute your weight through your feet.
Ask yourself, Is the pressure under each foot the same?
Where is the weight distributed? Under your heels? The base of your toes? Outside of your feet? Through the arches?

Soft Knees

Next, soften your knees.
Not everyone “locks their knees,” but most do. Locking our knees is a very passive way to stand. It allows us to hang onto our ligaments rather than use our muscles. You will not have to soften your knees if you already have an even weight distribution.

How does the weight distribution change after softening your knees?
Take a moment to go back and forth between locking and softening your knees to compare how it feels.
Aim to distribute your weight through the base of your big toe, your little toe, and the heel of each foot.
If a soft bend in your knees provides you with better weight distribution, this might be a good first step to improving your standing posture.

Feet, Pelvis, Rib Cage, and Torso Positioning

Next, press your feet firmly into the floor. Invite equal and opposite energy to rise through your soft knees, thighs, and pelvis.
Bring awareness to the space between your pelvis and your rib cage.
Elongate this space evenly through your body’s front, back, and sides.
Continue to lengthen your torso with the energy rising through your spine. Imagine two small helium balloons under each armpit. Finally, elongate the crown of your head toward the sky.

Quick Posture Tip: Balance a Book on Your Head

As a child of the 1960s, we sometimes walked around for a few minutes daily with books on our heads.

When you keep a book balanced on the top of your head, you get a sense of the alignment you need to maintain perfect posture.

With time and practice, it is much easier to maintain a great posture. Over time, you will lose your slouched posture.

Physical Therapy for Posture Correction

Many people have lost their full range of motion in specific muscles and joints. This leads to misalignment of the body.

A reduced range of motion can result from trauma. Your muscles and joints have adapted to how you have been sitting and standing for years.

When this occurs, seek the help of a trained professional, such as a physical therapist. They can identify the muscles that need stretching and those that need strengthening.

Physical Therapy or Chiropractic care can mobilize your joints to regain lost movement. This could be holding you back from perfect posture.

The longer you have poor posture, the more challenging it is to regain the alignment you once had. This is the case even with professional help.

Products for Your Posture

My online course, Perfect Your Posture, is used by thousands of people just like you to improve their posture. You can learn more by clicking on the image below.

Physical Therapy Posture Exercises

Anterior pelvic tilt and posterior pelvic tilt are common causes of poor posture. You will need the help of a Physical Therapist to treat either of these conditions.

Muscles attached to the pelvic bone can shorten and pull from one side. This can lead to overstretching and weakness on the opposite side.

The treatment protocol can get complicated.

I created several videos explaining anterior pelvic tilt and posterior pelvic tilt. I also discuss what to do about them.

Another big concern people have about their posture is the Dowager’s hump. I have a video on how to combat this posture as well as strategies for working at the computer, and more.

Flexed Posture

A flexed posture refers to a seated or slumped stance where our arms and legs are in front of our torso. It can also involve the spine curving forward.

Life now includes more forward-flexed postures (because of computers, iPads, and iPhones). Fewer activities involve extension, such as brisk walking. Even at the gym, they encourage you to use machines from a seated posture leading to rounded shoulders.

Postural muscles and upper back muscles are now more stretched than before. This is due to the imbalance between hours spent in a flexed posture instead of an extended posture.

This makes them mechanically less efficient and, thus, weaker. All the while, the muscles pulling you forward have gotten tighter. Over time this could lead to a kyphotic posture.

Back Brace for Posture

Today, you can find hundreds of back braces to pull you out of postural flexion or a forward flexed posture. These braces (or posture aid) can serve as quick reminders. But they do not give you the length and strength you need to build great posture!

Exercise and Postural Alignment

Many people ask me: Is it safe to workout and do balance exercises, strength training, or weight bearing with poor posture?

Individuals with the following conditions should exercise caution:

Posterior disc herniations,
Posterolateral disc herniations,
Osteopenia.
Osteoporosis.

I recommend you begin exercising with the standing tips I gave you above. Maintain your best posture while exercising.

A perfect posture will take years of strain off your muscles and joints. Bonus: It will keep you looking and feeling your best along the way!

Start with my Perfect Your Posture course or locate a trained professional to help you improve your posture.

Conclusion

With this guide and other resources on my site, you can now improve your posture.

How to Fix Rounded Shoulders

Margaret Martin — Thu, 15 Nov 2018 21:25:24 +0000

What are Rounded Shoulders?

Rounded shoulders are the result of poor posture. It is that rounding of the back and forward head posture you see so often in today’s society. The medical term for rounded shoulders among clinicians is orangutan posture. I use the term “orangutan posture” when speaking to other Physical Therapists.

Rounded shoulders can lead to hyper kyphosis, Dowager’s Hump, shoulder blade pain, and compression fractures.

For people with osteoporosis, osteopenia, or low bone mass, having rounded shoulders is something you want to avoid and eventually fix. The sooner you avoid rounded shoulders, the better it will be for your long term health.

To have perfect posture, on the other hand, you need to maintain postural alignment and keep your head straight above your spine. Perfect posture requires a strong foundation — starting from our feet, to our pelvic region, and up into our spine.

In this blog we talk about how to actively engage your posture muscles throughout the day to achieve your best posture.

In the photo, I am using a one meter stick to demonstrate proper postural alignment. The back of my head is touching the stick, as is my upper back. I have a slight space, about a hand-width in total, between my lower back and the stick.

Rounded Shoulder Test

There are several ways to test if you have rounded shoulders. If either of these is true, you likely have rounded shoulders and should take steps to correct your posture.

Orangutan Test

Look at recent photos of yourself. Rounded shoulders is sometimes referred to as the orangutan posture.

Do you have that look? If yes, this indicates that you have a rounded shoulders posture.

Thumb Test

Stand in your usual stance and let your arms hang freely. If both palms are facing behind you and your thumbs are pointing in, then you have rounded shoulders.

Back Reach Test

This rounded shoulder test is sometimes referred to as the “back reach test”. There are four parts.

Right Side: Stand in you usual stance. Reach behind your back with your right arm. Your right elbow should be pointing at the floor. Use your thumb and index finger of your right hand to measure the distance between the bottom tip of your shoulder blade and your spine. The distance for an average sized person should be no more than three inches. If your score is higher (give or take based on how big a person you are) then you probably have rounded shoulders.
Left Side: Perform the back reach test on the left side with your left arm. Is the distance between the spine and the left shoulder blade more than three inches? If yes, you have rounded shoulders.
Test Completion: If you are unable to complete either of the back reach tests because you are so tight in the front that you cannot reach back, you probably have rounder shoulders.
Comparison: The two distances you measured between the shoulder blades and the spine should be the same or close to the same. A large difference might indicate a shoulder imbalance and you should consult with a Physical Therapist.

Sternal Notch Test

Stand in your usual stance. Place your finger at the very top of your sternum at a location called the suprasternal (or jugular) notch. Think of a glass of water. If the glass is glued to a surface that is perfectly vertical, the glass should not tip and spill water. Now imagine the same glass of water glued to your suprasternal notch. Is the glass tilted forward? Does water spill out of the glass? If either of these is true, this indicates rounded shoulders and your objective is to keep your sternal notch elevated and flat.

Stick Test

Stand in your usual stance and place a one meter stick or broom stick behind you. Look in the mirror or, even better, have a friend take a side photo of you. Are you able to keep the back of your head and upper back in contact with the stick while, at the same time, maintain a slight space, about a hand width in total, between your lower back and the stick?

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

For example, poor postural alignment when you cough, sneeze, or reach for something can cause micro trauma to the spinal column. Over time, these micro traumas can add up and eventually lead to vertebral compression fractures.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

Unless we make adjustments to our environment or correct our posture, over time we weaken and stretch certain muscles and tighten other muscles. This muscular imbalance leads to poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Many of us do not know how to get and keep a perfect posture. To have a good posture we need to learn the fundamentals of good posture, know what exercises promote postural alignment, and how to bring good posture into our day to day activities.

This is why I created Perfect Posture in 30 Days. This course addresses each of these areas and shows you how to develop a perfect posture, how to modify your daily activities, and how to make your perfect posture a permanent part of your life.

