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Almost everyone will experience lower back and/or neck pain at some point in their lives, even if just in the form of a slight neck twinge after sleeping in an odd position. Spinal pain of the thoracic region (the upper & middle part of your back) is less common, however you might be surprised to discover how important this part of the body can be when it comes to pain and injury.  What is it?
The thoracic region refers to the part of the spine that is surrounded by the rib cage. It consists of 12 vertebrae with discs that sit between each of them. The thoracic spine isn’t an area that you might associate much with movement, however, this area can account for a surprising amount of flexibility, particularly in rotation. With joint attachments both between each side of the 12 vertebrae and a rib on either side, the thoracic spine has almost more individual joints than you can count. If each of these joints is not regularly moved through their full range they can tighten up and lose flexibility. This stiffness can become quite significant over time. Why is it important? Many people may not even notice this lack of movement, primarily because the neck and lower back provide much more range and can usually compensate for any loss of thoracic flexibility to complete everyday tasks. When there is no movement occurring in the thoracic region, this means that the structures of the joints in other regions are pushed closer to their limits of range, particularly during rotation. This results in more compression and stress on these joints and the structures surrounding them, such as nerves, blood vessels and muscles. Thoracic stiffness can be a significant risk factor for neck and lower back pain. This can also reduce the mobility of the chest wall, which can result in less efficient breathing mechanics and, in extreme cases, even reduced exercise tolerance. Thoracic spine movement is aslo important for normal shoulder function, as well as maintaining good posture. How can physiotherapy help? Your physiotherapist is able to assess your thoracic mobility and help you with treatments to improve your range of motion, both with manual therapy and home exercises. They may even help improve your thoracic flexibility as part of a treatment plan for neck and lower back pain. A posture improvement exercise program is also often required to improve the alignment of your thoracic spine and alleviate joint compression and muscle tightness.
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Most cases of neck pain have a postural component as part of the underlying problem. In such cases, recognising and understanding poor posture can play an important role in finding neck pain relief. Good posture, as it relates to the neck, is commonly considered when the ears are positioned directly above the shoulders with the chest open and shoulders back. In this neutral position, stress on the neck is minimised because the head’s weight is naturally balanced on the cervical spine.  Forward head posture occurs when the neck slants forward, placing the head further in front of the shoulders rather than directly above. This head position can lead to several problems:
The longer that poor posture is continued, such as being hunched over a computer or slouching on the couch, the more likely that neck pain, stiffness, and other symptoms may develop. Long-Term Effects of Forward Head Posture: Over time, forward head posture can put increasing amounts of stress on the neck and other areas of the body. Some long-term effects of forward head posture can include:
In a medically reviewed article from 2021, the website WebMD has listed commonly accepted benefits of having better posture. These are listed below. It also notes... "Our modern lifestyles may contribute to poor posture. Looking down at our phones or sitting at a desk for several hours a day working on a computer changes the way we hold ourselves. You may notice that you are slumped forward when performing these activities, rather than sitting or standing up straight."  Benefits of Good Posture
Good posture isn’t just about how you present yourself. Having poor posture can actually affect your physical and mental health. 1. Better mood and energy. One of the best benefits of good posture is the way that you feel about yourself. Improving your posture can help you stay focused and more energized throughout the day. This can help improve your mood too. Research also suggests that good posture can lead to more self-confidence. When you carry yourself well and feel good about yourself, you’re less likely to experience depressive thoughts. This can give you more self-esteem and a better feeling of pride and confidence in yourself. 2. Bone, joint, and muscle health. As mentioned, your posture depends on your muscles and bones. When you align your spine correctly, you put less stress on your joints and bones. This can lead to less overall pain or reduced chances of developing problems like osteoarthritis. Even though there are tons of exercises out there to help you improve your core muscle strength, doctors say that practicing proper posture is one of the best ways to help tone this muscle group. 3. Better breathing and fewer headaches. When you sit or stand up straight with your shoulders back, you’ll find that it’s easier to breathe. There’s more room to open up your chest for deeper breaths. Practicing poor posture, such as when you’re slouching over, can cause tension in your shoulders and neck. This can lead to headaches in your forehead or the back of your skull. 4. Improved spine and neck health. By practicing proper posture, you help reduce the risk of back and neck pain. Slouching or hunching at a desk can affect the way your spine grows. Back pain is actually one of the most common reasons why people miss work. If your job requires you to stand for long periods of time, standing properly can help you fight back against fatigue and leg pain or cramps. For most of us, screen time and sitting go hand in hand and both are only increasing as our lives move more online. While short periods in any posture aren't harmful, a lack of movement combined with long periods spent in hunched positions can lead to spinal pain, headaches, shoulder pain and more. If you're needing to spend more time in front of a screen, here are a few tips that can help you to keep flexible and avoid pain.  Set movement breaks
