We have all heard the saying “sit up straight” and we have all experienced that it’s not that easy. Posture is influenced by many factors such as our work, our daily habits, our exercise and the aging process. Imbalances often result from long-term compensation patterns and adaptations. Physical changes occur to the body’s anatomy and functional dynamics, often increasing the risk of pain and injury. However, prevention and early treatment in the form of posture education may be the perfect prescription.
For example, let’s examine the underlying reasons for the “rounded shoulder” posture that is observed in up to 70 percent of the population. Primarily an imbalance exists between the overused pushing and the underused pulling muscles, affecting the healthy positioning of the shoulder joint. The shoulders roll forward; motion becomes limited and shoulder shrugging increases. This leads to a tight chest and upper shoulder muscles, weak mid and lower back muscles, and a multitude of other anatomical deviations.
There may be no indication that these imbalances are problematic for years or maybe ever. However, the likelihood of developing pain is increased. Pain may occur from sore muscles or tension in the neck and upper back. It may occur from a shoulder impingement syndrome that developed for no apparent reason. Or even more concerning, pain may occur from an injury, such as a rotator cuff tear, that happened while taking luggage out of the car or moving a piece of furniture.
Recently, the importance of healthy posture has gained impressive recognition, especially in the medical industry. As healthcare is changing, providers are paying considerable attention to both outcomes and the cost of treatments. Just as diabetes management needs to be treated with proper diet, not just medication, shoulder pain needs to be treated comprehensively – not just with an injection or a surgery. Healthcare specialists have a responsibility to provide solutions, not just band-aids. And that is what patients are demanding as well.
Employers are one of those groups hardest hit by the additional costs of healthcare, which is rising by 15-25 percent per year. The increasing incidence of musculoskeletal disorders and their mismanagement severely burden the system. Included are such problems as nerve impingements, tendonitis, sprains, strains, low back, shoulder and neck pain. Over half of absenteeism from work and half of healthcare expenditures are due to musculoskeletal disorders. These “disorders” often respond well to patients’ proper early management and behavioral changes, but the truth of the matter is that most people know more about the workings of a cell phone than their own bodies.
As a practicing therapist, I have learned that doing is motivated by understanding. For an individual to include something new in their daily schedule or routine, they often need to understand the reason why. For example, deep breathing can help alleviate low back pain because of stabilizing fibers that attach the diaphragm to the lumbar spine. And tight upper chest muscles caused by sitting and forward reaching with many daily activities, negatively affects shoulder position, the ability to breathe deeply and the glide of the nerves that run underneath. Understanding these concepts may convince a patient of the importance of deep breathing and pectoral stretching exercises. Learning that the source of our problems may not just be our desk jobs, or driving all day, or repetitive activity can facilitate purposeful change. Sedentary lifestyles, poor habits and failure to implement proper early intervention when discomfort arises are risk factors that need to be addressed.
Take the example of a female medical sales representative in her early forties. She spends her days in meetings, luncheons, driving, and on her cell phone. She is slim and active outside of work, running or doing spin class several times a week, as well as yoga on a regular basis. She takes vitamins and eats healthy. However, she was suffering from neck pain, headaches and frequently woke up with numbness in both her hands and arms. She was worried that she may have to take time off work and even more concerned that surgery would be required.
This is a difficult “diagnosis” to address for a treating physician. The risk factors are negligible, the symptoms are non-specific, and an effective treatment plan is not necessarily apparent. However, with a postural assessment and training to stretch what was tight, strengthen what was weak and improve her daily work positions, her symptoms faded away in four weeks. Expensive testing such as X-rays, MRIs and nerve conduction studies were avoided and she is satisfied with her recovery.
Methods of treatment can and should be used as methods of prevention. The workplace is an excellent venue to provide this information. For employers, the benefits of healthy employees are abundant. Wellness education programs decrease healthcare costs and workers compensations claims while increasing productivity and workplace morale. Also, money for healthcare is limited in today’s economy and medical professionals are being called on for answers. Workplace health education may currently be perceived as a luxury, but it is a valuable part of the solution. Programs to improve weight management, nutrition, and heart health are on the rise. There is much that can be done to address the musculoskeletal injury epidemic, and trusted medical professionals are just the ones to advocate for the value of education, prevention and wellness.
Raina Trevenna, OTR/L, CHT is the founder of Designing Wellness, which specializes in affordable workplace wellness and musculoskeletal injury prevention. She has more than 15 years of experience as an Occupational Therapist and has multiple certifications in her field. She can be reached at firstname.lastname@example.org.