Caring for Yourself: A Maintenance and Prevention Strategy Part 3: Posture

This post is a continuation in a series on establishing a maintenance and prevention strategy, and may be best understood by reading prior related posts.

“Sit up straight!” “Pull your shoulders back!” “Stop slouching!” I can still hear the nuns barking at us in elementary school. For others it might be a well-meaning Mom. We’ve all seen slouchers, maybe in photos, maybe at a meeting, maybe we are/were the sloucher. It does communicate an aura – perhaps of depression, lack of confidence, possibly fatigue, maybe even trying to look cool versus nerdy. Bottom line is we do look better when we exhibit “good” posture. Yet this construct of good posture seems to be more of a lofty ideal we grasp for than an achievable goal. Exactly what is good posture, when do we “arrive” at it, how do we sustain it, and does it really matter?

Sister Act Nuns
The 1992 movie “Sister Act” is one of my all-time favorites. Whoopie Goldberg and her compatriots were NOTHING like the nuns who ruled my elementary school days. Photo accessed at

Let’s start with defining posture. Wikipedia states the following: The word posture comes from the Latin verb ponere, which means “to put or place.” The general concept of human posture refers to the “carriage of the body as a whole, the attitude of the body, or the position of the limbs (the arms and legs). They go on further to define poor posture as the posture that results from certain muscles tightening up or shortening while others lengthen and become weak, which often occurs as a result of one’s daily activities. It may lead to pain, injury, or other health problems. I’ll interject here that muscles are not that smart. They are the boots on the ground, the infantry following orders – muscles are not the generals. So I have issue with saying a muscle tightens up/shortens or lengthens/weakens all on its own, even as a result of daily activity (more on this in a bit). It’s responding to a stimulus (or lack thereof), namely from the nervous system.

Muscle spindle and golgi tendon organ
The nervous system elements that regulate muscle contraction/shortening and relaxation/lengthening. Muscles do not call the shots but are at the beck and call of these bosses. On the left is a magnification of a muscle spindle, courtesy of Dr. Carla Stecco. On the right is a depiction of the golgi tendon organ, accessed at Wikipedia.

Conversely, Webster’s New World Medical Dictionary defines good posture (also termed neutral posture) as the stance that is attained “when the joints are not bent and the spine is aligned and not twisted. Neutral posture has given rise to the idea of achieving ideal posture – proper alignment of the body’s segments such that the least amount of energy is required to maintain a desired position. The benefit of achieving this ideal position would be that the least amount of stress is placed on the body’s tissues. In this position, a person is able to completely and optimally attain balance and proportion of their body mass and framework, based on their physical limitations. Good posture optimizes breathing and affects the circulation of bodily fluids. Now this is a definition I can embrace! They even edged into answering the does-it-matter question with a resounding yes! Perhaps a better definition of poor posture would be any deviation from this ideal. Think of it like a pile of books that’s not stacked straight: makes it kind of precarious. Or holding a 20# weight in your hand. It requires more energy and places more stress on the arm to hold the weight out away from the trunk than required when hold it closer in. Think of your head and neck in the same manner: it requires less energy and places less stress on tissues to hold the head stacked over the neck stacked over the shoulders stacked over the hips, knees, and ankles instead of leaning out or forward.

Good posture front and side views
The image on the right shows good posture with the plumb line bisecting the ear, shoulder, hip, knee, and ankle. The image on the left depicts good alignment from a different perspective with the head, shoulders, and hips level. Images accessed at

So how can you know if you have good posture?” It’s actually pretty easy: by doing a POSTURE CHECK:

  • Stand with your back to an empty wall.
  • Position yourself so that your buttocks and your mid-back touch the wall. Depending on the size of your derriere, your heels and calf muscles may or may not touch the wall.
  • The back of your head should easily contact the wall. For me this feels very natural and easy. But for many people this feels unnatural, and some may not be able to contact the wall with the head even with effort to force it back. This would implicate the presence of what’s termed a forward head posture.
  • Another way to check posture is to stand with a plumb line to your side. If you don’t happen to have one hanging from the ceiling you can use a picture of yourself from the side and draw a line on it. Good posture would show the line bisecting the ear, shoulder, hip, knee, and ankle.
  • This also applies in the seated position: the plumb line should bisect the ears, shoulders, and hips, while the knee and ankle are not a factor in sitting. Keeping the back against the back of the chair helps align everything as well.
  • For a different perspective, stand facing a full length mirror. Ideally your eyes, ears, and shoulders should be level. Your hands perched on the highest point of your pelvis should also look relatively level.
Posture check demonstrating good and bad
A posture check is easy to perform on yourself. Stand with your buttocks and upper back touching the wall. Your head should easily contact the wall behind you as in the photo on the right. On the left Maddie is demonstrating a forward head posture. Photos by Colleen Whiteford.