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Rounded Shoulders Causes

The causes of rounded shoulders include the following:

You slouch when you sit and and let your body shape to the contour of the chair. Do this repeatedly over an extended period and you will develop rounded shoulders.
Your exercise program or your activities mostly include movements that reinforce rounded shoulder posture. Over time this will lead to rounded shoulders unless you do movements and activities to counteract the forward head posture.
You are not aware of your posture and over time certain postural muscles get long and weak while others get short and tight.

How to Avoid Rounded Shoulders When You Sit

We spend much of our lives sitting (some would argue we spend too much time sitting). Unfortunately, when we sit we can compromise our posture. As a result, we need to be mindful of where and how we sit.

Let’s start identify why some seats encourage poor posture and specifically, rounded shoulders.

Many chairs have a seat pan that is tilted slightly backwards and this causes the back of the chair to lean back. You often see this with benches in public parks or seats in common areas.

If you do not modify your sitting position, your body will contour to the shape of the chair. We do not want this to happen. Here is what happens when you let your body be shaped by the chair or bench:

Your knees get a little higher than your hips.
As you sink back into the chair, your shoulders get rounded.
Your pelvis and spine can no longer hold your ribcage up.
A collapsed ribcage will force your shoulder blades forward.
This will force the shoulder joint forward.
Finally, you go into a rounded shoulder posture.

How You Can Develop Rounded Shoulders

If you spend hours of your day in this position either reading, using your computer, or watching TV, then after many days, you will develop rounded shoulders. You will have trained your shoulders that this is where home is, where you are comfortable and where your posture should settle.

You develop rounded shoulders because certain muscles in the shoulders and the back get tight and and other muscles get long and weak. To change this you need to be mindful of your sitting position and posture and likely, perform exercises to stretch specific muscles and strengthen others.

To avoid rounded shoulders when you sit, we need to take into account two situations.

In the first situation, you are in a public space and you cannot modify the structure of the seat. What should you do?

In the second situation, you own the chair. What modifications can you do to your chair to avoid rounded shoulders?

How to Modify Your Sitting Position to Avoid Rounded Shoulders

Let’s start with the first situation. How do you modify your sitting position at a public bench, for example, in order to support your posture and reduce the incidence of rounded shoulders? We can do this with two small modifications to the way you sit.

First, sit on the edge of the bench. This allows you to naturally take control over your posture. It causes you to use your back muscles to hold your head over your shoulders and your shoulders over your hips.

Second, drop one of our knees. This causes your pelvis to tilt enough to create a little roundedness in the small of your back. This, in turn, aligns everything nicely.

How to Modify Your Chair to Avoid Rounded Shoulders

Can you modify your chair and avoid rounded shoulders or do you need to spend a lot of money and buy a new, posture-friendly chair? Let’s save you the money and instead make some small changes to your chair!

There are three simple modifications that you can make to most of the chairs you own or use regularly.

Add Height to the Chair

The first modification is to add a little height under the back legs to change the slope of the seat pan and straighten the back support. Here are several things you can do:

Place some cardboard under the two back feet of the chair.
Use duct tape to make the modification permanent.
Felt pads with adhesive sides will do the trick, if you do not like the cardboard.
Use more than one felt pad (or cardboard sheet) until the seat pan is level.
If you do a lot of forward leaning tasks in the chair, use felt pads to bring the seat pan into a slight forward tilted angle.
Make sure that the chair is stable after the adjustments.

Lumbar Back Support

The second modification is to use a back support for your lumbar spine.

Choose a back support that is the right size for you. The exact size depends upon the angle of the chair and how big you are.
In the video, the tilt of the chair is not significant. I want a back support that provides enough support to keep my posture aligned.
You will notice that I am a small person, so a slim roll works well for me. You might need something larger or maybe smaller.
If the back of the chair goes way far back, then you might need a larger roll.
It is important that the support feels right for your spine and puts you into a comfortable alignment.

Support Your Arms

Once you have elevated the back of the chair and installed a lumbar support, you might need a third modification. If it is a chair that you use for activities that require you to elevate your arms, such as knitting or reading, then you need to make changes to keep your shoulders in a comfortable and pain-free zone.

I recommend you place pillows on your lap to support the weight of your arms.

Put these three modifications together and you now have a chair that keeps your shoulders happy and helps you avoid rounded shoulders.

How to Avoid Rounded Shoulders When You Are Active

Many of my clients regularly do physical activities that often put them in a forward posture and cause rounded shoulders. Let’s identify some of these activities.

For each activity, I will recommend several strategies and exercises to prevent you from developing rounded shoulders.

Gardening

Gardening often takes us into a forward posture. Over time, these repeated movements can cause rounded shoulders.

Make sure that you do strengthening exercises for your back, the muscles between your shoulder blades, and the long muscles of your spine to allow you to garden with better alignment.

In addition to exercises, you should always be mindful of your posture when gardening. For example, gardeners have to weed the garden, lift heavy objects, mow the lawn, shovel dirt, and rake leaves.

These activities are strenuous and can cause you to go into flexion. Below you will find links to blog posts that show you how to perform each of these garden tasks and avoid rounded shoulders.

Swimming

I have clients who love to swim. Unfortunately, many limit their swimming activity to the forward or front crawl, a movement that puts you in a forward posture.

I recommend that my clients include movements that counteract the front crawl. For example, the back crawl is an effective way to counterbalance the front crawl.

Exercise Classes and Yoga

Many exercise and yoga classes are taught with many of the movements in a forward position.
However, that movement pattern brings us into a forward rounded shoulder posture.

Many instructors do not like to put you on the ground and have you do back strengthening such as the Prone/Floor M exercises or lifts because it is much easier to run a class with all movements in a forward posture.

If you tend to do a cardiovascular exercise or yoga class two or three times a week, think about what you are doing in so far as your shoulders and posture. Do you need to counterbalance these movements?

Instead of attending your class three times a week, reduce your attendance to two times per week and commit the free day to a workout dedicated working your back. Spend time opening your chest and stretch the muscles that tend to get short and tight, and strengthen the muscles that tend to get long and weak. We cover several of these exercises in the next section.

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Exercises for Rounded Shoulders

My online course, Perfect Posture in 30 Days, is designed to help you get the posture you want. Here are four exercises to fix rounded shoulders. The first two are stretching exercises and the remaining two are strengthening exercises for rounded shoulders.

They are designed so that you can easily do them at home or the gym. Earlier I mentioned that you should dedicate at least one workout per week to strengthening. These exercises would fit into that session.

I encourage you to do rounded shoulder exercises that both strengthen long and weak muscles and loosen muscles that are short and tight.

Stretches for Rounded Shoulders

I recommend two stretches for rounded shoulders:

Chest stretch on the floor
Arm reach stretch

1. The Chest Stretch on the Floor Exercise for Rounded Shoulders

This is one of a number of chest stretches for rounded shoulders found in Exercise for Better Bones.

This posture exercise is designed to stretch your muscles and help loosen those muscles that get tight and short because of poor posture. You should feel this work your chest and upper arms.

In the starting position:

Lie on your back with your hands resting over your ears, elbows pointing to the ceiling, and your knees bent.
Inhale using your diaphragm.

For the exercise movement, exhale and gently tighten your lower tummy as you:

Press your elbows downward and outward into the floor.
Keep the small of your back a hand-width from the floor.
Hold for one to two seconds.

Repeat five times.

Be mindful to keep your neck in a lengthened position.

If the back of your arms do not touch the floor, place a folded towel(s) or pillow(s) by your side so that you have something to push against. Over time, you should gradually reduce the support (towel or pillow) until you can get your arms to touch the floor.

You can also do this exercise standing up against the wall or sitting tall in a chair if you find getting on the floor to be too much of a challenge.

2. Arm Reach Stretch Exercise for Rounded Shoulders

Another great stretching exercise for rounded shoulders is the Arm Reach. It increases the flexibility of the muscles that put you in a forward head posture.

