Poor posture is habitual. If you or your child demonstrates bad posture, it is highly likely that poor habits have manufactured it. 

We’re typically born with “normal” curves in our spine that naturally place us in “good posture.” That natural curve is negatively impacted over time due to static posturing and the fact that we and our children spend more and more time seated in a chair, learning in the classroom, working at the computer, watching television, doing homework or playing video games. 

It is only a matter of time before gravity begins pulling us forward, creating a protruding head, flattened neck, rounded shoulders and slouched lower back.

Postural behaviors children learn today are habit forming and will affect them for life. Over time, poor posture can increase a child’s chances of injuring the spine as is in the case of a neck or back strain or chronic pain. 

A more permanent consequence is the possibility of abnormal bone growth in the spine.  This can occur when spinal bones change shape due to abnormal long-term pressures placed on them. Bones in the neck, middle and lower back can grow abnormally if they have too much pressure placed in one direction. As the bones change their shape, it becomes much more difficult to correct the problem.

Although most postural neck and back pains are reversible with habitual changes, sometimes it is structural in cases such as scoliosis. This can often run in the family and is usually detectable before or during adolescence.

How to help:

Children do not often understand why posture matters because they rarely experience back pain, unlike many adults. Help your child recognize good posture and its impact on their overall growth and development. Lead by example!

We know that posture is impacted by a combination of factors including good muscle control, strength and flexibility. So, involve your children whenever possible in activities that promote good posture. Get your child moving: swimming, dance, karate, gymnastics, skating, etc. Becoming involved with sports activities helps develop muscular skills as well as self-confidence which is often a strong influence in posture. 

Seating is often a significant factor leading to slouching. Make sure your child sits in an appropriately sized child-size chair, or a pneumatically adjustable chair. 

Remember the “Rule of 90’s.” Ears directly over the tips of your shoulders, hips flexed to 90 degrees, knees bent to 90 degrees and feet flat on the floor. 

Be sure the computer screen is directly in front of your face. Also, try to maintain a slight arch in your back by rolling your hips slightly forward. Feel free to assist this by placing a towel roll in the arched area. 

You can also try having your child sit on a physioball when completing homework or working on the computer. The instability of the ball forces core stabilization and good postural maintenance.

Video Games:

This is typically a time of especially poor posture. Have your child sit in a straight-backed chair instead of slouched back in the couch or crossed-legged on the floor leaning forward as if they cannot see the screen that is 4 feet away. And not even a joke, but if they still have to lean forward…have their eyes checked. Also, create time limits of play if necessary to promote movement out of the poor posture.

For younger children who slouch when doing homework while performing writing tasks, tape the piece of paper in the proper position, this being directly in front of the child and straight. Mimic when necessary. As much as it may seem cruel to embarrass them, it can also be very effective in promoting your child to stand up or sit straight.

A couple simple exercises for your children to practice are:

—Sitting scapular retractions and depressions: put your elbows in your back pockets by pinching your shoulder blades back while pushing your elbows back and down.

—“Superman” exercise: lay on stomach while lifting everything including your arms, legs, head and chest. Hold up while breathing for 3-5 seconds performing two to three sets of 10 repetitions

—Finally, fitting up your child for school can be difficult when it comes to backpacks. But a poorly fitting pack loaded with books can significantly impair posture. 

Picking the Backpack: 

Here are 7 tips on choosing the pack best for your child.

1. A padded back will minimize direct pressure on the back

2. Wide padded shoulder straps which will not hinder circulation to the arms which may cause numbness and tingling

3. Waist and chest belts to transfer some weight from the back and shoulders to the trunk and pelvis

4. Multiple compartments to better distribute the weight in the backpack

5. Reflective material to enhance visibility at night

6. Lightweight backpack

7. Correct Size selection of the pack is important as packs come in different sizes for different
age children

If you or someone you know suffers from pain or postural complications as described above, it is ill-advised to begin a new exercise program without consulting first with your physician, a physical therapist, certified athletic trainer, chiropractor, physiatrist or other specialist who regularly treats pain. If you would like to consult a physical therapist about an ergonomic evaluation, contact your local physical therapy clinic.

James Markwica, MS PT is a New York State Licensed Physical Therapist at LaMarco Physical Therapy, 417 Geyser Road in Ballston Spa and 30 Gick Road in Saratoga Springs. For questions of follow-up, contact James at (518) 587-3256 or online at www.lamarcopt.com.