Now’s a good time to clarify that I am NOT saying we should always look like this. We are humans, not robots or toy soldiers. We are meant to move and change positions. But if the majority of our time is spent in sub-optimal positions whether sitting or standing then, as noted above, more energy is expended just to function against gravity AND the tissues are subjected to greater stress. As mentioned above, if we assume these postures frequently and long enough then the tissues will begin to adapt in ways we may not like. Even frequent and/or prolonged sitting can gradually promote changes in the front of the hip that can lead to trouble, which is why I advocate breaking up periods of sitting (you can learn more about this here).

Seated posture good and bad
Posture in sitting is also important. It’s easy to lean forward with the head and shoulders as we read or work on the computer, as on the left. But it’s much less work and strain on the tissues to keep the head over the shoulders as on the right. It also helps to lean back into the back of the chair instead of being on the front of the seat. Photos by Colleen Whiteford.

So what can you do if you find yourself habitually assuming less-than-ideal postures? As with changing any other habit, awareness is the first step and hopefully being accomplished as you read this. There are products on the market to address faulty posture, such as braces to theoretically help pull the shoulders back or at least remind the offender to do so. Special tape can be applied to the skin on the upper back to serve the same purpose. In preparing this I even stumbled across a little device you wear on your back which vibrates to alert you that you’re slouching and need to sit up straight. Kind of like a perpetual nun, Mom, or even little angel on your shoulder prompting you to do right.

aids to promote good posture
Who knew posture could be so much fun? On the left, the vibrating device from Upright that alerts you to slouching, and even gives you a status report on your phone. On the top right is one style of brace that magically gets you upright and happy. On the bottom right is tape to hold you together. Then there’s the option of recruiting an angel to tap you on the shoulder when the devil makes you slouch. Thanks to Dalton, Lauren, and Felicity from the Pinehurst APT 2021 Halloween week!

While there may be some individuals who might benefit from these measures, I don’t recall ever recommending any of them (well, maybe the angel). For the most part I find that making people aware of their posture and teaching them posture checks goes a long way. I also like to instruct in a few simple exercises that I believe practically everyone should do. In the case of a forward head posture, the Chin Tuck exercise can be very helpful. The Doorway Lunge can also help to stretch out the front of the shoulders, which can shorten with bad posture. Changing a habit takes time, effort, and consistency especially if it’s been practiced for an extended period of time. And ultimately if a brace or other such cue helps to solve the problem then go for it! But I see it as a temporary measure, to be utilized in conjunction with these other elements.

If a posture check or the exercises suggested are difficult it’s possibly because you have not moved this way in a long time. Restriction(s) that are very chronic (present a long time) may prevent you from being able to get into these positions. You may be battling something that stretching and effort alone are not going to change, and require more help. If the tissues, let’s say the front of your neck and shoulders, have been overloaded for an extended period of time, then they may have developed densifications in the fascia that simply will not stretch out (you can read more about this here). Identifying the most problematic sites in the tissues and addressing them with Fascial Manipulation, percussion/vibration, cupping, and dry needling may be very helpful for promoting a more ideal, upright, and efficient posture. Then you may find yourself able to do these and other exercises, and make some positive and sustainable changes.

I hope you find this helpful, and in future posts I’ll continue on this topic of maintenance and prevention. Thanks for reading!

Wishing you health and joy!


Published by Colleen Murphy Whiteford

I am a physiotherapist, graduate of Saint Louis University Class of 1984. I married my best friend and business partner, Bill, who is also a physiotherapist, in 1988. We have worked together all these years - an example of God's grace! Together we started Appalachian Physical Therapy which continues to thrive. I am a big believer in the power of touch, the manual therapies, and treating holistically. There are many alternatives to medications, surgeries, and testing, but people are often uninformed. My perspective emphasizes the role of the connective tissues including the fascia. Lack of attention to this structure is the source of many physical ailments - our bodies are truly fearfully and wonderfully made (Psalm 139)! I am passionate about helping people of all ages and diagnoses maximize their health, and empowering them to understand their role in management and prevention of problems.

One thought on “Caring for Yourself: A Maintenance and Prevention Strategy Part 3: Posture

  1. Thanks Colleen! We all need to listen to you and practice good posture . . .My Mom used to have me walk around with books on my head—-

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