Posture is something that a lot of health professionals address with patients who come in for neck pain. Those of you who have been to a physiotherapist, would have a bit more knowledge about posture and biomechanics of the back and neck. However, the way our society is progressing, with the development of technology and the resultant jobs that are produced from technology, our occupations are becoming more sedentary. I believe the result of this is that physiotherapists are now dealing with a lot more postural issues throughout the age spectrum.

Children have access to iPads and computers from an early age, at school and at home. Prolonged periods of sitting at computers, using iPads/iPhones and other iGadgets can cause a great strain on the neck and back (especially if slouching), muscles and spine. Not only is it the use of these technologies, and our sedentary occupations, it is also a lack of awareness/knowledge about posture and the correct way to be sitting and standing. Many companies now have policies in the workplace to address these issues. However, I feel there is still a huge percentage of our population who do not know the basics of correct posture.

NECK POSTURE:

Poor neck posture can be characterised by:
• Slouched upper back (thoracic kyphosis)
• The chin sticking out (chin protrusion)
• Increased curvature/extension of the neck (increased cervical lordosis)
• Rounded shoulders (protracted shoulders)

Symptoms include but not limited to:
• Burning/aching pain on the musculature of the neck base of the skull, across the shoulders, and in the upper back
• Worsening pain with sustaining a position for a period of time (sitting, standing, driving, cycling, etc.)
• Pain can be alleviated with movement or changing position
• Stiffness in the neck and upper back
• Tightness with shoulder movements
• Headaches

There are many different approaches that are used to treat pain caused by poor posture. Preventative measures also can be put into place to avoid the production of pain. Your Physiotherapist will conduct a subjective and objective assessment to confirm the diagnosis and provide treatment and advice relevant to your individual needs.

Treatment can consist of, but not limited to:
• Education on posture and how to correct/retrain
• Prescribe exercises to improve strength, flexibility and stability
• Manual therapy in the form of massage, mobilisations, manipulations, etc.
• Electrotherapy (ultrasound for example)
• Dry needling
• Taping or bracing
• Ergonomic assessment and/or advice
• Activity modification
• Biomechanical correction
• Lumbar rolls, air cushions, (and other aides depending on your individual needs)
• Clinical Pilates

The prognosis for pain caused by poor posture is great (depending on patient compliance, as well). So if you feel you have poor posture that you would like to get help with, please contact our clinic on 47 233 552.

Reference:
Brukner, Peter., & Khan, Karim. (2012). Clinical Sports Medicine. NSW, Australia: McGraw –Hill Australia

Do you get pain when lifting your arm above your head or to the side? Is it uncomfortable to reach behind your back? Are you unable to lie on your affected shoulder when sleeping? These are signs that you may have impingement of your shoulder!

Shoulder and upper arm pain is one of the most common presentations we see as physiotherapists. This is due to the shoulder being one of the most moveable joints in the body.

A quick bit of shoulder anatomy!
The shoulder is made up of the head of the humerus (i.e. the top of the upper arm bone) and a shallow groove on the outside of the shoulder blade. This is what makes up the shoulder joint. Above the shoulder joint there is another bone which comes off the shoulder blade called the acromion. The area between the shoulder joint and the acromion is called the subacromial space, and there are various structures which run through this space including one of the rotator cuff tendons (the group of muscles that hold the shoulder in its socket) and a bursa (a small fluid sac which cushions the rotator cuff tendon). When we raise our arm up or to the side, the subacromial space narrows, however there is still room for the tendons and bursa. This is not the case with shoulder impingement.

What is shoulder impingement?
Shoulder impingement is where there is pinching of the rotator cuff tendon or bursa between the shoulder joint and the acromion. This is what causes your pain when lifting your arm up. Shoulder impingement is not a condition, rather a consequence of another underlying problem.

Things that can cause shoulder impingement include:
– Problems with your rotator cuff muscles, such as weakness, a tear or general overuse
– Weakness of the muscles that control your shoulder blade, which can alter how your shoulder works
– Tightness of the muscles around your shoulder and shoulder blade
– Instability of your shoulder (i.e. the ligaments around your shoulder are stretched which results in you having more movement than normal)
– Poor posture (i.e. having a slouched upper back or your chin poking forward)

Things you can do to help:
– Try to limit the stress on the rotator cuff tendons. You can do this by avoiding any activities or movements which cause your shoulder pain. This will allow the tendons to heal.
– See your physiotherapist! Because there are various factors which can cause impingement, it is important to identify the exact cause which is resulting in your pain. A physiotherapist will be able to do a thorough assessment to identify these dysfunctions, and will then be able to treat the cause of the impingement.