No posture is perfect

This is not medical advice.

I keep seeing posts on Reddit where people are taking pictures of their posture, and posting it. Is it good, bad, pelvis or collarbones tilted? Uneven?

I think this is partially a generational question. Younger people are more concerned with appearance, and tech savvy enough to quickly upload pictures to social media, while blindfolded, hands tied behind their back. Not saying it’s wrong. Getting help early can save a lot of pain and trouble later. Older generations, on average, are less concerned with appearance. Poor posture can be related to future pain and dysfunction.

In older generations, I’ve that people who stop laying on their stomach, have an increased chance of stooping forward. Prevention means more here. Once you lose that tolerance for lying on your stomach, it’s is very difficult to get back. People will tell me they just can’t do it anymore, whether it be stomach or back issues.

To start, it would probably be more accurate to say that no posture is perfect. In bodybuilding, the goal is to have perfect symmetry. In rehab, we know that there is going to be a stronger side. It would be abnormal to have perfect strength symmetry. We expect maybe a 10% discrepancy in strength between sides. After that it may be weakness associated with injury.

There are uneven forces in our environment. When we drive, we open car doors with the left arm. Sitting, our right pelvis is tilted forward as we reach the gas pedal. There are many examples of unevenness throughout the day.

When we see an amputee or stroke patient, we don’t go easy on the strong side to try and “even things out.” We try to make both sides as strong as possible. That’s more likely to improve function and symmetry.

There are even some aggressive weightlifting protocols, that specifically call for heavy one sided carries and deadlifts. They will only lift with one side of the body on that day, and pick another day for the other side. Sounds crazy, and very difficult for most fitness people to even consider. The theory is that increased stress and force on one side of the body will elicit a greater hormonal response, i.e., greater muscle building stimulus.

That’s an aggressive weightlifting protocol. In rehab it has been proven that working out one side will benefit the non exercised side, to a degree. Ideally we would always want a limb to be exercised, but sometimes that’s not possible.

If we fracture a leg, we may not be able to exercise it directly in the beginning. Research found that exercising the other leg in the meantime, still cut down on the affected sides’ atrophy (muscle loss). How much is a direct relationship I’m not sure is proven. One can argue that exercise response from the normal limb still elicits hormonal responses in the body, which are systemic.

It can be difficult to say what a “normal” neck and lower back posture is. In rehab we are making a subjective call on what is excessive. I’ve looked at thousands of postures, and am subjectively comparing past experience. Pain or discomfort is usually associated with what we think is the excessive curve or posture.

Lower extremity postures are the same. Some people are flat footed, knock kneed, hips drop, ext.

The long term answer to fix all these issues?

You guessed it, my sorry old trope about strengthening. Get to work.