Postures

Posture

Sit and Stand Tall and Straight

For many women, posture problems begin in junior high school. Perhaps you developed early and got into the habit of slouching to hide your breasts. Or maybe you were a head or so taller than most of your girlfriends and half the guys at school, so you slouched to minimize your height. Or maybe you were short, and years of wearing high heels to compensate pushed your hips forward into a "swayback."

Whatever the reason, poor posture can lead to back pain, one of the most common reasons women seek medical help. As you get older, poor posture can result from osteoporosis--a degenerative spinal condition that can cause spinal changes leading to a slumped-over, shoulders-caved-in stance (also called kyphosis or dowager's hump) in little old ladies.

"The hump is formed when your spine collapses on top," Irene Von Estorff, M.D., physiatrist and assistant professor of rehabilitation medicine at Cornell Medical Center in New York City. The result: Your shoulders get rounded and slumped.

More than appearance is at stake.

"Poor posture is a major concern," says Shirley Sahrmann, Ph.D., associate professor of physical therapy at Washington University School of Medicine in St. Louis. "Women develop osteoporosis and get a kyphotic posture. But if you already have kyphosis, it can be even worse."

STAND TALL FOR HEALTH AND BEAUTY

Women doctors say that it's never too late to learn to stand tall and improve your posture. In fact, the sooner you start, the higher the odds that you'll avoid the little old lady stance associated with osteoporosis. Try these suggestions.

Take the string test. "The first step toward learning good posture is becoming aware of what yours looks like," says Dr. Von Estorff. So stand in front of a mirror and notice your stance. Face the mirror and see if your shoulders are even, she says. Then view your posture from the side.

"If your shoulders are slumped forward and your head is down, imagine that you have a string in the middle of the ceiling pulling you up from the crown of your head so that you can stand tall again," says Rebecca Gorrell, education director of the Canyon Ranch wellness program in Tucson, Arizona.

Your weight should be distributed evenly on both feet, and your chest should be lifted and open, with your adbominals slightly contracted to support your lower back. Lifting and pressing your breastbone slightly forward will cause your shoulders to relax down, says Gorrell.

Lean against a wall. Good posture isn't standing in a rigid military stance, ready to salute your commanding officer. It means standing straight, but at ease, while tightening your abdominal muscles by pulling your tummy in and up, says Dr. Sahrmann.

How can you tell if you have it right? "Stand with your back against the wall and your heels three inches away," Dr. Sahrmann says. "You should be able to put your hand between the wall and your back at your waistline, with your head and shoulders close to, if not touching, the wall.

"Make sure that your knees are straight. If your knees are properly aligned, it's really hard not to stand straight," says Dr. Sahrmann.

Or try this as an exercise, she says: Stand with your back against the wall, tighten your abdominal muscles and raise your arms above your head without letting your back pull away from the wall.

Lift a leg. "If you're standing for long periods of time, place one foot on a rail or a stool to relieve back pain and maintain good posture," says Gorrell.

Don't sway with baby. To ease back pain and maintain good posture, any load should be carried squarely in front of you, using two hands. That includes your baby. "Holding your baby on one hip can lead to a permanent change in back and hip alignment," says Dr. Sahrmann.

Sit well. "To maintain good posture and avoid back pain, it's important to sit in a well-supported office chair," says Dr. Sahrmann. That means a chair in which your arms are supported so that your shoulders don't slope downward, your thighs are parallel to the floor, your knees are slightly higher than your hips and your feet touch the ground. If your feet don't touch, use a footstool.

Install a good chair in your home office. If, like millions of others, you find yourself seduced into spending hours online at your home computer, women doctors say that you also need a posture-friendly chair in your home office. So don't just pull over any old chair. Make sure that you're sitting on a chair with good back support.

Rotate with your chair. If your work arrangements require rotating your body, use a chair that rotates, too. "It is most important not to twist or rotate your body through large ranges of motion while sitting," says Dr. Sahrmann.

Keep moving. Don't stay in any one position at your desk for too long, says Dr. Von Estorff. "We lean forward to work at our desks," she says, and it's important to get up and stretch or even stretch in the chair.

Use a small pillow. When you're driving or flying or even sitting in an office chair for a long time, a small airline-size pillow or cushion or even a rolled-up towel placed behind the small of your back will help promote good posture by maintaining the natural curve in your spine, says Gorrell.

Relax your shoulders. "There's no special reason, but women have a tendency to hunch their shoulders when they're sitting at their desks or just concentrating," says Dr. Von Estorff. If that's a habit of yours, try to be aware of it, and relax your shoulders as soon as you notice the hunch.

Square off. One simple exercise to counteract the slump: Stand and try to bring your shoulder blades together in the back by pulling back your shoulders. Hold for ten seconds and release. Repeat at least three or four times. It will help strengthen your back muscles and prevent shoulder slump, says Dr. Von Estorff.

Shrug your shoulders. Dr. Von Estorff also suggests shoulder shrugs: Hunch up your shoulders toward your ears, then lower. Repeat two or three times.

Buy a correctly engineered bra. If you're big-breasted, wearing the wrong bra can pull your shoulders down, contributing to poor posture, says Dr. Sahrmann. She suggests wearing an underwire bra or a bra with straps that cross in the back to keep your chest high and your upper body posture firm.

Spare the heels. High heels put a strain on your lower back, often causing swayback, says Dr. Von Estorff. They throw your body off balance, thrusting out your pelvis when it should be tucked in. "Save your high heels for special occasions and wear shoes that keep you firmly planted on the ground the rest of the time," says Dr. Von Estorff.

Arch your back like a cat. Strong abdominal muscles are key to correcting swayback and achieving good posture, says Dr. Von Estorff. Try an exercise called the cat back: Get on all fours and arch your back, holding your tummy in for a count of 12. Do this three or four times a day at first, gradually getting to twice that.

Tone your trunk. "For good posture, you also need strong back muscles," says Debra Zillmer, M.D., orthopedic surgeon and medical director of the Gundersen Lutheran Sports Medicine Clinic in La Crosse, Wisconsin.

"Strengthening exercises help preserve the spine, ensuring good posture and lessening the possibility of lower-back pain," says Dr. Zillmer. She suggests push-ups or weightlifting using free weights or machines. "These exercises should be done using proper mechanics, so that maximum benefit can be obtained. See a certified athletic trainer or a physical therapist for proper instruction."

Move your whole body. Dr. Von Estorff says that regular exercise will help your posture.

"Athletes always have good posture," says Gorrell. Have you ever seen someone dunk a basket while her shoulders were rounded and slumped?

The optimum is a combination of aerobic exercises such as swimming or walking alternating with strength training such as weight lifting using free weights, machines or resistance bands, says Gorrell. Strength training should be done two or three times a week every other day or so, giving the body time to recuperate between workouts. Aerobic exercise should be done for at least 30 minutes at a time, a minimum of three times a week.

Sleep right. "If you sleep on your stomach, it will exaggerate the curve of your lower back," says Gorrell. Instead, either sleep on your side, with a pillow under your head and between your knees to keep your thighs and hips aligned, or on your back, with a pillow under your knees to relieve pressure in the lower-back area. And choose a pillow made of natural fibers (like down) that will mold to your body shape instead of a stiff synthetic that may arch your neck and head unnaturally.

(For other practical ways to prevent osteoporosis, see page 407.)