You Probably Have Bad Posture [Here’s How to Tell]

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Do I Have Bad Posture?

If you are 20 years or older, you probably have bad posture.

Just like Diabetes, many of you won’t know until you begin to develop symptoms.

After reading the last post, many people asked the inevitable question. How do I know if I have bad posture?

Fortunately, there are 4 easy ways to find out.

In Part 1 of the WCT Posture series, 5 Convincing Reasons Why Good Posture is Essential, we discuss the importance of good posture, and the consequences of neglecting it.

This post will cover:

– What does good posture look like?

– The 4 most common signs of bad posture, as well as the symptoms they produce

– Simple tests to see if you have any of these 4 postures

We will start with the head and work our way down.

Anyone of these major postural deviations has the potential to cause significant consequences- consequences that can worsen over time.

First A Quick Disclaimer

This post will not be comprehensive, as there are entire textbooks dedicated to the subject of posture.

However, this post is to highlight the highest yield information so that you can begin to make changes to your posture right away.

In addition, you will realize that most of these bad postures interrelate, and fixing one will usually help fix others. 

Once you familiarize yourself with these inefficient positions, you will be more aware of your own posture, and begin to cue yourself on how to avoid bad positions.

First, let us define what good posture is.

This is What Good Posture Looks Like

We will focus on proper standing posture, as it is easiest to see the most common signs of bad posture from a standing position.

Proper Standing Posture CheckList

When standing up, you must ensure that

  • Head is in a neutral position and the ear is lined up with the middle of the shoulder joint

  • The middle of the shoulder joint is in line with the ear

  • The upper and lower back are in a neutral position with a natural kyphotic and lordotic curve (slight curves are normal)

  • The middle of the hip is in line with the middle of the shoulder above and the middle of knee joint below

  • Middle of the knee is in line with the middle of the ankle

Proper Sitting Posture Checklist

Proper sitting posture looks almost exactly the same as standing posture. When sitting down, it is important to ensure that

  • Your head is in a neutral position. Adjust your book/computer/workstation to a height so that you are looking straight ahead and not having to overly extend or overly flex your neck.

  • Your ears should be aligned with the middle of your shoulder joing

  • Your shoulders should be in the middle of their socket and not overly protracted in front of you

  • Your upper and lower back should be in a neutral position. Your kyphotic and lordotic curves should have a slight physiologic curve

  • For your lower body, just ensure that your weight is evenly distributed between your two hips and your feet.

Obviously, these explanations are examples of perfect posture. It is not possible to be in the perfect position at all times. We must all move around and fidget, whether we are standing or sitting.

The important thing is to try your best and get back to a good neutral position as often as possible.

Ok so here is where things go wrong…

Bad Posture #1: Forward Head Posture

Forward head posture is exactly what it sounds like.

It refers to the position where your ears do not line up with your shoulders when looking at a side profile.

The forward head is usually a result of another postural inefficiency which we will discuss next known as Rounded Thoracic Spine (aka kyphosis) and being unaware of your neck position.

It is most commonly seen when people are sitting at a desk and looking at a computer screen in front of them.

When your head is not in line with your shoulders, your neck has to assume a compromised extended position just so that you can see what is in front of you. 

In order to compensate and look straight ahead, your chin will have to poke out, and you will flex the muscles in the back of your neck (which extends your head).

Forward Head Posture Pain Symptoms

Forward head posture places a lot of strain on the muscles of the posterior neck. As a result, this posture can lead to neck pain, upper back pain, and headaches.

How To Tell if You Have Forward Head Posture

  • If you have pain in the back of your neck, you probably have forward head posture.

  • If you cannot bring your chin to touch your chest while your teeth are clenched- you probably have forward head posture.

  • If the back of your neck isn’t straight when looking from the side- you definitely have forward head posture

Bad Posture #2: Rounded Thoracic Spine (Kyphosis)

Out of all the postural inefficiencies – rounded thoracic spine is probably the most prevalent.

This is because of our sedentary culture that cherishes sitting the majority of the day.  This topic is discussed in detail in our post on prolonged sitting.

When you sit, you tend to relax a lot of the muscles that would normally be activated when you are standing or moving around.

This includes the abdominal/core muscles as well as the spinal erectors which run vertically along either side of our spine.

When you sit for long periods of time, the muscles of your upper back will become inactivated and lengthened.

The end result is slouching.  You slouch for several hours a day, several times a week.  

The more time your body remains in a certain position, the more likely it will begin to adopt that position as its new norm.

A rounded thoracic spine can result in multiple other postural inefficiencies – forward head posture, decreased shoulder range of motion, and tightening of the muscles in your anterior thorax.

Furthermore, the muscles of your upper back become weak from a lack of use.

Kyphosis Pain Symptoms

A Kyphotic posture leads to pain and stiffness in the upper back and a tendency to strain your anterior shoulders and chest muscles. In addition, the pronounced curve in the thoracic spine can cause unnecessary wear and tear to your lordotic curve also resulting in low back pain.

