700 Children's® – A Blog by Pediatric Experts

Poor Posture: Fixing It Before It Becomes a Problem

Jun 25, 2020
Child with posture

Mom always told me, “Stand up straight!” As usual, she was right!

Our posture and alignment are extremely important to our bodies and how they work. Our muscles have a starting point, are attached at a particular place, and are specifically angled in order to work properly. If we slump forward, slouch and have our shoulders rounded forward these muscles will suffer.

This can lead to what would otherwise be preventable shoulder injuries. The shoulder joint is classified as a ball and socket type, like our hip, but nowhere near as stable. The hip has a deep socket and a lot of muscle built around it, making it very stable. The shoulder, on the other hand, not so much. 

The Shoulder Joint

While technically a ‘ball-and-socket’, the shoulder joint is a lot more like a bowling ball sitting on a golf tee. This gives our shoulder an incredible range of motion and allows us to be able to do things like pitching in softball and baseball, swimming, dance and gymnastics - the downside is, it is the most unstable joint in the human body. You can windmill your arm in complete circles; you can’t do that with your hips.

The socket of the shoulder is the end of your shoulder blade, and the shoulder blade floats on a large slab of muscle on the back of your ribs. The collarbone is the only bony connection of the shoulder blade, and your entire arm, to the rest of your skeleton. The muscles that hold our shoulder blade stable, which are also major players in our posture, are incredibly important.

Overuse Injuries

If we don’t use our muscles correctly they won’t work properly; this will lead to bad patterns in a joint that needs to be held as stable as possible. It can cause tendonitis, impingement, or pinching of tissues, and lead to a host of overuse injuries and pain will cause the muscles to shut down even more. 

If you have ever sprained your ankle, you start to limp as your muscles try to keep you from walking. I explain this to my patients as ‘The Turtle Effect’. If you scare a turtle, it retreats into its shell. If you insult a muscle, it will also ‘retreat’, or not deliver the flexibility, or range of motion and stability it is supposed to. 

This creates a snowball effect of ever-worsening issues. Whether it all started with bad posture, or an injury - even a minor one - or the combination of an injury on an already unstable system, now we can get into a loop that can be hard to correct without formal therapy and exercise.

Humans are a front-dominant species; we drive, cook, bat and throw, in the front. Because of this, we tend to have unbalanced muscles. Another culprit is technology. The human head weighs 10-12 lbs.  But, tilting your head down 15 degrees puts 27 lbs. of force on the neck, and looking all the way down at our phones (about 60 degrees) equals 60 lbs. of torque!  That adds stress to our whole neck and shoulder system.

Our chest muscles get tight, our upper back muscles, that are supposed to center and control the shoulder blades, are weaker in comparison. This leads to that forward, hunched-shoulder look. Stretching the chest muscles, strengthening the back and disciplining ourselves to ‘stand up straight’ goes a long way. 

Assessing Posture

You can easily assess a person’s posture by having them stand and look straight ahead. Viewing them from the side, you should see four points in a straight vertical line - the ear, the tip of the shoulder, and the edge of the thigh bone at the hip and the ankle bone. If the pattern zig-zags, they are out of line.

So, kids, listen to your mothers.  Stand up straight!

Sports Medicine at Nationwide Children's Hospital
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Nationwide Children's Hospital Medical Professional
Eric Leighton, AT, ATC
Sports Medicine

Eric Leighton is the lead athletic trainer for Functional Rehab at Nationwide Children's Hospital Sports Medicine. He is also the lead of the Performing Arts Medicine section within Sports Medicine. Eric has treating patients for over 20 years with a focus on performing arts athletes and dancers.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.