Posture Exercises - Where to Start

As a Physical Therapist I'm often asked “What are the best corrective posture exercises?” I am often surprised by this question. I get the feeling people think there is one magic exercise that will fix everything, kind of like a magic potion.

To be honest, I wish there was such an exercise unfortunately there is not. Why? Because everyones posture is different.

Our body is constantly changing and adapting to the daily demands placed upon it. Everyone already knows that if you work out a muscle it will get stronger. But what people don’t realize is that if you maintain your body in certain positions for long periods of time your muscles can also adapt by becoming tight or over stretched. Common examples of daily activities that can affect muscles include slouching on the couch, sleeping on your side, holding the phone between your shoulder and ear, etc…

So before being able to decide which posture exercises are best for you, you need to know what an ideal posture is and how close to it are you. Basically you need a road map of where you currently are and where you need to be. Sticking with the car analogy, you wouldn’t let a mechanic start working on your car without first figuring out if it is the brakes, engine or shocks. Likewise you shouldn’t start posture exercises before determining what specific body areas need work.

So what’s the best way to quickly assess your posture?

The best and easiest way is to look in a mirror.

What do I look for?



Facing the Mirror


* Do you notice a difference from left to right?

* Are your feet pointing straight ahead or out to the side?

* Are the arches of your feet high, medium, low or non existent?

* Are your knees directly over the top of your feet?

* Are your hips directly over the top of you knees?

* Is your pelvis rotated?

* Are your shoulders level?

* Is one shoulder more forward than the other?

* Is your head tilted to one side?



Standing Sideways to the Mirror


* Is the middle of your knee directly over the front of your ankle bone?

* Is your hip directly over the top of the your knee?

* Is your lower back flat, have a slight inward curve or a large inward curve?

* Is your upper back flat, have a slight outward curve or a large outward curve?

* Is your shoulder directly over the top of your hip?

* Is the back of your ear directly over the middle of your shoulder?


At this stage I’m just asking you to observe.

Next read the posts on good posture and the 4 common bad postures.

Which one are you most like?

By identifying your posture type we can better recommend the most appropriate posture exercises.

Posture Exercises - Upper Back Exercises

The term "Upper Back" refers to the region of your spine half way up your trunk to the base of your neck. Unfortunately it is all too common to see poor posture in this part of the body.

One typical poor posture for this area of the body is rounding of the shoulders. This basically puts the muscles of the upper back in a lengthened position that eventually causes them to loose strength.

There are many larger and smaller muscles of the upper back but the main muscle we want to focus on in strengthening is the Trapezius. It is one muscle but can be divided into three parts: Upper, Middle and Lower.



It is most common for the Middle and Lower portions of this muscle to become weak.

The video shows a way to exercise these parts of the muscle.



The key to these exercise is not to lift the arms up from the shoulder joint but to keep the arms heavy and create the movement by squeezing the shoulder blades together.

Do 10 times, build up to 3 sets of 10.

Posture Exercises - Back of Neck Stretch

The Back of the Neck muscles run from the base of the skull to the back of the neck or even to the shoulder blades.

These muscles include some larger muscles such as Trapezius and Levator Scapulae; to many smaller deeper muscles such as Rectus Capitis.





A head forward posture can cause these muscles to become tight. A head forward posture is common in today's society due to sitting for extended periods in a slumped position.

The video shows a few great methods for stretching the muscles at the back of the neck.



For best results hold the stretches for at least 30 seconds, Repeat several times daily.

Posture Exercises - Hamstring Stretches

The hamstrings are a group of muscles located at the back of the thigh. The names of these muscles include Semitendiosus, Semimembranosus and Bicep Femoris.



These muscles start at the pelvis and run down to the top of the back of the shin bone. They are important for good posture because they can effect the tilt of the pelvis, as well as the position the hip and the knee.

To correctly stretch the hamstring requires proper positioning of the pelvis as well the knee.

This video shows a few great techniques for stretching the hamstrings muscles. Look for the neutral position of the back while performing these stretches correctly. The video also includes a common mistake people make when stretching the hamstrings.



A hamstring stretch can also put a stretch the sciatic nerve, which starts in the lower back and runs down the back of the leg. Stop if stretching the hamstring causes pain.

For best results hold the stretches for at least 30 seconds, Repeat several times each leg.