Posture in itself isn't always a problem. Spending long periods of time in these postures without taking breaks is the problem. When your body is so used to one position, muscles may become shorter and joints stiffer, making it harder to move out of this posture without pain and discomfort. You can break up your day by setting a timer to move and take a break every 20-30 minutes. Using these short breaks for movement is a great way to both help focus at work and keep your body more flexible. Setup your work and home environment properly Adjusting your work station or setting up a place to relax at home where to you can avoid a hunched posture can help you to reduce time in the same posture. Your physiotherapist can give you tips for how to setup your home and office environment correctly. Take stock of your time spent sitting Time in the car, time on your computer and time on the couch can all quickly add up without you realising. By accounting for the amount of time you spend sitting, you can find more ways to move. For example, if you notice that you're sitting down as soon as you get home, try swapping out watching an episode on TV to going for a walk while listening to a podcast. Ask your physio or posture specialist for specific stretches If you can identify the posture you spend the most time in, your physio or posture specialist can help you to develop a specific exercise and stretching program to counteract these positions most directly and keep you strong and flexible. 1. Don't be a slouch It adds to the stress on your spine. That puts a strain on the bones, muscles, and joints you need to hold your neck and back in place. But poor posture isn't just bad for your back. A constant slump compressess your internal organs and makes it harder for your lungs and digestive system to work. Over time, that’ll make it hard to digest food or get enough air when you breathe.  2. Straighten up
A good path to better posture is to focus on standing tall. You'll feel better and look better. Pretend you’re standing against a wall to measure your height. Hold your head straight and tuck in your chin. Your ears should be over the middle of your shoulders. Stand with your shoulders back, knees straight, and belly tucked in. Straighten up so you feel like your head stretches toward the sky. 3. Don't slump at your desk It's comfortable to slouch, but it’s a posture no-no. Instead, sit all the way back in your chair. Place a small, rolled-up towel or lumbar cushion behind your lower back to protect your spine's natural curve. Bend your knees at a right angle and keep your feet flat on the floor. 4. Beware of "tech neck" On your smartphone a lot? Take a minute to stretch your neck. When you tilt your head down to check messages it really strains your spine. Over the course of a day (or a year!) that can have a big effect. To mix it up, lift the phone up and move your eyes more, not just your head down all the time. 5. Driving posture counts too Again, it's might be comfortable to recline during a long drive, but it isn’t great for your posture. Instead, consider sitting more upright. THave your your knees slightly bent, they should be at hip level or a little above. It's also good to put a pillow or rolled-up towel behind your lower back for support. 6. Save your high heels for special nights out They might look good, but they’re not good for you. High heeled shoes tilt your pelvis forward, which over-arches your lower back. That can put pressure on spinal joints and nerves, which can cause back pain. They also put more weight through your knees. Choose a lower heel for daily wear. 7. Sleep in a better alignment We spend a lot of hours in bed. Choose a firm mattress that helps hold your spine's natural shape. If you're a side sleeper, bend your knees slightly but don't hug them. Your pillow height should keep your head so it's level with your spine. Back sleepers should avoid big pillows and opt for a smaller one. 8. Exercise and keep your weight down Too much belly weight puts added stress on your back by pulling your pelvis forward. You also need strong muscles to support your spine. A well-designed workout plan will keep your body and spine in good shape, and that's really important. Keep your nutrition good too. Forward head posture (FHP) occurs when a person is leaning their head forward, out of neutral alignment with their spine. When the alignment of the head is off, it can cause a variety of problems, including stiffness in the neck, pain, and balance issues. The National Academy of Sports Medicine (NASM) define FHP as holding the head out, in front of its natural position over the cervical spine. A person with FHP also typically tilts their head back in order to look forward. This posture puts a strain on the muscles and bones of the neck. It can also lead to muscle imbalances, as some muscles support more of the load than others. According to a 2014 study, the forward position of the head puts increasing amounts of weight pressure on the spine.  People often associate FHP with using electronic devices for a long time, such as mobile phones or computers. However, any activity that causes a person to lean their head forward for a prolonged period of time can lead to chronic FHP.
