Improving Posture: Part II “Find Your Functional-Back Range” - By: James Hopkin

First and foremost, everyone must understand that spinal pain is rarely purely the result of a single incident. Usually, it is the cumulative effects of poor body mechanics during lifting/bending, repetitive movements including reaching and twisting, and poor posture. You can have a profound impact on the health and prevention of arthritic signs and symptoms by improving your body awareness as it relates to your posture.

Last month we discussed a neutral spine, the natural position of the spine when all body parts are in good alignment. Now, let’s find your functional range with respect to the spine. Remember, each person’s spine is different. The pelvic tilt exercise many of you are familiar with is a good way to go about finding the functional range. Pelvic Tilt…Lie on your back with both knees bent, feet flat on the floor or bed. Roll your hips so that you press the small of your back down into the surface you are laying on, making your back straight (flexed). Now, do the opposite by rolling your hips away from you so that your back is arched (extended). Somewhere during these movements you will notice more comfort…sometimes it is the relaxed position, sometimes it is at the end of either range, and sometimes it is in between. Do your best to establish your functional range, an area of movement within your pelvic tilt that feels better than the other areas of movement.

Now that you have found your functional range, what are you supposed to do with it? Some of you will prefer to keep your back more straight (flexed), others will like the back slightly arched (extended), and there are those who will prefer a range in between the two. Therefore, you have a bias towards a certain posture. Those with a flexion bias typically prefer sitting to standing or walking. They also like to have their legs bent when lying, with pillows or a wedge under their knees. Conversely, those with an extension bias prefer walking and standing to sitting. Lying flat on their stomach or back is often the most comfortable position. Finally, if you are in between you typically do well as long as you are not in the extreme of either posture; flexion or extension (back arched or made straight). Persons in this category must avoid sustained flexion as is common with gardening or sustained extension as is common with repetitive overhead movements in standing (ex: painting a ceiling). Either way, it is important to take breaks.

TIPS TO ACCOMMODATE YOUR BIAS

FLEXION
• When you need to stand for > 5 minutes use a stepstool or if you are doing dishes open up the cabinets below and rest one leg inside...notice how your back is less arched
• When walking, slightly tighten your abdominal muscles to minimize the effects of the repeated extension that is required
EXTENSION
• When sitting, use a lumbar roll (a hand towel rolled and taped together) in the small of your back to preserve the arch in your back
• Sitting in a car can often be most difficult as you are often quite flexed. Try to adjust the seat higher, if possible, so that your thighs are lower than your hips and recline your seat slightly. Again, a lumbar roll would be appropriate.
NEUTRAL
• Avoid sitting or standing for periods greater than 15 minutes, even it only means a 30 second break.

If you have trouble determining your bias and ideal posture, please consult one of the physical therapists at Foothills Sports Medicine. We would be happy to help you at any of our locations. If you have back discomfort regardless of posture or persistent back pain, these suggestions may not help you. Please contact your physician or set up a consultation with a physical therapist.

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