It is ironic that in the fast-paced world that we live in, most of us have slowed down or stopped moving, spending hours hunched over and glued to our screens and devices. This leads to progressive weakening of the upper back and neck muscles, forcing one into a forward head posture (where the head is leaned forward, deviating from its neutral alignment with the spine). This, in turn, causes a host of health issues, including neck pain, shoulder tension and tightness, respiratory complications and headaches. The good news is that with the right knowledge and exercises, we can actively work to strengthen these crucial muscles and improve our posture over time.
What causes poor upper back and neck posture?
Some of the main reasons for poor back and neck posture include:
♦ Sedentary lifestyle: Sitting for extended periods, especially in front of a computer or television, leads to inadvertent slouching. “If you spend long hours sitting or looking down at your phone, it can lead to forward head posture,” says Sunil Rajpal, physiotherapist and deputy head of the department of rehabilitation and sports medicine, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai.
♦ Improper ergonomics: Inadequate or improper workspace set-up, including the height of your chair, desk or computer monitor, can lead to unnatural neck and back positions. Improper ergonomics may also put you in a forward head posture. As one ages, proper ergonomics become all the more important as their bone density and strength decline over time. A systematic review and meta-analysis published in the journal Current Reviews in Musculoskeletal Medicine found age to be a confounding factor in the relation between forward head posture and neck pain. Forward head posture was significantly correlated with neck pain in adults and older adults. The results also revealed that adults with neck pain show increased forward head posture compared to asymptomatic adults.
♦ Weak muscles and thoracic spine: Weak upper back and neck muscles struggle to support the thoracic spine and maintain proper posture. A study published in the Journal of Physical Therapy Science found that forward head posture caused an expansion of the upper thorax and contraction of the lower thorax, which caused a decrease in respiratory function. “The posterior muscles of the back, neck and scapular region are the foundation of the cervical spine. Bending your neck beyond a certain extent will stretch all your posterior back muscles. The human spine stays erect because of these muscles, and if we keep our neck in flexion for a long time, these muscles will become weak,” says Dr Ishwar Keerthi, consultant spine surgery, KMC Hospital, Mangaluru.
♦ Push-to-pull muscle imbalance: “People mostly focus on the anterior mirror muscles [muscles in the front part of the body that are visible when looking at a mirror] when they exercise at the gym. This causes them to get stronger while leaving the posterior muscles relatively weak, which can lead to an imbalance and bad posture,” says Dr Keerthi. As a result, the chest muscles can become tight and the back muscles can lengthen, which in turn can lead to rounded shoulders.
♦ Other factors: We hold a lot of stress and anxiety in the shoulder and neck muscles. “Stress, anxiety and tension often manifest as tight muscles, which adversely affect your posture,” says Rajpal. In addition, carrying heavy bags on one shoulder or in one hand can also cause muscle imbalances and lead to poor posture over time.
Improper screen time posture, where one is constantly looking down at their gadgets, can strain the neck and lead to a forward head posture. Also, many people simply aren’t conscious of their improper posture and may need to be educated and reminded about good posture and how it can improve their lives.
Steps to achieve and maintain proper posture
According to experts, measures for correcting and maintaining proper upper body posture include:
♦ Awareness: It’s important to start by fixing your posture when you catch yourself lacking throughout the day. “Knowing about the problem will solve half of the problem. If you correct the ergonomics in your workstation, quite a bit is solved,” says Dr Keerthi. Use mirrors or have someone take photos of your posture from different angles to identify areas that need improvement.
♦ Ergonomics: Adjust your chair, desk and computer monitor to promote a neutral posture. “Pay attention to ergonomics at your workplace. Ensure your chair and desk are set up to support a neutral spine,” says Rajpal. While using gadgets, the screen should match your eye level to prevent overextension of the neck.
♦ Strengthening exercises: “If we strengthen the muscles of the neck, back and scapular region, the posture of the cervical spine will improve,” says Dr Keerthi. Exercises to strengthen the upper back and neck include:
- Upper back: Exercises like rows, shoulder blade squeezes, and lat pulldowns will strengthen the muscles between your shoulder blades.
- Neck: Gently tilt your head from side to side and perform neck isometric exercises. Chin tucks and neck rolls can be effective stretches. “Incorporate daily stretches to maintain flexibility in your neck and upper back. Don’t forget your core! A strong core provides a solid foundation for good posture,” says Rajpal.
♦ Mindful sitting: When sitting, keep your feet flat on the floor, your back against the chair and your shoulders relaxed. Use a lumbar support cushion if needed.
♦ Frequent breaks: If you have a sedentary job, take short breaks to stand up, stretch and walk around. “Follow the 20-20-20 rule. For every 20 minutes you look at a screen, shift your eyes to look at an object 20 feet away for at least 20 seconds,” explains Rajpal.
♦ Body awareness: Practice mindfulness and body awareness techniques to remind yourself to maintain good posture. “Stay mindful of your posture throughout the day. Imagine a string pulling you gently upward to encourage a straight spine,” says Rajpal.