Here are the step-by-step instructions:

Reach your arm behind you.
Lengthen.
All the while keep your spine straight.
You can either reach with one arm, or you can reach with both arms simultaneously.
Again, use the support that you need under your head.
Some people like to do it as this overhead reach, whatever feels best for you.

Anything that starts to open your body up is a great way to start increasing the mobility through your mid-back and help you to regain some of the lost range.

Strengthening Exercises to Correct Rounded Shoulders

I recommend two strengthening exercises to correct rounded shoulders:

Prone M exercise
Reverse fly

3. The Prone/Floor M Strengthening Exercises to Correct Rounded Shoulders

The Prone Exercise in M Position (also known as the Floor M) is a great postural strengthening exercise for rounded shoulders. It targets the neck extensors, spinal extensors, back, shoulders, and spine.

The following are the instructions for Prone Exercise in M Position.

With the Prone M Exercise, you’re going to need a pillow, and you’re going to need a little towel to place underneath your forehead.

I suggest that you come forward, place that pillow right underneath your pelvis, and the towel right underneath your forehead.

Before I go all the way down, I’ll say a little bit more or else it’s hard for you to hear me down there.

Your arms are going to be down by your side, and your focus is going to be on lifting your torso with your head in alignment with your body the whole time, off the floor.
Come down, arms by the side.
Take a nice breath in, and slowly, gently press the front of your pelvis into the pillow to help stabilize.
You’re going to squeeze your shoulder blades together, open your shoulders, and by doing so, your palms turn away from you.
Start lifting your chest and your head off the floor, so your neck is lifting off.

Neutral Head Position

Your head is always staying in a neutral position.

What is a “neutral position” for your head? Imagine a big giant coming up to you when were in the middle of an exercise and he flipped you on your feet from your prone position. At then you should be standing and looking straight ahead. If your head is looking straight ahead, you have “neutral position.”

You do not want to be in a position where you are standing (after the giant flips you) and you are looking up to the ceiling or looking down. That is not a “neutral position” for your head.

One More Time …

We’re going to review the Floor M one more time from the start.

Breathe in.
Slowly, gently press the front of your pelvis into the pillow.
Squeeze the shoulder blades down and back towards your back pocket.
You’re going to lift your torso off, your legs should not lift off. Eyes are just looking straight at the towel.

If you could imagine holding a little clementine, you would be holding that under your chin, and back down.

As with all the other exercises, I have a 1 to 2 second hold for this exercise, but if you are able to hold longer, 5 and 10 second holds are great with this exercise, as it really builds the endurance of your back muscles.

If you do not find the floor version of this exercise for rounded shoulders challenging, you can find progressively more difficult exercises in this prone exercise post.

4. Reverse Fly Strengthening Exercise to Correct Rounded Shoulders

I prescribe exercise for my clients that improve their forward head posture and rounded shoulders.

In the video, I demonstrate the Reverse Fly Exercise. It is very important that you maintain good alignment while performing this exercise and not move your head into a forward position.

You will notice that I put my back to the wall and maintain contact with the wall throughout the demonstration.

I place the back of my head against the wall. I am able to maintain good posture because I keep my head against the wall as I complete the Reverse Fly Exercise movement.

You might consider putting a thin piece of foam behind your head and holding it against the wall during the Reverse Fly Exercise.

Targets:

Muscles: Middle and Upper Back
Bones: Spine

Starting Position:

Stand with your buttocks, upper back and the back of your head against the wall. Keep your chin tucked in and eyes facing forward.
Your feet should be four to six inches from the wall, your knees slightly bent.
Hold the Theraband allowing roughly 12 to 18 inches of band between hands.
Inhale as you raise your arms to shoulder height with your thumbs pointing to the ceiling.

Movement:

Exhale and gently tighten your lower tummy as you:
Squeeze your shoulder blades together.
Arms back.
Return in a controlled manner to starting position and repeat until set is completed.

Tips:

To ease into this exercise, you can bring one arm back at a time.
You should have no more than a hand size space in the small of your back throughout this exercise.
Adjust the length of the band between your hands to get the resistance you need.
If your head does not rest easily against the wall hold a rolled face cloth between your head and the wall.

How Long Does it Take to Fix Rounded Shoulders?

A number of variables determine how long it takes to fix your rounded shoulders.

Have you had rounded shoulders for a long period of time? The longer the time, the more likely it will be an extended period of time undoing what habits you have built up and the status of your muscles.
Your commitment to fixing your rounded shoulders. Remember, posture is an active process — meaning you need to be actively aware of you posture all day long and engaging your postural muscles.
Access to a skilled health professional. You can speed up the process of fixing your rounded shoulders by working with a skilled health professional such as a Physical Therapist. They can help you make steady progress.

Rounded Shoulders Brace

I am often asked how to correct rounded shoulders with a brace. While I encourage my clients to fix their rounded shoulder with a combination of changing bad habits and exercises for rounded shoulders, there are times when a rounded shoulders brace can be a temporary way to address the problem. It is not a long term fix (good posture is).

Here are two rounded shoulders braces to consider.

Truform Rigid Spinal Orthosis
C.A.S.H. (Cruciform Anterior Spinal Hyperextension)

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Conclusion

I encourage you to think about the stationary things that you do (such as sitting) over an extended period of time and try to make modifications that improve your posture and avoid rounded shoulders.

In addition, consider the activities you love to do. Ask yourself:

Are you repeatedly doing movements that cause you to round your shoulders?
How can you counteract those movements through good alignment and exercise?

Follow these guidelines and you will soon fix your rounded shoulders.

Perfect Posture and Postural Alignment

I have a page dedicated to Perfect Posture. You can find information on how to get that perfect posture.

The post How to Fix Rounded Shoulders appeared first on MelioGuide.

How to Get Rid of Dowager’s Hump

Margaret Martin — Tue, 22 May 2018 18:57:35 +0000

Many of my patients are concerned that they will develop a Dowager’s Hump. As a result, I often get asked by patients, both young and old, how to prevent or how to get rid of Dowager’s Hump.

In this blog post on how to get rid of Dowager’s Hump we cover several important topics:

Definition.
Causes.
Symptoms.
Can you experience pain?
How to measure kyphosis.
How can you avoid, prevent, treat or get rid of it?
Should you use a brace?
Are there sleeping positions or pillows that will help?
Recommended exercises.
Time to correct your posture.

Let’s start with a definition of a Dowager’s Hump.

What is a Dowager's Hump

Dowager’s Hump is not a term often used when I went through a Physical Therapy school. I looked the term up and it happens that a dowager is somebody like Violet Crawley — Lady Grantham in “Downton Abbey”. Lady Grantham is formally known as Dowager Countess of Grantham, the widow of the Earl of Grantham.

The “hump” part of the term refers to the pronounced kyphosis that you see many women (perhaps Dowagers) have. As the elderly woman’s posture deteriorated, a hump would develop on the back of their upper thoracic spine and became known as a Dowager’s Hump.

Neck Hump or Buffalo Hump

You might also hear the terms neck hump or buffalo hump to describe a Dowager’s Hump. Don’t worry. They all refer to the same thing.

Hyperkyphosis

The proper medical term for Dowager’s Hump is hyperkyphosis. Hyperkyphosis describes an excessive curvature of the thoracic spine. It is also known as hunchback. The accepted and current standard for the definition hyperkyphosis is a kyphosis angle in excess of 50 degrees.(1)

Dowager’s Hump not necessarily associated with osteoporosis or spinal fusion. But it is something that many, many people worry about from as young as 15 years old to as old as 115 years old. People are concerned about their posture — and rightfully so.

I tell clients who are worried about Dowager’s Hump, that they should be mostly just concerned about their posture. I instruct them on what to do to correct or optimize their posture and hopefully avoid Dowager’s Hump or, in the case where people have progressed too far, reverse Dowager’s Hump. We’re going to cover that in more detail later in this blog post.

What Causes Dowager's Hump

That leads us into the next question my clients have: what causes Dowager’s Hump. There are three major causes.

Poor Posture Habits

During the times of Downton Abbey, Dowager’s Hump was brought on by aging and fatigue (and sometimes osteoporosis or poor posture). Today, Dowager’s Hump is a result of the poor posture caused by stooping over devices (such as the iPhone), slouching in front of computers, sitting in soft chairs, and our laissez-faire attitude in schools and at dinner tables.

