Back pain is one of the major disabling health conditions among older adults aged 60 years and older. Existing evidence suggests that prevalence rates of severe and chronic low back pain increase with older age. As compared to working-age adults, older adults are more likely to develop lower back pain like osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis
Consultant surgeon to Harley Street Spine
and Highgate Private Hospital
, Mr Bob Chatterjee says, “Most causes of lower back pain are age-related with physical and psychosocial changes, yet there is a still a lack of awareness, especially in older adults to the causes and effects of back pain and pain management. For example good posture is not only good practice for physical realignment, but good posture can also be associated with poor health and indicate a decrease in confidence as well as being a trigger for back problems. In our modern day society more of us are seated for longer hours more than ever before – this sedentary lifestyle can lead to poor posture if we don’t know how to sit and in turn lead to back pain issues”
Posture describes the way in which we hold our bodies. This representation of how we hold ourselves is made up of several different factors, including the structure of our skeletons, the tone of different muscles of the body, the activities that we do for work and pleasure, any injuries or age-related changes in the joints, our mood and many other different dynamics.
Harley Street Spine work with a team of specialists to help patients’ mobility which in turn assists them in improving their posture which can also help other a range of health concerns from breathing which in turn can improve concentration and overall self-esteem.
Highly recommended by Harley Street Spine is Jon Bowskill, corrective exercise specialist and director of the Bowskill clinic, who says, “Some of us will have asymmetries that are a natural accommodation and do not cause issues, however, for others some of these imbalances can create mechanical issues that can contribute to pain and physical limitations”. In our guest post below, Jon offers guidance on how to identify poor posture, how to improve it and the many benefits that come with a better physical stance:
How to identify poor posture – standing/static assessment
Each person is unique, so the posture of each person isn’t an exception. The best goal for posture is to work towards the best posture for you as an individual based on your own history and mechanics. There are three views to look at when measuring posture:
Here the midline of the ankle, the knee joint, the hip joint, the centre of the shoulder and the centre of the ear should all be in a vertical gravity line. If these points do not lie in close vertical proximity, then we call this a sagittal imbalance which is taken from the view that we are looking at.
The main lines to look at are the level of the knees, the hips, the shoulders and then the eyes. These lines should all be in parallel in the horizontal axis.
The third view to look at is if there are any rotations throughout the body, in other words, the pelvis or spine rotated to either the left or the right.
All of these can be viewed with the eye, more accurately assessed with physical therapy measuring tools or, where required, assessed where necessary by medical imaging.
Dynamic posture and movement variability
Whilst standing posture gives us a baseline of how the body is handling gravity, dynamic postures are in fact much more important in how we are able to move and hold the body as we go through everyday life. This will to a large extent determine what issues we may have from our posture. The most important part of dynamic postures is that you have a large array of different postures and positions that you can use for different tasks, and that tight muscles or restricted joints do not overly compromise this ability.
Dynamic assessment of posture should be specific to the kind of movements that are particular to everyday life. These should include reaching to the floor, twisting, reaching overhead, pulling, balancing, pushing, squatting, lunging and gait or running.
Exercises to improve posture will all depend on what type of posture you currently have and what aches and pains you may be suffering from or wanting to avoid.
For instance, people who spend long hours sitting at a desk, one of the commonest issues is an increased curve in the middle back or thoracic kyphosis accompanied by increased forward head carriage.
To improve this, the best exercise are those which loosen up the joints of the middle back, stretch the muscles of the front of the chest and shoulders and then strengthen up the muscles between the shoulder blades and down the long muscles of the middle back.
It is also common for certain postural issues to cross over to affect other areas of the body. For instance, if you have rounded shoulders from long hours at a desk and play tennis or golf at the weekends, this can affect the range of motion of rotation of the trunk and increase the movement required at the neck, shoulders or low back as a consequence. This can create unwanted over usage and wear and tear. In certain cases, where we hold certain postures for years, the small bones of the back, the facet joints can in fact remodel themselves to accommodate to changes in where load is being placed through the body. Once adapted, these changes cannot be undone but may be supported by strength training to improve function at that area.
How posture affects breathing
If we have poor posture and a rounded back, this can affect our ability to breathe efficiently. As the middle back becomes restricted, the ribcage is less able to expand and the lungs less able to draw in as much oxygen. This also leads to shallower and less effective breaths, which can also influence other factors such as feelings of tension and anxiety. With improved spinal extension and rib cage excursion, not only do the mechanics of respiration improve, but also the general sense of wellbeing and ability to relax.
Improved posture can help improve mental clarity
With increased oxygen uptake, we may naturally expect that our central nervous system function may improve. One of the other key factors here though is that improved relaxed breathing also facilitates the parasympathetic branch of the autonomic nervous system. This is the branch of the nervous system that helps us to access the intelligent decision making centres of the brain, and steers us away from snappy fight or flight driven decisions. Better breathing makes for more relaxed and well thought out decision-making.
Better posture can encourage a more positive mindset
Our posture gives out very particular signals to those around us and we subconsciously read these signals that we call body language. With a slumped and rounded posture you appear less confident and have less of a dynamic physical presence.
In addition, the worse your posture, the less cheerful you are likely to feel on the inside. These neural connections are established as children and if you look at the postures children take up when upset or disappointed, these all correlate to poorer postural positions we may see as we get older. Look up and lift your chest for a better view of the world and a better feeling within yourself.
Do people who suffer from back pain experience positive changes when they improve their posture?
Often people with low back pain move toward postures that can be an accommodation to a problem to begin with, helping to keep pressure off a painful area. At the time, this can be necessary but if they then adapt to holding these positions for the longer term, this can then knock on to create other issues, and so it is important to address these kinds of compensations with the right kinds of stretches and exercises.
Certain postures can also create more pressure in different areas of the body too, so for example, chronically tight hamstrings can mean that as you bend forwards, the pelvis becomes anchored too early and the low back then flexes beyond its efficient range. Over time and many repetitions, this can then create longer term problems.
For this reason, if you do have low back pain it is important to understand which parts of your system move well and which may need more mobility or strength to improve how the body moves and what can then be done to increase the speed of your recovery.