Posture Exercises - Lower Back Stretches

Lower Back muscles is a term that refers to several difference muscles, of varying sizes, of the lower back. Sustained postures can cause tightness in these muscles, e.g. sitting on the edge of your chair, or sitting in a chair with your knees lower than your hips.

The muscles of the lower back include the Latissmus Dorsi, Multifidus, Longissimus and Iliocostalis.

The Latissmus Dorsi (or Lats) is a more superfical muscles, where Multifdus, Longissimus and Iliocostalis are deeper back muscles.

Below is a picture showing the different layers.





Tightness in the lower back muscles can effect the position of the pelvis as well as the curve of the lower back. If these muscles become tight you will typically see an increased lordosis (an increased backwards curve of the lower back) and/or an anterior tilt of the pelvis (the top of the pelvis is rotated forward).

To learn more about lordotic posture click on the link.

Lower back stretches aren't for everyone. They are best suited for someone with tight lower back muscles.

Why is this?

In order to stretch the muscles of the lower back you need to bring the lumber spine into some flexion i.e. bending the lower back forward. If your muscles are not tight you may be stretching the ligaments instead or placing extra stresses on the discs.

This video shows some great techniques for stretching the lower back muscles muscles.

Posture Exercises – Front Neck Muscles

The Deep Neck Flexors are small muscles at the front of your neck.



It is common for these muscles to become weak. Activities of modern living such as working at a computer of put us in a head forward posture. A head forward posture puts these muscles in a lengthened position. When a muscle is consistently in a lengthen position it has a harder time contracting efficiently. If a muscle doesn’t contract well it will loose strength.

These muscles are responsible for the movement of tucking your chin in, similar to if you were nodding your head. Although they assist in this movement there more significant contribution is to aid in stability of the different neck vertebrae.

In the video, as in most of our videos on posture exercises, we have included two versions, an easy and hard version.



For some reason sometimes this video is not showing up in the blog. If it is not working it can be viewed by clicking here.

The key to these exercises is too keep the chin tucked in.

Be aware that you will probably find the harder version challenging. Do not do if it causes pain

For these posture exercises try holding them for 10 second. Repeat 5 times gradually building 10. Once you can do 10 gradually increase the time of the hold.

Posture Exercises - Abdominals & External Obliques

When most people think of Abdominal Exercises they think of a sit up or a crunch, unfortunately these are not one of the best posture exercises. Why? To understand this we need to look at the make up of the Abdominal Muscles.

The Abdominal Muscles are made up of 4 different muscles: Transverse Abdominus, External Oblique, Internal Oblique & Rectus Abdominus.



Each muscles layers on top of each other, with their muscle fibers being orientated in a different direction. The combined criss cross nature of the their fibers acts like a supporting corset, keeping things in good alignment and protecting the spine.

The sit up and crunch mostly work the Rectus Abdominus, also known as the Six Pack Ab. The Rectus Abdominus is the abdominal muscle furthest from the spine. Because of this it is also the muscle that is least able to contribute to stability and good posture.

A better Abdominal posture exercise is one that exercises the deeper muscles. The video below shows such an exercise.



The key to these exercises is too keep the belly button drawn in towards the spine when moving and not to let the back arch off the ground.

For these posture exercises start with 10 each leg, gradually building up to 3 sets of 10.

Gluteus Maximus Strengthening

The Gluteus Maximus is the anatomical name for the main muscle of your backside. It is a large powerful muscle that aids in movement as well as stability. It is the largest of the three Gluteal muscles which include the Gluteus Maximus, Gluteus Medius, and Gluteus Minimus.

The Gluteus Maximus runs from the pelvis to the thigh bone (Femur) as well as inserting into the ITB (Iliotibial band). Due to its attachments, weakness in this muscle can lead to an altered position of the pelvis as well as decreased hip functioning and stability.



The Gluteus Maximus often becomes weak in Sway Back posture. Another common cause of weakness is when the hamstring muscles (the muscles at the back of thigh) becomes too strong and dominant and tries to take over the work of the backside muscles. This results in weakness because the gluts are being used less.

In order to be able to strengthen these muscles we first need to be able to feel the contraction in these muscles. People often have difficulty isolating this muscle.

Watch the video to learn how to isolating the glut max and how to start strengthening it. Remember in order to get the maximum benefit you must feel it in the backside and not the hamstrings.



The first method shows how to isolate the muscle. There should be no movement of the spine.

The second method is a progression. One again only perform if you feel it in the backside muscles.

