• Lauren Natale

3 Tips to Improve Your Posture

Proper posture can help ease chronic pain, reduce the risk of injury while exercising, and improve blood flow. Achieving and maintaining proper posture can be challenging after a spinal cord injury, stroke, or a traumatic brain injury. Here are a few guidelines to help improve your posture during exercise and everyday life.


#1: Pay Close Attention to Pelvic Position

Pelvic position plays a huge role in posture regardless of whether or not you can voluntarily control your core and hip muscles. The ideal position for improved balance and muscle recruitment is a neutral pelvic position. The way you achieve this position will depend on the level of your injury or the nature of your paralysis.

Imagine the top of your hips as the top or brim of a glass. If that glass were full, a neutral pelvic position would ensure that no liquid would spill out. If your hips are shifted backwards in too much of a posterior pelvic tilt water would spill out of the back of the glass. Too much of an anterior pelvic tilt caused by your hips shifting forward would result in water spilling out of the front of the glass. When you begin by standing or sitting up straight with your head over your hips, as your spine, head, and shoulders move forward and backwards, your hips will tilt them. If you cannot voluntarily control your hips, use the movement of your head, chest, and shoulders to bring your hips into a neutral position. This can be achieved in a standing or seated position and can be very helpful in preventing pressure sores in wheelchair users. Sitting in too much of a posterior pelvic tilt puts a lot of pressure on your tail bone especially if your weight is not evenly distributed by your seat cushion.

As your spine, head, and shoulders move forward and backwards, your hips will tilt with them. If you cannot voluntarily control your hips, use the movement of your head, chest, and shoulders to bring your hips into a neutral position.

#2: Understand That Your Shoulders Play A Large Role In Posture

Other than the influence that your torso and shoulders have on your pelvic position, there are ways that your shoulders can be positioned to reduce pain and maximize movement. Two of the main structures in your arm and shoulder are your humerus (upper arm bone) and your scapula (shoulder blade). The movement or coordination between these two is called scapulo-humeral rhythm. Both of these bones need to rotate in order for you to lift your arm without pain or limitation. Often times after a neurological injury the muscles of the shoulder girdle, back, and neck are weakened. A common mistake that I have observed is to lift your shoulder up towards your ear to compensate for that weakness then try to lift your arm. Not only does this overuse your upper trapezius muscles (the muscles between your neck and shoulder), an area where many people already carry stress, it makes the movement harder and prevents the top of your humerus from moving without pressing tendons into another bone and causing pain.

In order to prevent this, be aware of your the position that your shoulders and shoulder blades are when you are exercising or anytime you are moving your arms. Engaging the muscles in your upper back to keep your shoulder blades down before you lift your arms is a good rule of thumb.


#3: Practice Good Posture Out Of Your Chair

This tip is specifically for wheelchair users, although it can be applicable for anyone who spends extended periods of time in a seated position. While it is important to practice good posture in your chair, once you have some experience with that the next step is to get on the floor, sit on the edge of the bed, or any other surface that you can safely get onto. This will challenge your posture and make you develop and engage different muscles than you will in your wheelchair.

While it is important to practice good posture in your chair, once you have some experience with that the next step is to get on the floor, sit on the edge of the bed, or any other surface that you can safely get onto.

This doesn't have to be an extended period of time. Do you have a favorite chair or recliner in the house? Spend 5 mins sitting in it without using back support, then proceed to use it as you normally would. Take some extra time in bed either sitting on the edge or sitting upright before you lay down and try to maintain balance with good posture. If that becomes too easy, see if you can lift one arm at a time in the air while sitting upright with a neutral pelvic position.


If you have any favorite tips or exercises for posture leave them in a comment below!




References:

  1. https://www.researchgate.net/figure/Altered-control-of-pelvic-position-changes-the-alignment-and-control-mechanisms_fig1_44663716

  2. https://medcline.com/blogs/shoulder-pain/

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