Some other potential causes of FHP include:
Prevention If a person sits at a desk for long periods of time, they should focus on maintaining proper posture. This includes:
Given that FHP results in a combination of some tight muscles groups, along with some underacyive, or weak muscles, the best corrective or prevntative program you can do is a series of stretching and strengthening exercises. This will help to correct your muscle imbalances around your neck, shoulders and upper back, which will then make it much easier for you to stay in a better alignment, or posture. For more specific information on which exercises are best for you, and indeed whether you actually have FHP, it's best to contact your posture specialist or physiotherapist. Correct posture and alignment, especially while sitting for prolonged periods, is essential for office workers in order to prevent work related pain and injuries. Admittedly, most of us sit with poor posture at some point, but when a person has to adopt their sitting position for long periods of time, often day in and day out, poor health issues can result.  Some consequences of prolonged incorrect sitting posture…
- Headaches - Neck pain and spasm - Interscapular/thoracic pain and stiffness - Lower back pain - Muscular tension throughout the shoulder girdle - Wrist, forearm or elbow pain - Potential for lumbar disc irritation/bulging What to do about it… Many people admit they know they have poor posture, but don’t know what to do about it. This is where education becomes crucial. Correct workstation setup is very simple to teach and the most effective preventative tool we have in helping people avoid the above potentially disabling problems. At Perth Posture Centre we are well trained and experienced in educating patients about workstation setup, postural corrective exercises and manual therapy that will alleviate any problems that may have arisen from poor office work habits. We use a combination of soft tissue massage, trigger point release, spinal mobilisation, dry needling (acupuncture) and exercises to stretch and strengthen anti-gravity muscles as well as improving alignment when we are faced with these workers. As usual, early detection and referral for treatment is the key. Are you guilty of having poor posture while reading this blog post? If so, you may be suffering from a modern day health challenge called “tech neck.” Poor posture while utilising technology is a very common factor contributing to poor postural design. Technology is recognized as one of the principle causes of the modern day posture epidemic. Poor posture due to looking down at a mobile phone is so common that a new diagnosis has been created to explain the phenomenon, and that is “tech neck.”  Do you suffer from headaches, neck pain, shoulder tightness or fatigue?
If you do, it could be due to your posture while using technology. Repetitive stresses from checking your mobile phone with improper posture or having slouched posture at work on your computer can have a tremendous impact on your posture and your health. The impact of proper posture is far beyond the musculoskeletal system. Consider the following research studies showing that forward head posture has a negative impact on your health. Did you know…?
Instead of looking down while sending a text message, checking your email or social media, raise your phone to eye level to avoid excessive strain to your neck and upper back. Also, be sure that when using a computer your screen is close enough where you can see it clearly without jutting your head forward, as well as having it at the correct height so you're not looking down to see the viewing area. For proper posture while using technology, consider the following posture tips to re-train poor posture habits.
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