Postural Problems

The American Academy of Orthopedic Surgeons defined posture “as the relative arrangement of the parts of the body. Good posture is that state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity, irrespective of the attitude (erect, lying, squating, or stooping) in which these structures are working or resting. Under such conditions the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs. Poor posture is a faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support.”

Most people have a good idea of what posture is, though unfortunately good posture is becoming harder and harder to come by with the ever-increasing stresses associated with our modern lifestyle. For most of us, this takes the form of forward head movement and stooped or rounded shoulders. Sometimes it is seen as a hunched-back posture or exaggerated sway back posture or even hyper-extended locked knees.

When you busily go about everyday tasks, you may not be aware of these postural and biomechanical imbalances. What this does is upset the symmetry and strength of your body, problematically if you don’t pay attention to this early on you may be creating learned behaviours and bad habits. This can lead to injury and also other future health concerns as multiple research studies have now shown.

Rene Cailliet, a renowned author on the topic, demonstrated that for every inch of forward head positioning you have; the physical force exerted on the neck and shoulders by the head actually doubles. As an example, if your head weighs 10 kilograms, and it shifts forward only a couple of centimetres, your neck is now carrying approximately 20 kilograms of load. When bones and soft tissues are under this sort of stress for a long period of time, damage starts to occur. Over time, these changes can become chronic or even permanent. Some researchers have gone as far as to say that chronic postural disorders are probably the most common initiating or contributing cause of chronic back pain. As thoracic kyphosis (hunched back posture) increases, there are associated abnormal changes to normal curvature of the low back and positioning of the shoulder girdle. This causes overloading to the support structures of the low back and shoulder girdle.

Postural faults speed up the aging process by placing abnormal strain on the spinal cord, spinal joints and the surrounding support muscles and tissues. In addition to pain and discomfort, if left uncorrected research indicates that postural faults cause degeneration and potentially even early mortality.

The reason poor posture has been associated with an increased mortality rate is due to an increased likelihood of reduced vital lung and arterial capacity in an individual. An alarming study by the American Geriatric Society found that individuals with hyper-kyphotic posture (defined as forward head carriage caused by internally rotated shoulders and hyper-flexion of the upper back, otherwise known commonly as a hunch-back posture) were approximately 2x more likely to die from pulmonary causes and had a 2.4x greater likelihood of dying from atherosclerosis. This study linked consequences of poor posture with loss of overall height, reduced pulmonary function, decreased physical function/performance and reduced capacity to perform activities of active daily living. It also demonstrated that these individuals had significantly poorer balance, slower gait and decreased stair climbing speed - all of which have also been associated with an increased risk of falls.

The study also stated that these hyper-kyphotic individuals had an increased risk of future vertebral and extremity fractures, independent of their bone density status. Older women with hyperkhyphosis had the most concerning fracture risk ratio, being found to have a 70% increased risk of future fracture, independent of age or prior fracture.

Postural assessment is a critical part of the physical examination procedures performed by chiropractors. With chiropractic care helping patients to improve their spinal mobility, you can more effectively implement the strengthening exercises which can help to restore you to a better and more efficient posture.

At NT Chiropractic and Wellness Centre our team of chiropractors is passionate in continually improving their own posture long term and would love to assist you and your family to do the same.


Kado DM, Huang MH, Karlamangla AS, Barrett-Connor E, Greendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. J Am Geriatr Soc 2004;52:1662-7.

Katzman WB, Wanek L, Shepherd JA, Sellmeyer DE. Age-related hyperkyphosis: its causes, consequences, and management. J Orthop Sports Phys Ther 2010;40:352-60.Posture and its relationship to orthopaedic disabilities. A report of the Posture Committee of the American Academy of Orthopedic Surgeons 1947