The Most Common Postural Problem ( that you've probably never heard of )

Many of my patients have alternating symptoms of neck pain, shoulder pain and low back pain. They come to my office for the symptom that is currently the worst, and tend to downplay the symptoms that are currently minimal. They don't realize that all of the symptoms are related to the same dysfunction. Their spine is too straight.

When you look at a spine from the front, you want it to be straight (see pic below). But if you do see curvatures here, it is called scoliosis.

When you look at a spine from the side, there are normal curvatures. In the picture below the person is facing right. The forward curve to the neck and low back are called lordosis. The backward curve of the upper back is called a kyphosis. The pelvis tilts forward slightly as well. These are all natural and necessary for normal pain free function. These curvatures, along with the intervertebral discs, help to provide normal movement as well as shock absorption.

Many of us have lost touch with our bodies to the point where WHAT WE THINK is straight and upright really IS NOT. This is most common in those that have a job which requires them to sit. Sitting usually tilts the pelvis back, slouches the low back, and gives our upper body a slight forward lean. With good intentions, many of us try to correct this posture. But instead of tilting the pelvis to initiate the change, we straighten our upper backs. This eliminates the natural and necessary kyphotic curvature.

This dysfunction results in elongated low back and neck muscles that can't do their job. Muscles get weaker as they get longer. They tend to fatigue more quickly. This position also puts more pressure on the intervertebral discs of the neck and low back. So not only can your muscles hurt, but your joints as well. The muscles around the shoulder blades (scapulae) also become painful because the joint surfaces don't match up. The scapulae have a concave underside to them, which glides along the ribcage. The backside of the ribcage should be convex to match the surface, as in the picture below. But with a flat back, it is not. As the scapulae are pulled away from the ribcage, the muscles are elongated. Again, an elongated muscle is weaker, and fatigues more quickly.

Flat back posture also makes it difficult to take in a full breath, as the ribcage cannot fully spread out like it should. Altered breathing patterns result in fatigue of the muscles of the neck and low back, as these are relied upon more often. This spinal flattening plus a slight pitch forward is the most common postural problem I see in the office today. I know what you are thinking - "What can I do about it?" Stay tuned. You get your answer in my next blog.