No longer are children or young people encouraged to sit up tall. It’s quite common today to see people hanging out and young people sitting in a slouched position. The photo of the young woman to the right clearly shows the slouching position seen so often in day-to-day life — especially in light of new mobile devices.

These habits create significant challenges for you, and for us as Therapists, when you want to change and optimize your posture. This is because all of a sudden, the causes, which is just habitual slouching, become something that you need to habitually unlearn.

Compression Fractures

In the population I serve, I will see women who have had multiple compression fractures of their vertebrae. When that happens, then the vertebrae become wedged. The vertebrae no longer has a flat edge on each end, but rather the front of the vertebrae takes on that wedge shape. That wedge encourages the spine to take on that deformity or the Dowager Hump shape.

The photo above of the older gentleman (with his face obscured for privacy reasons) is someone with severe Dowager’s Hump.

There are a few other medical conditions that are associated with the dowager’s hump or the kyphotic posture but the major causes are poor posture and compression fracture.

What people tend to worry about is a big fatty pad that sometimes people will behind their neck. Well, the body is very intelligent. If you have to hold up an 11-pound head all day long, then the body is going to try to create more strength in this area by laying down more tissues. The fatty pad is your body’s way of trying to deal with the forward head posture.

Scheuermann’s Disease

Scheuermann’s disease is a disease of the young that persists into adulthood. It develops in adolescence when the spine is growing. During this developmental period your spine fails to develop normally and you develop an exaggerated rounded mid or lower back (hunched back).

One third of people with Scheuermann’s disease also develop scoliosis. Pain is a symptom that often appears later in the disease process. Difficulty bending backwards (doing upward dog pose or sphinx pose) is another symptom.

If you suspect that you or a person you love may have Scheuermann’s disease, you should speak to your doctor. An X-ray will confirm the disease and Physiotherapy is recommended

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Dowager Hump Symptoms

How do you know if you have Dowager’s Hump and what are the Dowager Hump symptoms you should be concerned about? Dowager Hump symptoms include:

Shallow breathing.
Problems breathing.
Indigestion.
Pelvic floor problems.
Rotator cuff problems.
Tennis elbow.
Carpal tunnel.
Neck problems.
Jaw problems.
Headaches.

Stand Tall with Perfect Posture

One of the reasons I’m dressed like this (in the video) is to show you what happens when I alter my posture. Then you’ll see some of the symptoms that people are concerned about.

If I’m standing tall, my arms rest by my side. They’re not resting in front of me. They’re resting alongside my body.

I have a natural little arch at the small of my back, my mid-back is fairly flat, and I have a small arch in the back of my neck. My ear is lined up over the middle of my shoulder.

When I do that, my organs have lots of space to do what they love to do. I can take nice full breaths and open my ribs. This allows me to suck in my stomach, engage my deep core muscles, and support my pelvic floor.

Dowager Hump Symptoms from Poor Posture

When I hang out with my arms in front of me, it gets harder for me to be able to hold in my tummy. This in not an optimum posture and it is very tiring.

When you are in this posture, the ribs start pushing down and your liver, stomach, and all your intestines get crushed into a smaller smaller space.

This can cause Dowager Hump symptoms like:

Shallow breathing.
Poor indigestion.
In addition, all this pressure makes it harder on your pelvic floor.
The forward shoulder posture can cause rotator cuff problems, tennis elbow, and carpal tunnel problems.
Dowager Hump can put pressure on the suboccipital muscles at the base of our skull and cause neck problems, jaw problems, and headaches.

There are studies that put healthy college-age students in this forward posture for 15 minutes. This brief and small change to their posture caused neck pain and headaches.

Dowager's Hump Pain

My clients often ask, “Should I worry about my poor posture and Dowager’s Hump causing pain?” The answer is a definite yes. Dowager hump can lead to shoulder problems, tennis elbow, carpal tunnel, headaches, neck pain, and jaw pain.

Kyphosis Measurement for Dowager's Hump

How do you know for sure if you have Dowager’s Hump or a poor posture? Is there an agreed-upon standard for kyphosis measurement that you or your Therapist can use to get the definitive answer?

There are sophisticated ways of kyphosis measurement with x-rays but that approach is generally not accessible to many people.

Fortunately, a group of researchers(2) recently had a very clever idea and found a simple way to measure kyphosis — our forward head posture — without expensive equipment. They developed a technique called hyperkyphotic measures using distance to wall.

How to Do the Kyphosis Measurement

Here is how they do a kyphosis measurement.

Line up — heels, sacrum, mid-back, and as much as ahead as possible — flat against a wall.
For purposes of today’s video, we’re just using the post here on my pulley system.
If you’re a clinician watching this, or if you want to do this for yourself, you could use a flat wall.
You want to measure the distance between your C7 and the wall.
How do you figure out where C7 is? Let’s find C7.
Take your index finger and place it down your neck.
Come to one bony prominence, a bony bit here that sticks out more than the others — that’s usually your first thoracic.
Our spine goes from cervical to thoracic — so that’s the first thoracic.
Look for the last cervical or C7.
Take your third finger and place it just above.
As you bring your head down, and then bring your head back up, the bone that you were feeling should disappear underneath your fingers.
If the bone disappears, that is your C7.
That is what you’re going to measure when you come up to the wall.
Go up against the wall and feel the distance between your vertebrae and the post.
I have roughly a finger width.
Determine that width in centimetres.

Scoring the Kyphosis Measurement Results

Here are the guidelines to determine your level of kyphosis or Dowager’s Hump:

Very mild kyphosis is considered anything under five centimetres.
Between 5.1 and eight was considered moderate.
Eight centimetres or above is considered severe.

If you score between very mild to moderate, this would be an opportune time to start focusing on changing your alignment for the better. Because if you wait until it gets severe, and when that distance is more in the range of eight centimetres or more, then that also was shown to have a higher rate of fractures of the vertebrae.

This technique is useful for both clinicians and individuals because sometimes we lose track of what good posture is today because so many people have bad posture. This is one way for you to check in on yourself and go, “How is my posture doing today or this month?”

This kyphosis measurement technique is easy and accurate. Before the availability of this technique, we used to rely solely on measuring the distance between the head and the wall. Our goal is to encourage the lengthening or retraction of the neck and this new kyphosis measurement technique fits the bill. This is what we consider optimum alignment of the head and neck. We will cover that in more detail when we get to the exercise section in this post.

Dowager's Hump Treatment Options

What are the recommended treatments for fixing a Dowager’s Hump or your bad posture?

I would like to say that you could do neck hump treatment all by yourself. And for the most part, if you’re in the early stages of kyphosis (as measured by the kyphosis measurement technique described above), you certainly can.

But I would be doing a disservice to myself as a clinician, and all the other wonderful therapists out there if I said you didn’t need our help.

Let’s walk through some of the Dowager’s Hump treatment options I recommend to my clients.

Neck Hump Treatment and How to Get Rid of Dowager’s Hump

A manual Physical Therapist (therapists that use their hands) can use a number of treatment options to correct a Dowager’s Hump and regain your good posture. These include:

Myofascial release.
Taping.
Specific mobilization or movements of the vertebrae that have been stiff for a long time.

How to Avoid Dowager’s Hump

There are a number of things that you can do to avoid a Dowager’s Hump. We will cover these here. If your posture has already become kyphotic, these techniques will help considerably before your work with the manual therapist.

Sitting Posture

Time to talk about sitting posture.

When your knees are higher than your hips, it’s very hard to sit up straight. When your knees higher than your hips it tilts your pelvis back, flattens your lower back. By flattening that nice little arch that once existed in the back, the rest of the back wants to fall forward and then the head follows.

The very first thing you can do to correct your sitting posture in sitting is to alter the surface that you’re sitting on. Look at where your knees are relative to your hips.

I often have to sit on the edge of chairs. By doing so, my knees drop down below the height of my hips. That allows me to tilt my pelvis forward.

