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  • Writer's pictureMary Brooking

Painful posture?

Poor posture can develop gradually but if we lack the core strength and stability to control our posture, and therefore our movements, the forces that daily life loads onto our bodies can begin to cause pain and difficulty with everyday tasks and activities, which may become a vicious cycle.

How does poor posture become reinforcing?

Core stability muscles, or postural muscles, are the deep muscles in your abdomen, pelvis, hips and back which act as scaffolding holding you together.

Postural muscles are designed to be switched on and used for long periods of time and so are naturally fatigue resistant, however they only work properly if the body is in a good posture. If not, a vicious cycle often develops where lack of use due to poor posture, inactivity or injury leads to the core muscles becoming less used, less efficient and therefore more difficult to activate.

Their opposing muscles, which do the opposite action, compensate by becoming overactive, shorter and tighter as a result of working harder and for longer than they are designed to. This results in patterns of short, tight muscles and long, weak muscles though the core, neck, back and pelvis which in turn can often leads to compensation effects through shoulders and hips.

How does poor posture impact us?

Imbalances arise around joints as postural muscles, which have become weakened and lengthened are out of balance with their opposing muscles, causing pain and joint stress.

Weak postural muscles result in reduced balance and co-ordination, meaning more effort is required to retain balance, causing fatigue which often reinforces poor posture, and therefore further weakening of postural muscles as well as increasing accident risk.

Ischaemic muscle pain, spasms and trigger points are frequently experienced in these short, tight muscles as a result of a lack of blood flow, inhibited by their state of constant activation. Short, tight muscles can also begin to press on and irritate nerves resulting in nerve pain related issues through shoulders, hips, arms and legs.

Breathing and digestion can also be affected by poor posture as altered body shape means organs and systems are compressed and inhibited.

So what is good posture?


  • Weight is evenly distributed across foot (or centred on mid-foot) and balanced equally between both feet

  • Knees very slightly bent, not locked back straight

  • Hips should be neutral, if your pelvis was a bucket no water would be coming out of the back or the front

  • Natural spine – avoid a feeling of hunching, extension or reaching

  • Core should feel active and engaged

  • Shoulders should be drawn down and back, having the palms of your hands facing forwards can help find this feeling

  • Center your head on the shoulders, ears in line with middle of the shoulders

  • Chin should not be up or down, but level and shouldn’t be poked forward

  • Keep the eyes forward


  • Sit with your weight equal on both sides/cheeks of your bottom, well back in seat and feet flat on floor.

  • Sit with your hips, knees and ankles at right angles, thighs level with knees. Don’t have your knees higher than your hips (a common driving or sofa position) or much lower than your hips.

  • Sit with a curve in your low back (see picture) as this allows the pelvis to sit directly under the points of your shoulders so you sit on the bony points of your bottom.

  • Keep the shoulders relaxed, down and back

  • Keep the head in midline, on top of and in line with the shoulders, don’t reach forward from the neck and keep the chin level and tucked in, not poked forward.

None of us can maintain this correct upright posture unsupported for long periods of time, so it is important that the furniture you are sitting on supports your spinal curves, be that at your desk, in your car or on the sofa at home.


As when you are sitting and standing, you are aiming to keep the 'spine in line' when lying down. The role of the mattress and pillows is to help support the natural curves in your spine. Avoid too many pillows under your head when lying on your back or side, as this can push your head up straining muscles and joints in your neck. Ideally your pillow should only be under your head, not under the shoulder as well. The pillow should fill the gap between your head and shoulder, keeping your head in line with your spine. This creates the least amount of strain.

How can we regain good posture?

Simple changes in posture can be beneficial and these can be incorporated into everyday activities. Changes are best practised little and often - try re-setting your posture using the guidelines above every time you make a cup of tea, every time you leave your home or every time you sit down.

Use this technique to help you find and feel your standing neutral spine, the basis not just for good standing posture but for every kind of activity.

Exercise, Strength & Mobility

Our posture reflects our core strength, our mobility and our habits. Poor posture in daily life means we move a certain way, which then transfers to how we run, ride or participate in any activity. Above we’ve given some tips about how to change your daily posture but to maintain these changes we need strength to give us the ability to control our posture through core stability. Strength training to build core stability, combined with increasing mobility in the shoulders, hips and ankles, result in better postural control and therefore movement patterns in any exercise that are both powerful and robust.

Posture is not a detail when it comes to running, its one of the most important aspects of running form; it helps prevents injuries, and can make you faster. Poor postural alignment often shifts the propulsion of running from the powerful, fatigue resistant glutes & hip muscles to the less fatigue resistant & less efficient muscles around the knees meaning our muscles have to work harder. It can also mean our feet land too far in front of our body, increasing the stress placed on our body with each footfall and increasing the likelihood of an injury caused by tissues being overloaded.

In cycling a strong core is essential to counteract the tendency to rest on the saddle and the handlebars with a hunched lower back and little muscular involvement which leads to lower back and gluteal muscles, permanently on stretch, lengthening, stiffening and losing efficiency, resulting often in both lower back pain and less power output. Yes, a strength session means less time running or riding but the benefits that two 15 to 30 minute strength sessions a week will bring to both performance and injury risk reduction are considerable. How does sports massage help?

Sports massage is effective at reducing ischaemic muscle pain caused by poor posture because massage can release the tight muscles that cause the constriction and restore proper flow of oxygen and nutrients to the muscle. However this reduction is not permanent and without a postural change the ischaemic pain will return. A longer term benefit of sports massage is therefore help identifying postural issues and a personalised plan towards postural improvement including posture re-setting and targeted strength & mobility exercises. The pain relief that comes from massages can provide a very helpful window to start making these changes so a positive cycle can replace the previous negative one.

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