One component of preventing musculoskeletal pain is assuming healthy postures. In general, a healthy posture is one in which alignment of the segments minimizes the external forces against which the body must work. Posture can be either static, such as sitting, or dynamic, such as lifting. This article will provide a few hints for healthy static postures based on biomechanical principles and clinical experiences.
There are two approaches to obtaining healthy posture: one is to educate the person, and the other is to alter the environment. Other components of preventing musculoskeletal pain are good muscle strength, endurance, joint flexibility, nutrition and emotional balance.
A common form of postural stress while working at a desk or computer is poor sitting posture. Poor sitting posture consists of the lower back slumped into the chair, the shoulders drooped forward, the head protruding forward (the ears are in front of the shoulders) and the head maintained in an upwardly tilted direction or rotated direction. What can be done to maintain a healthy sitting posture?
* Develop an awareness of your posture: Are your head, shoulders and spine aligned? Are the muscles around your jaw and tongue relaxed? Are your shoulders relaxed? Is there a sensation of pressure or ache in your lower back?
* Minimize the forces around the joints: 1) use the back of the chair for support; 2) when doing work at a desk, such as reading or writing, elevate and incline the work toward you by putting a large notebook on your desk; your head should not have to bend down more than 30 degrees from the horizontal position to see your work; and 3) support your wrists in a neutral position.
* Balance the forces around the joints: 1) keep your feet in contact with the floor even if you have to use a phone book to elevate the floor; 2) take equal weight on both feet by keeping your legs and feet uncrossed; 3) support the natural curve in your lower back with either a chair with good lumbar support, or a small towel roll placed at about waist level (the support should not force you into an exaggerated arch, but should support the natural curve present); and 4) when working at the computer, the keyboard should be at a height so that your shoulders and hands can relax. Depending on your size and workstation height, try bringing the keyboard down closer to the lap or raising the keyboard off the desk.
* Maintain good circulation by interrupting a sustained position every 15 to 20 minutes with small movements such as arching and flattening your lower back in the chair or pinching your shoulder blades together.
One note of caution: if you have assumed poor posture for many years, you may no longer have the joint mobility necessary to achieve the above postures. Don't strain, but get as close as you comfortably can to a healthy posture. If pain persists, you may want an evaluation by a physical therapist or physician. By developing an awareness of your alignment, applying biomechanical principles and analyzing your environment, you are beginning to take control of your musculoskeletal health. For a free brochure on posture call the American Physical Therapy Association at 800-999-APTA.
Brenda Greene is an orthopaedic clinical specialist and instructor in the Division of Physical Therapy in the School of Medicine. The Wellness column is coordinated by the Seretean Center for Health Promotion.