The third method is a more challenging progression. We recommend Lying on pillows to avoid arching your lower back. The hip has limited movement backwards, so it is better to start with the knee below the hip and bring it up to hip level than to go beyond it.

Start these progressions performing 10 repetitions each leg, building up to 3 sets of 10.

Hip Flexor Stretches

Tight hip flexors are a common posture fault. Knowing how to stretch your tight hip flexors is a crucial for improving your posture. Tightness in these muscles can effect the lower back, the hip joint and the position of the pelvis.

Hip flexors refer to five muscles that start from the lumbar spine or the pelvis and insert into the leg. These muscles include the Iliacus, Psoas Major, Psoas Minor, Rectus Femoris and Tensor Fasciae Latae.

Psoas Major, Psoas Minor and Iliacus combine to form one insertion into the thigh bone (Femur). The Tensor Faciae Latae inserts into the Iliotibial Band (ITB) that runs down the outside of the thigh and inserts into the shin bone (Tibia).

The Rectus Femoris is a two joint muscle, meaning that it crosses both the hip and the knee joint.





Watch the video to learn how to stretch the hip flexor muscles.



Method one is a gentle stretch for very tight hip flexors. Lie down on your back. Pull one knee up to your chest keeping the other leg on the ground. You may also have to recruit your abdominal muscles (draw your belly button into your spine) to stabilize the pelvis.

The second method involves you kneeling in a lunge position. Tuck the front of your pelvis up towards your head and lunge forward. You should feel a stretch at the front of the hip on the leg that you are kneeling on.

The third method is performed standing. It focuses more on the Rectus Femoris by incorporating both the hip and the knee. Stand with your back to a kitchen counter. Place one foot up on the counter. Tuck the front of your pelvis up towards your head. Make sure your knee is directly below your hip. You should feel a good stretch in the front of your thigh.

Hold each stretch for 10-20 seconds, repeat 3 times, do twice a day.

Do not perform this exercise if it gives pain. Stretching is OK but pain is not.

Hip Flexor Strengthening Exercises

When most people think of problems with the hip flexor muscles they think of tight hip flexors. But like any other muscle in the body it is also possible to have weak hip flexors.

Weakness in the hip flexor muscles can effect the position of the pelvis which ultimately effects the functioning of the hip and the lower back.

As previously discussed in the stretching the hip flexors post, hip flexors refers to five muscles that cross the front of the hip and help bend the hip. These muscles include the Iliacus, Psoas Major, Psoas Minor, Rectus Femoris and Tensor Fasciae Latae.

When it comes to weak hip flexors the main muscles we are concerned about are the Psoas Major, Psoas Minor and Iliacus. These muscles combine together to form one insertion into the thigh bone and are often collectively referred to as Iliopsoas.



Strengthening these muscles is NOT for everyone. Because the origins of these muscles start in the lower back, it is crucial to have a strong core to help stabilize the spine.

Do not perform these exercises if you already have tight hip flexors.

Hip Flexor strengthening exercises are most suited for people with Flat Back posture and Sway Back Posture.

With out proper spine stabilization exercising these muscles can cause increased compression forces on the lower back which can lead to back problems. To learn more about how to strengthen the core muscles click here.

Watch this video to learn how to strengthen the hip flexor muscles.



Exercise Tips
The Iliopsoas muscle is the only hip flexor that works at the end of range hip flexion. Therefore in order to make sure we are strengthening the Iliopsoas and not the other hip flexors, use your hands to help place the hip in end of range hip flexion (i.e. maximum bending of the hip).

Be aware of your posture, sit with a straight back, and make sure to gently contract your abdominal muscles by drawing the belly button in towards your spine, to help stabilize the spine.

Method 2 shows a way to add resistance to this exercise.

Hold each repetition for 10 seconds, repeat 10 times.

Stop this exercise immediately if it gives you pain.

Bad Posture – Number 4 of 4 – Sway Back Posture

Sway Back posture can often be one of the more tricky postures to recognize. It looks similar to Lordotic posture except the pelvis is in a neutral position. The correct Posture Exercises can be of great benefit for someone with this type of alignment.

This type of posture is characterized by a forward displacement of the hips. If you were to draw a vertical line upwards from the front of the ankle bones, the hips will be in front of this line. The Upper Back is displaced backwards to counter balance the forward position of the hips. Commonly someone with this type of posture will have poorly defined gluteal (backside) muscles. This type of posture is common in both men and women.