I can encourage that process a little bit more by rolling up a little blanket and placing it in underneath my sit bones.

Dyna Disc

There are also devices such as a Dyna Disc or a sit-in disc. They’re inflatable discs that are actually covered in cloth or a little bit warmer fabric that you place under your pelvis to tilt your pelvis forward.

Each of these things encourage a re-creation or support of the little arch in the small of your back so that all of your vertebrae line up. This alignment then allows your head to come back over your shoulder.

Soft Sofas

Another recommendation is not to use soft sofas because they don’t have the proper support for your posture.

This leads us to driving. The seats in cars and planes are poorly designed for the human body. You have to use the same techniques I described to correct your posture when driving or flying.

Even though cars often come with lumbar rolls, they’re frequently not in locations where your body needs them. You have to deflate the one in the car and bring your own lumbar roll.

Supports for Your Back While Sitting and Driving

There are a lot of different rolls you can purchase that support your back. Other low cost options include simply using

A little scarf.
Extra mittens in the wintertime.
A paper towel roll.

Once you set your best sitting posture before starting to drive, adjust your rearview mirror so that it is your reminder that if you don’t see behind you, then you’ve slouched back down.

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Dowager Hump Brace

It takes a lot of work to get a perfect posture. However, not everyone wants to make that commitment. Clients often ask me:

Can I just use a Dowager Hump brace?
Would a Dowager Hump correction brace help me?

A Dowager Hump brace is not a long term solution. While I prefer clients do neck hump exercises to strengthen their muscles and improve their posture, there are Dowager Hump braces that can help. They are appropriate if you have had a compression fracture. I have broken down the different options by degree of kyphosis.

Dowager Hump Brace for Minimal Kyphosis

Consider a rigid brace if have an acute vertebral fractures and minimal kyphosis. These two models meet this requirement:

Truform Rigid Spinal Orthosis
C.A.S.H. (Cruciform Anterior Spinal Hyperextension)

Dowager Hump Brace for Advanced Kyphosis

People with acute vertebral fractures and more advanced kyphosis should consider a semi-rigid support:

Camp XXI Thoracolumbar Support
Fast-Wrap Thoracolumbar Support
Spinomed III

Dowager Hump Brace Alternatives

There are Dowager Hump brace alternatives that can remind you that your posture is less than perfect:

A product such as a Lumo Lift, will beep or vibrate to remind you that you just slouched.
Another trick is taping that makes you kinesthetically aware of your posture.

Dowager’s Hump Correction Brace

I think that anything that gives you that reminder when you drift into your comfort zone and remind you to get back into good posture is worthwhile. I find that the younger you are, the faster you can get out of your comfort zone and back into good posture. However, it can take as long as three months to get back if you’ve been habitually slouching.

Keep in mind that that tool should only be used for short periods of time. A brace is exactly that — it’s a brace. Technically, your muscles will actually get weaker if you use it and do not work on strengthening your postural muscles.

You ideally want to lengthen muscles that are in front, and strengthen muscles that are in back. And that’s something we’ll cover later on. But there are rules to play with braces especially when pain is involved. But use them under guidance and use them for short-term.

I wrote an article on posture aid recommendations and orthotic back braces that might be worth a read.

Support Bras and Breast Reduction

Many of my clients ask me about bras, something I don’t have a lot of personal experience in. I used to worry but now that I’m in my late 50s, I’m really happy that I have small breasts.

I don’t have a lot of experience, but I have had a lot of clients with big breasts. The extra weight of the breast does put a lot more demand on the mid-back. Provincial governments in Canada pay for breast reductions for women that are very large-breasted because it does cause chronic mid-back pain and neck pain.

I’m not an advocate of a breast reduction, but certainly, there is a role for that if that’s a challenge that you have in your life.

Otherwise, I strongly encourage you to search out the proper support bra for yourself. I have many large-breasted clients who have found that perfect bra that has made a difference in their life. I encourage you to go that route if that’s something that you need.

Dowager's Hump Pillow and Sleeping Position

Many people ask me to recommend a Dowager’s Hump pillow and if I can recommend a Dowager’s Hump sleeping position.

Dowager’s Hump Pillow

We talked one of the symptoms of forward head posture being neck pain. Often, if you wake up in the morning or during the night and your neck pain is worse, then your pillow is definitely one of the contributing causes.

When we think about the optimum pillow or the support that we need when we’re sleeping, a lot of it has to do with what position we sleep in. When we’re sleeping on our back the only thing that needs support, if we have good alignment, is the arch and the small of our neck.

If we tend to have a bit of a forward head posture, we’re going to need to support that space. Otherwise, our head is going to fall back. The more forward your head is, the more pillow you’re going to need to support. But know that if you continually support yourself when you’re lying on your back, you are never going to have an opportunity to actually get a little bit of a stretch and to gradually bring yourself back.

Dowager’s Hump Sleeping Position

In many movies you always see the actor in bed with two big pillows. But this is terrible for the average person because it puts you back into the same head forward posture. Your spine never gets an opportunity to elongate.

If you’re a back sleeper, try to minimize your pillows as much as possible, so that you have the support just in the small of your neck. You don’t really need anything under your head.

But if your head is not yet comfortable going all the way flat, do use the smallest pillow you can under your head and still support your neck. Pillows should not be underneath your shoulders.

If you’re a side sleeper, however, then you are going to want to have a pillow that allows you to fill in the space between your shoulder and your neck. A pillow that is little bit flatter in this situation works, and the other pillow can be used between your knees and ankles. you want your chin to line up in the middle of your breastbone.

I hope these tips help you have a better night’s sleep and wake up pain-free.

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

Dowager's Hump Exercises or Neck Hump Exercises

I have a comprehensive online course, Perfect Posture in 30 Days, dedicated to helping you improve your posture and fix your dowager’s hump. I encourage you to check it out.

The postural exercises listed below are from Perfect Posture in 30 Days and are for Dowager’s Hump or neck hump.

Dowager’s Hump (Buffalo Hump / Neck Hump) Exercises

Exercises to get rid of buffalo hump or neck hump fall into two broad categories: stretching and strengthening exercises. I will give you a sample of some of the stretching exercises in this section. You can find the rest of the stretching exercises and the strengthening exercises in my online course, Perfect Posture in 30 Days.

Sternocleidomastoid Stretch

There are certain muscles that get particularly tight when we have a forward head posture. Before we can do the Dowager’s Hump stretching exercises, we need to stretch these muscles.

One of these is called the sternocleidomastoid — the mastoid process muscle. You will see this muscle when I turn my head. There is another branch of the sternocleidomastoid that goes down to the clavicle bone.

How to Locate the Sternocleidomastoid

How do you find the sternocleidomastoid? Here are the steps:

Take your pulse with the opposite hand.
Come down and find your pulse.
Once you’ve found your pulse, replace your index and third finger with your thumb.
Thumb goes in the place of your pulse.
Push away from your pulse (you don’t ever want a massage your pulse anywhere in your body).
Turn your head a little bit more, and that muscle is going to come right into your thumb.
Grab the other side of the muscle with your fingers.
That gentle squeeze is all that muscle needs for a massage.
If you squeeze it and it feels fine, you’re going to move up the muscle, just follow that rope-like structure, all the way near your temporomandibular joint — your jaw.
Come all the way up.
Then you’re going to work your way back down.
Again, stay away from the pulse and work your way down the muscle.
If there are spots that are somewhat painful, note that you can’t hurt the muscle by squeezing it, but do respect the fact that you want to just create an intensity of about 5 out of 10.
Throughout the day, go back and squeeze it 10 to 12 times and then leave it alone.
Do this several times a day until you can get rid of all the tender spots in these muscles.

The sternocleidomastoid is one key muscle for you to work on.

Suboccipital Muscles Stretch

The next muscle you are going to stretch before you start your Dowager’s Hump exercises is at the base of your skull. We’re going to use balls on the floor.

The little muscles at the base of the neck, the suboccipital muscles, get very tight from being in a forward head posture. When you try to stretch your neck, the muscles don’t want to let go because they have little trigger points in them.

