Standing up straight is not just something our parents remind us to do, it also happens to be good for our health. Posture describes the position of the body in space, but the realities of how we stand and move in day-to-day life is much more complex. Healthy postures encourage proper alignment of body structures, while unhealthy postures can lead to a host of issues, including muscle and joint pain, balance impairment and decreased mobility. Awareness of the body’s proper static and dynamic position is essential to maintaining a healthy spine.

The Spine and Its Role in Posture 

The body’s main support system is the spine, which consists of three sections. The cervical spine supports the weight of the head and connects it to the shoulders, enabling us to turn our heads from side to side as well as up and down. The thoracic spine stabilizes the rib cage, which protects the vital organs. The lumbar spine consists of thicker, more robust vertebrae, as they are the main load bearers and enable us to rotate our bodies and bend forward and to the side.

Muscle tightness or joint immobility can shift the spine out of its ideal positioning, causing postural dysfunction. A recent study published in the journal Physical Therapy Rehabilitation Science estimates that 66 percent of the population is living with forward head posture (FHP), a cervical spine dysfunction that occurs when the head moves forward in front of the body. FHP can lead to headaches, migraines and jaw pain. Thoracic kyphosis, a rounded upper back, reportedly impacts 20 to 50 percent of the population and impairs numerous functions, including digestion and breathing. The lumbar spine is at particularly high risk for joint disease as both lumbar muscle strength and pelvic mobility decrease in sedentary individuals. Low back and pelvic immobility are contributing factors for the estimated 103 million individuals worldwide that live with lumbar spinal stenosis, a narrowing of the spinal canal that may cause pain or numbness in the legs. 

Three-Step Process to Take Control of Our Posture

Step One: Identification  

In her book Rethink Your Position, biomechanist Katy Bowman recommends that we pay attention to a few common signals the body sends out to call attention to an imbalanced weight distribution, including aches in the feet or low back and tension of the shoulders or neck. “Good alignment isn’t about any one fixed position, but a healthy range of positions,” she says. “By focusing less on memorizing postures and more on learning about load on parts of the body, you can optimize your positioning for many different activities.” 

Bowman recommends a quick and easy way to self-assess if a postural imbalance is present and, if so, to identify where the imbalance begins: “The body's joints stack in a vertical line. You can use a plumb line to indicate where your parts are supposed to be. If you take a string with a weight at the end and drop it down from your shoulder, it should line up with the hip, knee and ankle on the way down.” 

Step Two: Correction

Dr. Krista Burns, co-author of The Posture Principles and founder of the American Posture Institute, recommends a two-minute exercise routine, performed while standing against a wall, that addresses each segment of the spine. Repeat each exercise five times.

1. Neck retraction: Push the head forward away from the wall as far as possible, then pull it back so the base of the skull contacts the wall. Keep the eyes parallel to the horizon, rather than looking up toward the sky.

2. Posture angel: Stand with the back against the wall, elbows bent and tucked in close to the waist. Keeping the back of the hands against the wall, reach up as far as possible then slowly lower back to starting position. This movement, which is like making a snow angel while standing, should be felt between the shoulder blades when performed correctly. 

3. Pelvic tilt: Arch the back so there is a small space between the wall and the lower spine, then tuck in the tail, flattening the spine against the wall and closing that space. This exercise helps initiate movement into the lower joints.

Step Three: Maintenance 

The key to maintaining a healthy posture is frequent movement, which can include an hourly stretch break or a bi-hourly range-of-motion routine to move muscles and joints throughout the day. To make postural exercises a habit, physical therapist and integrative health coach Margie Bissinger recommends pairing an exercise routine with something that is already done multiple times a day, for example mealtime. “People are busy, so it is hard to always dedicate that mental space to awareness of their head or back position,” she states. "When they pair it with something they’re routinely doing, it becomes a habit, and that is when the mental load of the task starts to go away.” 

Cristina Parker holds a doctorate in physical therapy. She is a researcher, health content writer, educator and clinician specializing in neurologic disorders, limb-loss rehabilitation and adaptive sports techniques.