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Is poor posture causing your back pain?

LiveMint logoLiveMint 29-05-2017 Sohini Sen

When he was growing up, Vijay Rudraraju used to play tennis and cricket. In 2008, during one of his tennis sessions, the Bengaluru-based 44-year-old felt a pain in the shoulders while lifting the racket. The pain increased gradually, and within a few days he couldn’t move his hands above the shoulder without crying out in pain. He tried out various therapies—from acupuncture to yoga, Kerala Ayurveda to physical therapy. Nothing worked.

An MRI scan led to a diagnosis of spondylitis and surgery was recommended.

“I didn’t want to go in for surgery, yet the pain had increased so much that I could not sleep for more than 3 hours at a stretch. I would wake up feeling giddy and unless I did physiotherapy daily, the pain would return,’ says Rudraraju, a senior director with Ericsson.

At 6ft, Rudraraju is a tall man, so as a young teen he began slouching to fit in. This may not have been a problem at the time, but with age, he has realized his neck muscles cannot support the slouch any longer. In 2016, he read about the Gokhale method which uses everyday exercises to correct bad posture and decided to give it a shot. He attended a month-long course, chose exercises that would help him correct his posture and tried to include them in his routine. In the last one year, he says the pain has decreased and he is more conscious of the way he sits, stands or even sleeps.

The side effects

Bad posture is not unique to Rudraraju. Most of us have grown up hearing reminders about sitting straight, not slouching while reading, etc. At first glance, bad posture only means a bend in the spinal cord, but it can actually lead to a variety of serious health issues, including back pain, indigestion, even breathing problems.

“Poor posture affects the ‘nuts and bolts’ of your body—the muscles, joints, the entire anatomical structure. For example, if you have hunched shoulders and tight pectoral muscles, that makes it difficult for the lungs to expand. Your breathing is compromised and you become more susceptible to upper respiratory tract disorders,” explains Esther Gokhale, posture expert and founder of the Gokhale method.

Gokhale is quick to point out the several “mistakes” that can lead to bad posture and, in turn, health problems: tucking the pelvis in, trying to sit too straight by actually making an arch with the backbone, and pulling the neck too forward while working in front of the computer—the list is quite long.

Nearly 70-80% of the people who complain of back pain actually find that the fault is in their posture, says Tejas Upasani, joint replacement surgeon at the Upasani Hospital in Mumbai. He adds that “changing lifestyles, work that involves sitting for long hours, people looking into their cellphones all the time—small things like these impact posture more than we realize. Ideally, it should be corrected by adolescence, because after that there is only a partial correction”.

The way out

Doctors will be able to tell patients if the root cause is bad posture once they rule out injury or nerve entrapment (which can happen if a nerve is trapped due to direct pressure on it). “With a bad posture, your back muscles are likely to be weak. This can lead to injury if you try to lift something heavy, make you giddy if you bend forward, or make it difficult for you to walk long distances,” says Ameet Pispati, consultant orthopaedic surgeon at the Jaslok Hospital and Research Centre in Mumbai. Dr Pispati usually recommends a three- to six-month postural correction programme with physical therapists to patients with a bad posture. However, the time it takes to correct posture can increase with age.

Take, for example, 27-year-old Gaurav Sonawane, a marketing and business developer and former professional dancer. Sonawane, who used to dance with Shiamak Davar’s Institute for the Performing Arts in Mumbai, felt pain in the lower back in 2012. The doctor told him the constant exertion and movement had taken a toll and a gap had appeared between his vertebral joints. “I could not stand for 15-20 seconds at a stretch, let alone go back on stage. After a year and-a half of physical therapy, the pain has decreased a lot, but it needs constant work,” says Sonawane.

His physical therapist would help him stretch and massage his back for the first two-three months. He was then taught the Alexander Technique—a type of physiotherapy that helps get rid of tension in muscles. The exercises uses the body weight to stretch, strengthen and relax tensed muscles. Sonawane has recently returned to dancing as a hobby, and uses the Alexander Technique to warm up for his routines.

Whether it is yoga stretching asanas, or the Gokhale method or the Alexander Technique—posture correction requires constant effort and can take a long time (anything from three months to several years). But the benefits are long-lasting, as Sonawane and Rudraraju have discovered.

“The ‘unlearning’ was a challenge. I had to remember to walk in a certain way, use my laptop in a particular style, roll my shoulders every 2 hours, etc. But then it is a conscious choice you have to make, and the choice becomes easier when you know the pain will come back if you do not,” says Rudraraju.

Gaurav Sonawane practices the Alexander technique daily. Photo: Abhijit Bhatlekar/Mint

Preventive measures

The way we perform daily activities can affect our posture

While carrying backpacks

Most children sling their bags on one shoulder. This puts undue stress on one side, leading to soreness later on. Reducing the weight of the bag and using both the straps to carry it is a useful precaution, says Vijaya Baskar, a physiotherapist at Nightingales Home Health Services, Mumbai. 

While sitting

Most people tend to slouch a bit while sitting in a car. “The car seat design hardly helps to keep your posture in check. Roll or fold a towel and place it horizontally on your seat. The more curved your seat is, the thicker the rolled towel should be,” says Esther Gokhale.

Office chairs, with their poorly designed ergonomics, don’t help either. Tejas Upasani says, “The backrest and armrests of chairs should be used. While in office, also place a footstool, or place your feet on the ground. This will decrease the strain on your back, arms and feet”.

While in office

Many of us keep our laptops on the desk and then have to keep our necks slightly tilted to look at the screen. Keep the monitor just slightly lower than eye level to reduce stress on the neck. “The back of your wrists should be flat or slightly arched backwards to prevent Carpal tunnel syndrome. Even the monitor brightness or desk lamp can affect your posture. A light which is too bright can cause you to pull your neck back, to increase the distance between the light source and eyes,” advises Dr Baskar.

While sleeping

You will notice that while sleeping on your side, the upper shoulder often rolls forward. This stresses the upper thoracic spine and reinforces the bad habit of slumping. “You can also place a small towel roll between your waist and the bed to eliminate the sag in your waist. Keeping a pillow between your knees can help reduce the twist in the spine, caused by knees being narrower than the hips,” explains Gokhale.

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