Here are the steps to stretch the suboccipital muscles:

Place a small ball at the base of your skull.
Rest your hands over the ball, and then gently move your head as though you’re turning from side to side ever so slightly — that’s probably the most comfortable.
For some people, a little bit of a nod might do it on some of the side muscles.
You just want to have enough pressure that you feel a gentle release in the muscles of the base of your neck.

Chin Tuck Stretch

Once those muscles feel released, the next stretch you can do for the little suboccipital muscles is the Chin Tuck stretch Dowager’s Hump exercise. You draw your chin down towards the ground and you want to feel a lengthening in those muscles of the base of your skull.

Chest Stretch

The Chest Stretch Dowager’s Hump exercise will open up the muscles of your chest that have been pulled forward.

To open up your pec minor, have your hands up by your ears, and then breath in.
As you exhale, bring your upper arms and forearms down towards the mat.
Inhale back up.
Exhale back.

Pay Attention to the Small of Your Back

The reason I encourage people to incorporate their breath is that oftentimes if you’re very tight, as you bring your arms back, your low back is going to want to take advantage of that space that is trying to give up.

Before you begin any of these postural exercises, you want to make sure that the space that’s in the small of your back stays the same throughout the exercise.

Placing a little rolled towel, about the size of your hand, in the small of your back is really helpful. This support will keep your spine in its very best alignment the whole time that you do that exercise.

Pay Attention to the Placement of Your Head

Pay special attention to your head and its placement while doing the Dowager’s Hump stretching exercises.

If you find that when you lie flat on your back that your head wants to look back, then take as many towels as you need and fold them under your head until you have your very best posture.
Focus on maintaining a nice alignment.
Do not use more towels than you need because that’s just going to put you back to where your head has been for too long.
You’re just trying to get a little tiny bit of a stretch while you’re doing the exercise and keeping your alignment the whole time.

Arm Reach Stretch Exercise

Another great Dowager’s Hump stretching exercise to increase the flexibility of the muscles that pull you forward is an Arm Reach. Here are the step-by-step instructions:

Reach your arm behind you.
Lengthen.
All the while keep your spine straight.
You can either reach with one arm, or you can reach with both arms simultaneously.
Again, use the support that you need under your head.
Some people like to do it as this overhead reach, whatever feels best for you.

Anything that starts to open your body up is a great way to start increasing the mobility through your mid-back and help you to regain some of the lost range.

Angel in the Snow Stretch Exercise

The last Dowager’s Hump exercise I will cover is called an Angel Wings or Angel in the Snow stretch.

Press your arms down as though you’re creating an indentation in the snow, and you
Continue to slide up.
Keep your chin tucked.
Keep that small space in the small of your back.
As long as your arms stay in contact with the floor, keep sliding up.
If you lose contact then that’s as far as you go for this day and then come back down.

These are a few examples of the Dowager’s Hump postural exercises that you’ll find in Perfect Posture in 30 Days. Each exercise will help you work on improving your posture.

How Long Does it Take to Correct Dowager's Hump

Many people ask, “How long does it take to correct Dowager’s Hump or fix bad posture? How long will it take before I get rid of my Dowager’s Hump?”

The fact is that you didn’t get tight and you didn’t develop poor posture overnight. You should not expect to get straight overnight either.

I often give my clients the analogy of a book. If your head is forward by roughly 550 pages (as I demonstrate in the video) then you could imagine over a year and a half if you’re diligent and consciously thinking about your posture and alignment, maybe you will reduce your forward head posture by one page width a day.

If you want quick results, that probably feels slow. But if you’re only in your 20s, by the time you’re still in your 20s, you’ll have beautiful posture and a whole different outlook on how you feel, and how your body looks.

The longer you wait, the harder it is to make those corrections — but they’re still possible.

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

References

Hyperkyphosis definition from spine-health.com. https://www.spine-health.com/glossary/hyperkyphosis
Suwannarat P, et al, Hyperkyphotic measures using distance from the wall: validity, reliability, and distance from the wall to indicate the risk for thoracic hyperkyphosis and vertebral fracture., Arch Osteoporosis, 2018 Mar 12;13(1):25.
The Trigger Point Therapy Workbook – Your Self-Treatment Guide for Pain Relief Authors: Clair and Amber Davies. 3rd edition.
W. B. Katzman, E. Vittinghoff, F. Lin, A. Schafer, R. K. Long, S. Wong, A. Gladin, B. Fan, B. Allaire, D. M. Kado and N. E. Lane, Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial, Osteoporosis International, 10.1007/s00198-017-4109-x, 28, 10, (2831-2841), (2017).
Greendale, Gail, et al., Yoga Decreases Kyphosis in Senior Women and Men with Adult‐Onset Hyperkyphosis: Results of a Randomized Controlled Trial, 28 August 2009, Journal of the American Geriatrics Society
Cho J, et al., Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial, BMC Musculoskeletal Disorder, 2017; 18:525
Shih HS, et al, Effects of Kinesio taping and exercise on forward head posture., J Back Musculoskeletal Rehabilitation, 2017; 30(4): 725-733

Perfect Posture and Postural Alignment

I have a page dedicated to Perfect Posture. You can find information on how to get that perfect posture. For those of you interested in dedicated Physiotherapy, I also offer one-on-one Physical Therapy postural alignment through my Posture Alignment Therapy.

The post How to Get Rid of Dowager’s Hump appeared first on MelioGuide.

Posture Aid Recommendations

Margaret Martin — Wed, 13 Aug 2014 08:56:08 +0000

We all want the perfect posture. It would be great to have a posture aid that once-and-for-all corrects our posture so that we achieve perfect postural alignment. Does such a posture aid exist? A Physical Therapist in Toronto recently contacted me and asked for posture aid recommendations for one her senior clients.

Can you recommend a weighted vest or posture aids for shoulders (specifically to assist with shoulder retraction and prevention of increasing kyphosis) for a 80 year old female author who spends significant time on the computer?

Her workstation is appropriately arranged and she does take frequent short stretching breaks but she is very aware of her posture and wants to maintain it. Look forward to hearing from you.

— WB, Toronto, Ontario

Natural Aids to Improve Posture

I am generally not a big fan of a posture aid or a brace for posture correction. My preference is to educate people to achieve perfect posture or to work with them directly on posture alignment therapy through Physical Therapy postural restoration.

You should look at your client’s tissues. She may be tight in the muscles and fascia. This could lead to forward rounding of her shoulder blades and cause her to be weak in the muscles that help her to sit tall and keep her shoulder blades back. Incorporate stretches and strengthening exercises that address your client’s needs. Each of these techniques are the keys to perfect posture.

Posture Exercises and Stretch Breaks

Not all stretch breaks are equally as helpful. Reverse shoulder shrugs should be encouraged over forward shoulder shrugs to help reposition the shoulder blades and open up the chest.

In my yoga class, I encourage reverse shoulder shrugs as a warm up. I add a chest lift as you shrug and bring your arms away from your sides. Open your arms and hands as you squeeze your shoulder blades back. Repeat as often as you need.

Another one of a number of exercises to improve posture for seniors (as well as everyone!) is the reverse fly exercise. In the blog, I demonstrate how to do this exercise as well as a modification for people unable to do the standard version.

Workstation Posture Adjustments

Glad to read that you have ensured her workstation is well adjusted. I have gone into too many workplaces after an ergonomic evaluation and still had to make many workstation posture adjustments.

I worked for over five years in industry evaluating workstations and found three common problems that affected employees’ posture. For readers who may not be as familiar with these problems, I have listed them off with solutions for each:

Computer monitor distance is too far and height is too low

Your monitor should be positioned to allow you to hold your head tall over your shoulders. The screen should be roughly 18-inches from your eyes with the top 1/3 of the screen being situated at a 15-degree angle from the horizon. Ensure that if you wear glasses, you get a pair dedicated for computer usage. Laptop users should consider hooking up to a monitor.

Angle of the seat pan is flat or back

One feature in a good work chair is that you can achieve a forward tilt of the seat pan itself. This allows you to come forward from your pelvis rather than your spine or shoulder blades or head and neck.

