By Marc Forrest, PT, DPT, MS, OCS
Poor posture is a common but frequently overlooked component of chronic neck and back pain in patients of all ages, a problem that has significantly increased during the COVID-19 pandemic.
In many of these cases, physical therapy can be a powerful weapon to strengthen muscle groups that support and stabilize the spine, which can relieve muscle tightness and increase range of motion.
The pandemic has had a significant impact on the daily habits of youth and adults, much of it negative in terms of posture.
Children and teenagers have spent more time inside at home and glued to their cell phones, tablets, laptops and gaming systems in place of school and free-time activities, including organized sports and outdoor group play.
Many adults, meanwhile, had to leave their offices to work at home. They traded ergonomic chairs and spine-friendly equipment such as adjustable or standing desks for couches or kitchen tables where they perched with their laptops.
All age groups, then, have tended to sit in awkward, hunched positions, with their shoulders and backs rounded and their heads tipped forward.
Normal posture – ears directly above the shoulders, eyes straight ahead, shoulders back, chest open, back straight – keeps the head’s weight naturally balanced on the spine and maintains the normal lordotic curvature of the spine.
Many patients now are dealing with pain linked to muscle tightness, including in the pectoral, upper trapezius and hip flexors; weakness in the abdominal, hip and gluteal muscles; nerve impingements; and decreased range of motion.
Thankfully, physical therapy exercises and fixing bad posture habits can be a relatively easy fix for nagging discomfort. Patients may be able to learn these corrective measures in as few as one or two in-office sessions, particularly if they’re younger and in overall good health.
For instance, lumbopelvic stabilization and stretching exercises are a gold standard for relieving low back pain. They target deep core muscles that stabilize the lumbar spine, including lumbar extensor, abdominal, oblique and gluteal muscles. Pelvic tilts, arm and leg lifts, curl-ups, planks, and bridge exercises are examples of these movements.
Another simple but important fix is to take regular breaks from sitting. Ideally, people should get up and move at least every hour – and preferably every 30 minutes – as well as perform seated stretches such as chin tucks, shoulder shrugs and spinal rotations.
Additionally, athletes and coaches should be aware that anyone who has taken pandemic-related breaks from sports will need to rebuild stamina and flexibility slowly.
I encourage physicians who see a patient complaining of chronic cervical and lumbar pain to consider a referral to a physical therapist as part of their treatment strategy, especially if they also notice any abnormal spinal curvature.
They should feel confident that most patients will respond well – and often quickly – to this noninvasive approach.
Dr. Forrest is Director of Physical Therapy for Hampton Roads Orthopaedics Spine & Sports Medicine, based in its Newport News office. He also is a Board certified Orthopedic Clinical Specialist. hrosm.com
