Do You Slouch? Physical Therapy Can Help!

Slouching is Common, but…

The other day, my patient who is being treated for mid-back pain came in with her 3 children. The children sat in our Physical Therapy gym with their respective “toys” while mom was being treated by the therapist. Mom explained that the kids off from school and she did not want them to be alone at home.

At our clinic, we love children and encourage parents to bring them whenever possible. These particular children ranged in age from 6 to 13 years and were very well behaved while enjoying their ipad, iphone and books.

As a physical therapist, I am trained to observe and what I saw was that all of the children slouched so much that their heads were almost at the level of their chest.  This can indicate certain underlying problems, so as an experiment I asked them gently to sit up  a little straighter. Interestingly, the younger ones were able to maintain the posture for 10 minutes while the older one complained of mid-back pain immediately upon sitting up straight.

I believe, in this day of computers and video games, slouching has become pretty much an epidemic. As a matter of fact, most people are slouched whether they are sitting, standing or walking. I see the “question mark” posture on a daily basis everywhere I look.  And most individuals are completely unaware of it or don’t realize that it’s a problem.

Slouching is Not Normal and It Creates Long Term Damage

Here is the truth about slouching:

1.       It is a direct correlation to how strong or weak, the spinal or core muscles are. It also indicates whether these muscles are capable of holding the spine in proper alignment. When I say ‘spinal muscles’ I am referring to the muscles lining the spine in the front, back, to the sides and also in-between. These are major postural stabilizers.

2.       Slouching is also related to stiffness and misalignment of the bones of the spine.

3.       Inactivity or poor function of a part of the body can also lead to slouching. This is more prevalent in individuals who work in sitting professions e.g. computer professionals, students etc.

4.       In some cases, young girls or boys learn to slouch early on with the advent of puberty because they are embarrassed by their height or development.

Nevertheless, slouching is detrimental. The mid-back learns very quickly to adapt to the bent posture and the muscles in that region shorten. Once this occurs, the bones and joints in that region tend to get rigid in the bent position resisting any attempt to move or straighten them.

In fact, people feel soreness and pain on trying to sit straight. Chronic slouching leads to poor breathing capacity because the rib cage has a smaller area in which to expand. It is very rare for people who slouch to sustain well on long hikes or endurance based activities.  And as one gets older the mid-back spinal bones tend to start collapsing on top of each other, leading to potential nerve damage and arthritis.

What’s the Solution?

Now, how do we stop this and start inculcating a good habit of sitting straight? It actually needs to be started right at infancy. Young infants should be encouraged to play on their tummy for long periods. Crawling, not only within small distances, but also down long hallways should be encouraged for infants.

As they grow older, pull ups, bar hangs, single leg hopping, and jump rope activities should be emphasized. Good study habits with a proper table and chair are very important. Too often children do their homework or studying sitting at the kitchen counter, coffee table, couch, or bed because it is comfortable. That is not ideal and should be discouraged for long term health.

If slouching persists through adulthood, simple changes as mentioned above may not be enough to treat the problem. One must consult a physical therapist to get a comprehensive evaluation and understanding of all the possible physical impairments associated with adulthood slouching.

X-rays and bone density testing may be requested by the physician to rule out any bone damage. In some patients, traditional physical therapy management with manual therapy and focused exercises may be all that is needed to treat the problem.

Other patients might require a more advanced approach with extensive core training, biofeedback training and traction, in addition to manual work in order to achieve success.

At our physical therapy clinic at HealthNOW, we employ the PneuBack chair (a unique exercise machine using pneumatic pressure for a series of back extension exercises) that works wonders with slouching and other postural dysfunction. We plot the patient’s spinal curve on a graph and use the coordinates to customize an exercise session for the patient. It’s painless and highly effective.

Slouching has practically become an epidemic but we can cause a change with education and good physical therapy treatment. It goes far beyond appearance, slouching actually creates physical problems.

It you or someone you know slouches, feel free to contact me for a free health analysis. We’ll let you know what we can do to assist you.

In health,

Dr Rupa Chakravarty, DPT, OCS
Director of HealthNOW Physical Therapy

Permission is granted to repost this article in its entirety with credit to Dr Rupa Chakravarty & HealthNOW Medical Center and a clickable link back to this page.