If you are at home or cannot afford an adjustable chair, you can either sit on a folded blanket with the blanket being placed just under your “sit bones” to create a forward tilt of your pelvis. Wedges or inflatable discs also create a similar tilt. They are not as comfortable but, on the positive side, it encourage users to get up more often. Individuals with weak postural muscles that need to rely on back support will need a support in their low back (lumbar spine) to help them maintain alignment through the rest of their spine.

Mouse and keyboard position

In order to minimize stress on the upper back and neck and avoid the forward rounding of the shoulder blades, the mouse and keyboard should be positioned such that your elbows are by your side and angled between 80 and 110 degrees (close to a right angle). This will also ensure that your wrists are in a fairly neutral position.

Posture Aid Options

If you and your client decide to go the route of a brace or a posture aid, I have included a few that I have tried.

Generally, unless your dealing with a healing fracture or a pain issue, the brace should only be used for a few minutes per day.

The aim of the brace or posture aid is to help you retrain your muscles and not take over for them. For example, findings from studies of black lifting belts showed that over time the belts actually weakened muscles and put the users at a bigger risk for injury and poor posture.

1. Posture Medic Posture Aid

I consider the Posture Medic posture aid to be an overpriced exercise band and not a good choice as a posture aid. I mention it because it is now found in Staples, Shoppers’ Drug Mart and other major retail outlets. Many feel the price is right but as the saying goes “you get what you pay for”.

In order to evaluate this product, I purchased one several years ago when they first came on the market (and sized according to recommendation on their charts). Despite being small breasted and relatively lean it pinched the tissue around my chest and made any activity uncomfortable.

The only client I had who liked this posture aid was tall and very thin. The padding over the rubber bands is not particularly comfortable and there is too much compression in the armpit region.

2. The Lumo Back Posture Aid

I have had mixed success with the Lumo Back posture aid. It seems to work best for individuals who slouch from their lumbar spine first.

They also offer another posture aid product — the Lumo Lift. I have tried that too and have not found it to be very useful.

3. Stillness Buddy Posture Aid

If your patient gets lost in her work and needs a reminder to stretch and move around, I would recommend the Stillness Buddy. The app was developed to help us become aware of the present and take the time to enjoy that moment.

4. Weighted Kypho Orthosis Posture Aid

Lastly, if your client does not sit back in her chair then a weighted kypho-orthosis might do the trick. This device is discussed in my Working with Osteoporosis and Osteopenia continuing education course.

It has been used in studies looking to correct very stooped postures. It is generally worn while up and walking around, it does help to counter act the forward weight of the head and shoulders by providing a counter weight of 0.25 – 2 pounds just below the shoulder blades. In studies it was only worn for two 30-minute intervals per day.

If you want to read more on this topic, read my blog Orthotic Back Brace • Postural Kyphosis Brace.

The Downton Abbey Posture Aid

When it comes to posture, small changes throughout the day can lead to big gains. Be consistent.

Think of the characters in the popular television series Downton Abbey. When the characters are sitting and standing throughout the day, note how they maintain postural alignment. If you can get a butler and maids to do all the heavy lifting, you will be all set!

Posture Aid Suggestions

If there are posture aids you would like me to review, please leave a comment below. Thanks.

Perfect Posture

To learn more about Perfect Posture, visit my page dedicated to this topic.

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How to Prevent Kyphotic Posture

Margaret Martin — Fri, 02 May 2014 21:46:08 +0000

In today’s post I describe what causes a kyphotic posture and provide recommendations for people with kyphotic posture (also known as osteoporosis posture, in layman’s terms). The post and video also cover how poor posture habits can lead to vertebral compression fractures.

Individuals with osteoporosis, osteopenia or low bone density need to learn how to move carefully when they exercise and perform activities of daily living. This means that they need to practice and maintain a good postural alignment.

The video above:

Explains some key concepts related to postural alignment and describes the difference between flexion and extension.
Reviews the vertebral column and discusses compression fractures, and explains vertebral compression fractures.

In other articles on this site and in Exercise for Better Bones, I provide exercise recommendations to correct your posture.

Osteoporosis Posture

Individuals with osteoporosis can experience vertebral compression fractures — sometimes referred to as wedge fractures or simply “compressions”.

These fractures in the spine can cause a stooped, or forward-leaning posture. In the medical world, this is known as a kyphotic posture. Hyperkyphosis is an exaggerated forward thoracic curvature. Either of these is sometimes referred to as an “osteoporosis posture”.

It is important to note that there is a causal relationship between kyphosis or hyperkyphosis and vertebral compression fractures. (1) A 2009 study at University of California Los Angeles (UCLA) looked at whether “kyphosis of the thoracic spine is an independent risk factor for future osteoporotic fractures”. The researchers concluded “whereas hyperkyphosis may often result from vertebral fractures, our study findings suggest that hyperkyphotic posture itself may be an important risk factor for future fractures.”

A forward-leaning, stooped posture can lead to a number of changes in your body including difficulty breathing and poor balance.

Poor balance, in turn, can lead to falls. Falls are the most common cause of what is referred to as a macro-trauma or fracture of the spine, wrist(s), hips.

Best Postural Alignment

The diagnosis of osteopenia or osteoporosis has provided you with information you were not aware of.

If there is a silver lining in the diagnosis, it is that you now know that you can do more proactive things to prevent a fracture. You are in a better position to keep yourself safe during day-to-day activities.

Rather than be concerned about compressing your spine, you can be empowered to keep your self strong and your spine safe. Throughout the day, in all your daily activities and while exercising you can reinforce good alignment.

Ask those you love to kindly point out when they see you slouch. This will allow you, as you strengthen your spine, to gradually make changes to how you move.

Vertebral Body

The vertebral column is also known as our spinal column. Our head sits at the very top and the pelvis sits on either side of the sacrum. To the right is an illustration that identifies the major parts of the vertebral body:

The small protruding bones you feel at the back of your neck and down to the sacrum are the individual spinous processes of each vertebra.

The stomach-facing side of the vertebra is referred to as the body of the vertebra. It is shaped like a marshmallow. This is the portion of the vertebra that is most vulnerable to compression fractures. We will concentrate our discussion on this part of the spine.

The image to the right is a cross section of one of the vertebral bodies in the spine. Note the knobby section (facing out and away from your body) and the smooth side (facing towards the inside your body).

There are different kinds of bone within the vertebral body. The outside of the vertebral body is a hard bone called cortical bone.

Inside the vertebral body is trabecular bone — also referred to as cancellous or spongy bone. Trabecular bone is porous and is composed of trabeculated bone tissue.

The spongy bone is very vibrant and moving. It allows the vertebrae to be light and flexible within the vertebral body and it absorbs shocks. (More on this later.)

The image, to the right, illustrates these two types of bone in the spine and also shows how osteoporotic trabecular bone is more porous than comparable normal trabecular bone.

Vertebra Shock Absorption

The image to the right shows the relationship between discs and vertebra. Discs serve as shock absorbers. They are located between each vertebra.

When we are young, the disc is plump and well-hydrated. As we age, the discs start to degenerate. Occasionally if the body of the vertebra is weak, the disc material bulges into the bone.

Another shock absorber for the spine is located within the vertebral body itself.

Trabeculae and Shock Absorption

It is important to realize that the trabecular bone inside the vertebral body is a sponge that absorbs the force of impacts when you walk, run, or jump. The trabeculae is strongest when it absorbs the forces evenly.

When you stand in your best postural alignment throughout the day and distribute forces evenly, all of those little trabeculae on the inside absorb the forces evenly. There are thousands of little trabeculae absorbing the forces — and that is a miracle of nature.

Unsafe Loading on the Vertebra

Unsafe loading on the vertebra can occur during a number of activities, including the following:

Coughing
Tying your shoes
Opening the fridge door
Texting
Gardening

In each of these instances, there is a constant forward lean on the front of the vertebral bodies. These forces are unevenly distributed across the trabeculae and eventually some of those little trabeculae will crack.

This might not happen the first time you slouch forward. But eventually some will start to crack. And then a few more crack, and then a few more after that.

