Posture changes are expected to occur over time. Our daily habits, muscle tension, injury guarding, and even how we use technology, can all affect our posture.
Tuning in to our posture is something we may not actively do, so when posture changes are not recognised it can create issues, including headaches, breathing issues, and neck pain. For women, pregnancy, menopause, and breast changes can affect posture, making posture management a form of good fitness and an important aspect for women to consider when understanding and focusing on their health and wellbeing.
“The images of women getting smaller as time goes on really, really wind me up,” says Siobhán O’Donovan, a chartered physiotherapist specialising in musculoskeletal physiotherapy. While she recognises that there are hormonal changes that affect our bone density and vertebral height, there are things that can be done to offset and reduce this.
“Yes, there will be some compression of disc height over time which will decrease overall height,” she says, “but the relative amount of that potential difference is not what we see in many women.
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“Poorly supported breast weight increases our likelihood of ‘getting smaller’ as time goes on. During pregnancy, the bump weight and unrecognised increased breast weight, can result in women adopting a posture where they lean back into their lower back, increasing the chances of developing low back or pelvic girdle pain during or after their pregnancy.”
How a woman’s posture changes over time is dependent on how she allows it to change against the natural instinct of gravity without postural management. “If we constantly give in to gravity, we lose the wave-like shape of our spine – the slight curve in at the top or neck area, out in the middle or middle upper back area, and in at the lower back – and it can look more like a reverse C shape,” says O’Donovan. This is when the head is forward of the body and reverses the curve inward with the midback curve increasing or looking like it is going further backward, and the low back curve also reversing its shape.
“There are definitely things that can be done to improve posture,” says O’Donovan, “but these methods will be individual to each person’s existing situation. You ideally need to identify your individual alignment to see whether there may be any benefit to you in changing it.”
When an issue occurs, O’Donovan advises that attempting to fix one part of the body in isolation can be counterintuitive. “Like the song goes,” she says, “‘the knee bone connects to the thigh bone’, so what happens at your feet can ultimately affect your head position. We begin at the feet and work our way up the body. I like the concept of body parts being stacked over each other, as this will minimise the gravitational pull of body parts that lie outside the imaginary line within the stack.”
To understand the idea of the stacked position, O’Donovan explains that ideally, the aim is to have the hips and pelvis over the ankles with the shoulder and rib cage over the hips and pelvis and the head over the centre of the rib cage. In reality, without support we are unlikely to be aware of stacking or how to actively pursue this optimal posture.
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“For me, postural correction is about getting people to think more about coming back from the ‘outside the stack’ position towards their best version of stacked,” says O’Donovan. “We absolutely do not advocate a ramrod military-style rigidity, as that in turn can create a fear of movement, which we definitely don’t want.”
As a person ages, common changes include the shoulders moving forward, the back becoming more rounded, the body shortening, and the bustline dropping. However, O’Donovan reminds us that “common” does not mean inevitable and that we can only do the best we can when it comes to managing our posture.
“Joints respond to the position they are held in,” O’Donovan says, “so for example someone whose head has been in a position that is forward of their spine for a long time won’t necessarily be immediately able to bring their head back on the top of their spine.
“The joints will potentially have become stiff due to the more limited range of movement available to them in that position, with surrounding muscles adapting to the position by shortening in some instances and lengthening in others. Repetitive coaxing and gentle persuasion will be required to regain movement so that both joints and muscles can change from that learned state to a new one.”
Posture management throughout a woman’s varying life-stages can improve mobility, boost confidence and energy and reduced risk of injury. O’Donovan is an advocate for supporting women in appropriate posture management. She designed and set up PostureFitting, a physiotherapy system combining the postural aspect of supporting breast weight with the passive element of bra fitting. “This combination is unique, previously offered in neither the physiotherapy nor the lingerie worlds, as each stay within their own area of expertise,” says O’Donovan.
“Postural awareness and bra-fitting will individually improve posture, but bra-fitting will only create a temporary improvement. Postural awareness on its own changes the position of the breast relative to the floor but does not move them upwards on the chest wall itself.”
O’Donovan works with women and girls of all ages and life stages to educate, empower, and enlighten them on how to be able to support their breast weight. “We help women to turn their dipped headlights to full beam, with minimum effort,” she says. “Breasts change over our lifetime, and this is information that all women should know. I am often asked how often women should get fitted for a bra, and my answer is always daily, via DIY. We teach techniques to help you to adjust your bra daily based on whatever hormonal changes your breasts are undergoing, be that within your menstrual cycle, or due to the fluctuations pregnancy and menopause can bring.”
Correcting posture is dependent on how often a person carries out their postural cues instead of ignoring them, how often and how far the body deviates from the ideal stacked position, how accessible movement is and how a person can avoid placing themselves in negative postural positions such as slouching.
Advice for maintaining an optimal posture:
- “Be aware of the concept of stacking,” O’Donovan says. “This helps to prevent not only musculoskeletal issues, but it also helps us to function better in terms of breathing, pelvic floor, and mood.”
- O’Donovan recommends avoiding staying in any one posture for too long. “Our spines and hips and shoulders like to move, and we should therefore do that as much as possible.”
- “Getting into optimal posture, little and often, will help to strengthen the supporting back muscles which will then facilitate getting into, rather than falling out of, optimal posture more often and for longer,” she says. “This in turn results in the muscles adapting to that position which is a hugely positive cycle.”