Summary
Head – the head is forward of the shoulders
Neck – the neck is slightly extended
Upper Back – the Upper Back has an increased curve, convex backwards. The upper back is displaced backwards in regards to the lower back
Lower Back – the Lower back has a decreased (flatten) curve
Pelvis –the top of pelvis is titled backwards
Hip Joints – both hips are generally hyperextended with hips forward of ankles and knees
Knee Joints – both knees are hyperextended
Ankle Joints – the ankles are in a neutral position, i.e. the leg is at right angles to the sole of the foot

Weak & Over Stretched Muscles
The forward displacement of the hips causes the Hip Flexors & External Obliques (side abdominal muscles) to be in a lengthened position. These muscles should be preventing the pelvis from tilting backwards. Due to the increased curve of the Upper Back, the Upper Back muscles are over stretched and weak. The head forward position causes the Front Neck muscles to be over stretched and weak.

Tight & Overly Strong Muscles
The backwards tilt of the pelvis causes the Hamstrings & Internal Obliques (another side abdominal muscle) to be tight and overly strong.

Overly Strong Muscles but not Tight
The Lower Back muscles are overly strong but generally not tight due to the neutral position of the pelvis.

Posture Exercises
Exercises that strengthen the Hip Flexors, External Obliques, Upper Back muscles and Front Neck muscles; while stretching the Hamstrings & Internal Obliques would be of benefit.

Strengthening the Gluteal Muscles will also help balance the overly strong Lower Back Muscles.

Please visit the Posture Exercises section for more information.

Bad Posture – Number 3 of 4 – Flat Back Posture

Flat back posture is another common postural habit that can benefit greatly from Posture Exercises.

This type of posture is characterized by a flat lower back. This type of posture is common in both men and women.



Summary
Head – the head is forward of shoulders
Neck – the neck is slightly extended
Upper Back – the upper part of the Upper Back has an increased curve, convex backwards. The lower part of the Upper Back is flat
Lower Back –the Lower Back has a decreased curve or no curve, i.e. flat
Pelvis – the top of pelvis is titled backwards
Hip Joints – both hips are extended
Knee Joints – both knees are generally extended, although sometimes can be slightly bent
Ankle Joints –the angle between the leg and the sole of foot is greater than 90 degrees

Weak & Over Stretched Muscles
The Hip Flexors (muscles at the front of the hip) can be weak and long. This muscles should prevent the top of the pelvis from tilting backwards.

Tight & Overly Strong Muscles
The hamstrings, that attach to the back of the pelvis, can be tight and overly strong pulling the back of the pelvis down causing it to tilt backwards. Frequently the abdominal muscles are too strong, pulling the front of the pelvis upwards, also contributing to the backwards tilt of the pelvis.

Posture Exercises
Exercises that strengthen the Hip Flexors and lengthen the Abdominal & Hamstrings muscles are of benefit to someone with this type of posture.

To see how these exercises are performed please visit the Posture Exercises section.

Bad Posture – Number 2 of 4 - Lordotic Posture

Today we are going to look at Lordotic Posture and how to use posture exercises to correct it.

Lordotic Posture or Lordosis is the medical term for an increased forward curve of the lower back.



Summary
Head – the head is usually in a neutral position, i.e. not tilted forward or backwards.
Neck – there is usually a normal curve in the neck
Upper Back – there is usually a normal curve in the upper back
Lower Back – the lower back as an increased curve, convex forward
Pelvis – the top of pelvis titled forward
Knee Joints – the knees are slightly hyperextended
Ankle Joints – the angle between the leg and the sole of foot is greater than 90 degrees

Weak & Over Stretched Muscles
If you look at the above pictures notice how the forward tilt of the pelvis increases the distance between the top of the pelvis and the ribs. This puts the Front Abdominal muscles is a lengthened weak position. The front abdominal muscles should counteract the forward tilt of the pelvis keeping it in a neutral position. Since the hamstrings insert into the back of the pelvis, the forward tilt of the pelvis puts the hamstrings in a lengthened position. The hamstrings may or may not be weak but should also help prevent the forward tilt of the pelvis.

Tight & Overly Strong Muscles
An increase curve of the Lower Back will put the Lower Back Muscles in a shortened position. These muscles can also be overly strong helping pull the back of the pelvis upwards causing a forward pelvic tilt. The Hip Flexors (muscles at the front of the hip) can also be tight and overly strong, also helping tilt the top of the pelvis forward.