It’s those thousands of little repeated motions that snaps one of the trabeculae — one of the cross bridges in this internal sponge of the body of the vertebrae.

Another trabeculae snaps and eventually when you go to do something (like reaching for your shoes), that little internal scaffolding can’t hold you up anymore and an outer crack in the cortical bone develops.

Leading to Vertebral Compression

Compression of vertebrae is common over the age of 80 years. With osteoporosis, vertebra can compress at a much younger age. Slight compressions are so common that they are generally not reported until the vertebra is at least 25% compressed.

Sometimes you hear your physician diagnose this as a vertebral compression but not a vertebral fracture. The image below shows a vertebral body (at the top of the spinal column) that is compressed.

The vertebral body can continue on the path to more compression. The image below shows the same vertebral body eight weeks later. Note how much more the vertebral body is compressed.

Once you know that you have a compressed vertebra, it becomes even more important to be mindful of how you move, push, pull, carry, and do your daily activities. It is well known that once you have one compressed vertebra, that your chance of having another increases.

Kyphotic or Osteoporosis Posture

Overtime these vertebral bodies compress to the point where the individual develops a stooped kyphotic or osteoporosis posture.

Save Those Forward Flexions

I suggest you reserve those flexions for the precious moments in your life. Otherwise, I recommend you avoid flexion and instead learn to make perfect posture part of your day-to-day life.

Conclusion

Having read this post, you understand the difference between the two types of bone and now have reason to be more careful with your posture.

If you want to learn more about the BMD or DEXA test procedure, read my blog on bone density test. I also prepared an article on understanding bone density test results and, in another blog, explain the FRAX Calculator.

How to Have a Perfect Posture

Posture is the foundation of all movement and exercise. This is why I developed the online course, Perfect Posture in 30 Days.

Perfect Posture

A perfect posture has many benefits.

Reduces your risk of back, neck and shoulder pain.
Improves balance and the reduces the chance of a fall.
Promotes a positive self-image.

Posture and Osteoporosis

Good postural alignment is especially important for individuals with osteoporosis and low bone density.

Simple movements you do everyday can lead to small fractures to the spine.

A poor posture contributes to balance issues. As a result, individuals with osteoporosis and low bone density are at risk of a macro trauma to the spine because of balance problems.

The Source of Poor Posture

Why don’t more of us have a perfect posture? Because many of the activities we do in today’s modern world involve forward flexion.

Activities such as reading in bed, using a mobile phone, gaming, texting, sitting for hours hunched over a laptop computer, knitting, crocheting, and many more encourage forward flexion.

Many people take this forward movement into their exercise and leisure activities. Unfortunately, this reinforces poor postural alignment.

We need to fix this imbalance, modify our movements so that we can get the posture we want.

How to Achieve a Perfect Posture

Perfect Posture in 30 Days will improve your posture, boost your confidence, and allow you to live a pain free life.

How Many Osteoporosis Posture Exercises?

A patient recently contacted me about her osteoporosis posture exercise program. She was wondering whether she would gain much from an additional osteoporosis posture exercise set.

Here is her question in detail:

Hi Margaret, I remember that you said that the Floor M exercise would be especially valuable to me. Since then, I have done one to two sets of Floor M every other day.

It’s sometimes hard to do two sets; but one set is doable.

How much more benefit do you get from doing two sets versus one set? (I am using a three pound sand weight on my upper back/shoulder area when I do the exercise.)

I must say I have reached the point where I feel the difference in my body because I can stand up straighter and my husband has noticed! Feel better! LOVE your program! Thanks again.

Osteoporosis Posture Exercise • The Answer

I was excited to hear about her dedication and her progress. Here is my response:

Thank you for sharing the good news about your posture changes. Very exciting!!

Studies have shown up to a 40% increase in strength when going from one set to two sets on an exercise. So it is worth it! Consider using one to two pound weights on your back for the second set until things get easier.

The Lesson Learned

This demonstrates that a small change in someone’s exercise program can have dramatic effects.

In this case, increasing the number of sets by one could lead to a 40% strength gain. And if the leap was initially too much, the client could gradually build up her sets by incrementing (or decreasing) her weight so that she could progress.

Postural Dysfunction and Low Back Pain

Could your quest for the perfect posture causing you low back pain? I have client who is a perfectionist. I have coached her to be more careful about her postural alignment. She follows everything I say — to the letter.

I have encouraged her to flex from the hip and avoid flexion of the spine. As a result, she has completely eliminated spinal flexion in her exercise movements and activities of daily living! However, this has lead to a condition called flexion dysfunction which, in turn, has caused her to experience low back pain.

Flexion Dysfunction

If you are a Physical Therapist, look out for this condition when assessing your clients. If you are a client, you probably should seek guidance from an experienced Physical Therapist.

I encourage her to maintain a full range of motion in her spine.

Flexion Dysfunction Exercises

At the same time, I am not telling her to practice poor posture and flex from the spine in an unsafe way.

However, I do urge her to do some flexion in unweighted positions. These could be performed in the water or lying on your side — where you allow your spine to get into its full range of flexion and extension.

The video illustrates these recommended flexion dysfunction exercises.

References

Huang MH, et al. Hyperkyphotic Posture and Risk of Future Osteoporotic Fractures: The Rancho Bernardo Study. Journal of Bone and Mineral Research (JBMR). Published online 2005 Dec 5. 2006 March; 21(3): 419-423

Perfect Posture and Postural Alignment

I have a page dedicated to Perfect Posture.

The post How to Prevent Kyphotic Posture appeared first on MelioGuide.

Posture Archives - MelioGuide

Perfect Posture Guide

Table of Contents

Benefits of Perfect Posture

What’s Stopping You From Getting the Perfect Posture?

Posture and New Technology

Posture and Furniture Design

How to Have a Perfect Posture

Perfect Posture When Standing.

Follow these instructions as you look at the video:

Soft Knees

Feet, Pelvis, Rib Cage, and Torso Positioning

Quick Posture Tip: Balance a Book on Your Head

Physical Therapy for Posture Correction

Products for Your Posture

Physical Therapy Posture Exercises

Flexed Posture

Back Brace for Posture

Exercise and Postural Alignment

Conclusion

Recommended Posts on Posture

Perfect Posture Guide

How to Fix Rounded Shoulders

How to Get Rid of Dowager’s Hump

Posture Aid Recommendations

How to Prevent Kyphotic Posture

Margaret Martin

How to Fix Rounded Shoulders

Table of Contents

What are Rounded Shoulders?

Rounded Shoulder Test

Orangutan Test

Thumb Test

Back Reach Test

Sternal Notch Test

Stick Test

How to Have a Perfect Posture

Perfect Posture

Posture and Osteoporosis

The Source of Poor Posture

How to Achieve a Perfect Posture

Rounded Shoulders Causes

How to Avoid Rounded Shoulders When You Sit

How You Can Develop Rounded Shoulders

How to Modify Your Sitting Position to Avoid Rounded Shoulders

How to Modify Your Chair to Avoid Rounded Shoulders

Add Height to the Chair

Lumbar Back Support

Support Your Arms

How to Avoid Rounded Shoulders When You Are Active

Gardening

Swimming

Exercise Classes and Yoga

How to Have a Perfect Posture

Perfect Posture

Posture and Osteoporosis

The Source of Poor Posture

How to Achieve a Perfect Posture

Exercises for Rounded Shoulders

Stretches for Rounded Shoulders

1. The Chest Stretch on the Floor Exercise for Rounded Shoulders

2. Arm Reach Stretch Exercise for Rounded Shoulders

Strengthening Exercises to Correct Rounded Shoulders

3. The Prone/Floor M Strengthening Exercises to Correct Rounded Shoulders

Neutral Head Position

One More Time …

4. Reverse Fly Strengthening Exercise to Correct Rounded Shoulders

Targets:

Starting Position:

Movement:

Tips:

How Long Does it Take to Fix Rounded Shoulders?

Rounded Shoulders Brace

How to Have a Perfect Posture

Perfect Posture

Posture and Osteoporosis

The Source of Poor Posture

How to Achieve a Perfect Posture

Conclusion

Perfect Posture and Postural Alignment