Perhaps you have completed your spring clean up, started the weekly mowing, and if you are lucky you may have even returned to the bowling lanes, the tennis courts, the golf course or even the gym.  You just now realize that the small tenderness, the miniscule but sharp pinch or even the slight weakness you felt while lifting the leaf bags just hasn’t gone away.  In fact, it’s worse … much worse, and ibuprofen isn’t touching it.  There are many reasons for this, but unfortunately you may have injured your rotator cuff.

The rotator cuff is composed of four muscles and their tendons within the shoulder.  These muscles (supraspinatus, infraspinatus, subscapularis and teres minor) function with the common goal of holding your upper arm bone, the humerus, firmly to the scapula or shoulder blade as if holding a golf ball to tee while being held sideways.  The muscles of the cuff counteract the motion provided by the larger muscles of the shoulder allowing us to raise the hand overhead.  With any compromise of these muscles you would find great difficulty in moving your arm higher than chest height depending on the severity.

While reaching for the leaves stuck in the bushes or lifting your leaf bags seems to be the cause of your pain, this relatively common injury is often caused from a fall onto an outstretched arm or directly onto the shoulder, lifting, throwing, pulling or repeatedly moving the arm back and forth, especially overhead.

Predisposing factors may expose you to a greater potential of injury of the rotator cuff.  Poor postures such as forward or protracted shoulders in combination with any of the listed motions will likely increase the amount of wear and tear creating strain on the muscles of the cuff.  Variations in the shoulder structure causing narrowing under the outer edge of the collarbone may also create an impingement.  Additionally, repeated trauma, degeneration and some medications may further weaken your tendons and impact your shoulder’s performance.

Once the pain begins it may be difficult to identify the culprit.  Potentially injuries may include tendonitis (inflammation of the tendons), bursitis (inflammation of the fluid-filled sacks deep within the shoulder), strain or overloading of the muscles and tearing.

Accompanying your pain you may commonly experience point tenderness to the touch on the outer or upper aspect of the shoulder, weakness, range of motion loss and an inability or unwillingness to move.  These symptoms my be most prevalent when washing your hair, reaching for the gallon of milk, putting on a jacket or even sleeping on the affected shoulder.  The degree of your injury may be indicated in your pain or functional loss with these types of activities.  

If this sounds like you, and you are unable to use your arm for work or play, it may be time to seek help from your healthcare professional.  Depending on your complaint of pain, strength and outcome of specialized testing, one may require further testing to determine whether or not the patient is a surgical or non-surgical candidate.  It is most common that you will not require surgical intervention.  Properly treating your pain and eliminating your condition can take a few weeks to several months

Treatments may include anything from rest, ice/heat, steroid injections, pain relievers or surgery.  Commonly NSAIDS and physical therapy can assist you in relieving your pain, restore your range of motion and strengthen areas of deficiency.  Determination of the cause and possible risk factors in suffering a rotator cuff injury will guide your treatment with the goal of preventing future injuries.

Effectively preventing rotator cuff injuries begins with proper flexibility and balanced strength.  Scapular strengthening of the mid and upper back muscles can ensure proper posture and subsequently optimal mechanical set-up of the shoulder prior to any movement at all.  Such simple exercises may be done with the resistance of therapeutic rubber bands in standing or light weights while on your stomach.  Internal and external rotation strengthening with the elbow tight to your side will effectively strengthen not only the muscles of the rotator cuff, but also the front of the shoulder and your scapular stabilizers.  Additionally, stretching and resistance training overhead are vital to balanced flexibility and strength.  Be sure to seek the advice of a professional to assure proper mechanics as poor mechanics may actually create a rotator cuff injury, not prevent it.

If you or someone you know suffers from acute or chronic shoulder pain, it is ill-advised to begin a new exercise program, or return to sports without consulting with your physician, physical therapist, physiatrist or other specialist who regularly treats shoulder pain. It is important to first get an accurate diagnosis for the cause of pain, as the specific exercises recommended will depend on the cause and degree of the injury.

James Markwica, MS PT is a New York State Licensed Physical Therapist at LaMarco Physical Therapy, 417 Geyser Road in Ballston Spa and 538 Maple Ave in Saratoga Springs.  For questions or follow-up, contact James at 587-3256 or online at www.lamarcopt.com.