Posture Exercises
Exercises that Strengthen the Abdominal Muscles and Hamstrings, while stretching the Lower back Muscles and Hip Flexors would be of benefit to someone with this type of alignment.

See the Posture Exercises section to learn more.

Bad Posture – The 4 Most Common Bad Habits

The reason to look at Bad Postures is because unfortunately most of us fall into one of these 4 categories. It is important to identify which of these 4 bad habits we are most like so that we can determine which posture exercises are the most appropriate for us.

The 4 types of Bad Postures are Kyphotic, Lordotic, Flat Back, and Sway Back. Today we will focus on Kyphotic Posture.

Kyphotic Posture
Kyphotic is the medical term for an increased curve of the upper back. It is very common, but not limited to elderly ladies.



Summary
Head – the head is usually forward of the shoulders
Neck – the neck is hyperextended
Shoulder Blades – the shoulder blades are pulled around the upper back towards the arms giving a rounded shoulder appearance
Upper Back – the upper back has an increased convex backwards curve
Lower Back – the lower back has an increased convex forward curve
Pelvis – top of pelvis is titled forward
Hip Joints – the hip joints are slightly bent
Knee Joints – the knees are slightly hyperextended
Ankle Joints – the angle of the ankle joint (between the leg and the sole of foot) is greater than 90 degrees

Weak & Over Stretched Muscles
Notice in the pictures that the head is protruded forward. This puts the Front Neck muscles in a longer position than desired. This sustained lengthened position effects the contractile capability of the muscle, which in turn causes the muscle to lose strength.

The increased curve of the Upper Back puts the Upper Back muscles in a lengthened position and therefore causes weakness in these muscles. In this position these weakened muscles can not adequately support the upper back.

The External Oblique muscles (one of the two side abdominal muscles) are also over stretched and therefore weak caused by the forward tilt of the pelvis.

The tilt of the pelvis can also lengthen and weaken the Hamstrings.

If the External Oblique and Hamstrings were working properly they would maintain the pelvis in a neutral position.

Tight & Overly Strong Muscles
The Hip Flexors (muscles at the front of the hip) may be tight or too strong pulling the top of pelvis forward.

The Back of Neck muscles are tight tilting the back of the head backwards, causing the head to protrude forward.

Posture Exercises
Exercises that Strengthen the Front Neck muscles, the Upper Back muscles, External Obliques and Hamstrings; while stretching the Hip Flexors and Back of Neck muscles are appropriate for someone with this type of posture.

See Posture Exercises to learn how these exercises are performed.

Good Posture – The Ideal

Good posture is the result we are trying to achieve by doing posture exercises.

So what does good posture look like?



Often a picture says a thousand words. I have included a diagram of a front and side view as well as a description of what should be happening at each body part.

Front View
Head – the head is in a neutral position. Meaning not tilted to the left or right.
Shoulder – the shoulders are level
Hip Joints – the hip joints are level
Knee Joints – the knees are level
Feet – both feet are pointing straight ahead

Side View
Head – the head is in a neutral position. Meaning not tilted forward or not tilted backwards. Notice the back of the ear is directly over the top of the middle shoulder.
Neck – the neck has a normal curve. A normal curve is a slight forward convex curve.
Shoulder Blades – the shoulder blades are flat against the upper back
Upper Back – the normal curve of the upper back is a slight convex curve pointing backwards
Lower Back – the normal curve for the lower back is a slightly convex curve pointing forward
Pelvis – the pelvis is in a neutral position (*See below*)
Hip Joints – the hip joint is in a neutral position, meaning not bent or not hyperextended.
Knee Joints – the knee is in a neutral position, meaning not bent or not hyperextended.
Ankle Joints – the ankle joint is in a neutral position, meaning the angle between the leg and the sole of the foot is 90 degrees.

*The front and back muscles (core muscles) that attach to the pelvis maintain its ideal position i.e. the upward tension of the abdominal muscles is counter balanced by the downward tension of the hip flexors; the upward pull of the back muscles is counter balanced by the downward pull of the gluteal (backside) muscles.*

Posture is a habit. It is something under our control. We decide whether we want it to be a good habit or a bad habit. Posture exercises will help you make it a good habit.

How Can I Help?

My posts always include useful information about posture. Today I wanted to do something a little different. For this I will need your help.

Why do I need your help.

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