Sunita Mani, PT, DPT, MBA, CEAS
Are you slouching as you read this?
Are your shoulders rounded?
Is your neck bent forward?
If you’re like most people, you neglect your posture often.
Unfortunately, if you forget about your posture for too long, your lower back may give you a painful reminder.
At Princeton Rehabilitation, a unit of Penn Medicine Princeton Medical Center, physical therapists treat low back pain through techniques that include a focus on postural awareness and correction.
Common Medical Problem
Back pain, especially low back pain, is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives, according to the National Institutes of Health.
There are many causes of low back pain including:
• A herniated or bulging disk, which occurs when the jelly-like center of the disk between the bones in your spine leaks or bulges out and presses on your spinal nerves.
• Disk degeneration, which occurs when the space between the bones in your spine begins to shrink because the discs are decreasing in size. This causes the bones to rub against one another and may cause pain.
• Stenosis, which is the narrowing of the spaces in your spine. This is often a normal part of aging, but if spaces narrow to the point that nerves or the spinal cord are compressed, this could cause pain or weakness in the back or legs.
Low back pain may be described as a dull ache or a sharp, stabbing pain. It could be recent (acute) or ongoing (chronic). The overwhelming majority of people who have experienced low back pain will have a recurrence at some point in the future if left untreated.
If low back pain doesn’t improve or worsens after two or three weeks, you should call your doctor. Additionally, call your doctor if:
• Your pain extends below your knee and does not change in location or intensity, even if you change positions.
• You have numbness in your groin or buttocks and have a loss of bowel or bladder control.
• You have fever, chills, nausea, vomiting or weakness.
• Your pain was caused by a traumatic injury such as a car accident or a fall.
• Your pain is so intense you can’t move around.
A Common Contributor
Poor posture is a common contributor to low back pain. In addition, poor posture can decrease flexibility, affect movement, and throw your entire musculoskeletal system out of alignment.
In general, posture refers to how you hold your body. More specifically, dynamic posture is how you hold yourself when you are moving, such as walking, running, or bending to pick up something. Static posture is how you hold yourself when you are sitting, standing, or sleeping.
Both dynamic and static posture are important to your spinal health and in maintaining its three natural curves — at your neck, mid-back, and low back.
To maintain proper posture, your chin should be “tucked” and your ears should be aligned with your shoulders. Further, your shoulder blades should be squeezed and your belly should be “sucked in.”
Try this simple exercise to practice proper posture:
• Fully relax your muscles and slouch down. In other words, sit poorly.
• Then, sit fully upright by squeezing your shoulder blades together and pushing your chest out, tucking your chin back, tightening your abdominal muscles, and exaggerating the curve in your low back.
• Now, relax about 10% by taking the strain off your muscles. Hold this position for 10 seconds. That’s proper posture.
• Repeat from step one. If this is done for 10 repetitions, two to three times a day, your awareness of proper postural alignment — and your posture overall — will improve.
Tips for Improving Posture
Improving your posture starts with noticing when you’re not sitting or standing properly. The simple act of being mindful of your posture can help you straighten up. Other tips include:
• Make sure your lower back is fully supported when you sit. If your chair does not have a backrest that can support your lumbar spine, use a foam roll or other support to reinforce the curve of your low back. It should be firm so it gives you proper support rather than just molding into your natural position.
• When you sit, make sure your thighs and hips are supported. Sit on a well-padded seat with your thighs and hips parallel to the floor. Scoot all the way back so there is no space between the back of the chair and your seat. Your feet should be flat on the floor.
• Take frequent breaks from sitting. Get up. Walk around. Stretch. Try not to remain sitting for longer than 45 minutes at a time.
• If you stand for long periods of time, rest one foot on a low stool to relieve pressure on your back. Switch feet every 15 minutes.
• When lifting, avoid bending forward. Instead, bring the hips and buttocks back and bend at the knees. The large muscles in your legs are designed to lift, while the muscles in your back are designed for postural support.
• Wear comfortable shoes. Improper footwear can lead to unnecessary stress placed on your muscles and joints, which can negatively affect your posture.
• Stay physically active. Physical activity is not only good for your overall health, it also helps improve your posture by keeping your muscles strong. Exercises that strengthen your core are especially helpful.
Physical Therapy Can Help
Lower back pain can often be relieved without expensive surgery or the side effects of medication. Literature shows that conservative management of low back pain, including physical therapy, often has comparable long-term results to surgery. Physical therapy can reduce lower back pain by improving your postural awareness, strengthening the muscles that support your spine, and restoring your mobility.
At Princeton Rehabilitation, physical therapists conduct a comprehensive initial evaluation and use the results to develop your individualized plan of care and personal goals. Importantly, physical therapy places a great deal of emphasis on patient education and ownership. You will learn home exercises and self-care techniques to manage your condition independently.
Princeton Rehabilitation offers in-person physical therapy appointments in Hamilton, Monroe, Plainsboro, Princeton, and South Brunswick. For patients seeking care at the Monroe site, transportation may be available.
Princeton Rehabilitation follows Centers for Disease Control and Prevention guidelines including proper and frequent cleaning of all surfaces and equipment with hospital grade disinfectant, social distancing, proper PPE, and patient screenings upon entry. Further, physical therapists at Princeton Rehabilitation see only one patient per hour, which improves quality, attention, and minimizes the number of people in the clinic at once.
Telemedicine appointments are also available, allowing patients to connect with their physical therapists remotely through a secure video application on a smartphone, desktop, or laptop computer for effective one-on-one care from the safety of their own home.
For more information or to find a physical therapist with Princeton Rehabilitation, call 609-853-7840 or visit www.princetonhcs.org.
Sunita Mani, PT, DPT, MBA, CEAS, holds a doctorate degree in physical therapy and is the director of outpatient rehabilitation at Princeton Fitness & Wellness in Plainsboro and South Brunswick Wellness Center.