How To Tell If You Have A Rounded Thoracic Spine

  • Stand up and have someone take a picture of you directly from the side. (Make sure to not overly compensate your posture, and stand as you would normally). If the middle of your shoulder joint does not line up with the middle of your hip joint vertically, then your probably have a rounded spine.

  • If your kyphotic curve simply looks very pronounced, then you have a rounded thoracic spine.

  • Stand up against a wall with your feet six inches away from the wall. Can you make three points of contact with your head, upper back, and butt without pushing your head back? If you cannot, you probably have a rounded thoracic spine.

Bad Posture #3: Rounded (Internally Rotated) Shoulders

Internally rotated shoulders can occur independently or in conjunction with a rounded thoracic spine.

In normal anatomy, the shoulder joint should sit in the center of the shoulder socket with equal and opposite forces tugging on it from both anteriorly and posteriorly.

However, we always focus on our anterior side, or what is in front of us.

Think about how many times your arms are out in front of your body; typing on a computer, writing, cooking, cleaning, or pushing objects.

How often do you perform the opposite task? Tasks that bring your shoulder towards your back, aka pulling movements?

If you’re like most people – the answer is never.  Therefore, the anterior muscles and tendons become significantly stronger (aka they tighten and shorten) than the posterior muscles and tendons.

As a result, your anterior muscles pull the shoulder joint forward in the socket, rotating them in towards the midline (internal rotation).

Rounded Shoulder Pain Symptoms

The rounded shoulder posture deviates your shoulder joints forward out of their sockets. As a result, this can cause pain in the front of your shoulders, especially when bringing your arms overhead or when you perform exercises such as pushups, bench presses, or even Pullups .

How To Tell If You Have Internally Rotated Shoulders

  • Stand up and grab two pencils. Hold them perpendicularly in your clenched hands so that the lead tips are facing away in front of you. Now, look at the pencils. Which way are they pointing? If they are angled towards each other- you have internally rotated shoulders.

  • Take a picture of your side profile. If you cannot draw a straight vertical line from the back of your ear to the middle of your shoulder joint, you have internally rotated shoulders.

Bad Posture #4: Anterior Pelvic Tilt (Lordosis)

Do you have low back pain? According to the NIH, so do 80% of adults.

Low back pain is extremely complex and can have many different etiologies.  Many people have dedicated their lives to the diagnosis and treatment of low back pain.

Anterior pelvic tilt, aka lordosis, is one of the more common causes of low back pain in young adults.  Again, too much sitting is usually the culprit.

This posture is highly prevalent in tall, thin runway models.

It’s also prevalent in individuals who try to puff out their butt to make it look bigger.

When you sit, your hip flexors (the muscles that bring your thighs towards your chest) are in constant flexion.

Again, the longer you stay in a certain position, the more likely your body will adapt the new position as its baseline.

Tight, short hip flexors will pull on the pelvis from the front, creating an anterior tilt and exaggerating your lordotic spinal curve.

Furthermore, the muscles on the posterior side of the pelvis, namely the glutes and the hamstrings will become elongated and inactivated by a lack of use.

Anterior pelvic tilt was the biggest cause of my low back pain when I first started learning about posture and pain.

Anterior Pelvic Tilt Pain Symptoms

The Anterior Pelvic Tilt rotates your pelvis forward putting excessive strain on the muscles of your lower back. Therefore, this posture will result in low back pain sooner or later, as well as an increased risk of disc bulge and herniation. 

It can also lead to discomfort in the anterior hip, as these muscles are extremely tight and over activated.

How To Tell If You Have Anterior Pelvic Tilt

  • Lay on the floor on your back, and bend your knees.  From this position squeeze your glutes as hard as you can until your hips are extended and you create a ‘Glute Bridge’.

  • Are you able to draw a straight line from your knees down to your shoulders? Or are you broken at the hips? If you are broken at the hips and cannot achieve a full hip extension, then you probably have lordosis from tight hip flexors.

  • Look at a side profile photo of yourself. Is there an exaggerated lordotic curve in your lower back and a bellowing out of your belly These are also indications that you have excessive anterior pelvic tilt.

Ok, My Posture Sucks: How Do I Fix My Bad Posture?

Now that you are aware of what bad posture looks like, you may have noticed that you exhibit some of them.

You have also probably seen many other individuals with one or more of these abnormal postures.  They are extremely prevalent in our society.

The good news is, you can fix them.

Next you should read:

Now we turn it over to you.

How many of these abnormal postures do you have?

Have you noticed any friends or family members with these positions?

Do you know of any other positions we could add to this list?

Comment below and let us know!

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Alex Robles, MD, CPT / Brittany Robles, MD, MPH

Alex Robles, MD, CPT / Brittany Robles, MD, MPH

Alex & Brittany Robles are physicians, a NASM CPT, health & fitness experts, and founders of The White Coat Trainer, a site dedicated to improving the health and fitness of busy individuals. Their advice has been featured on KevinMD, The Doctor Weighs In, My Fitness Pal, Reader's Digest, Livestrong, and The Active Times. Learn more about them here.

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2 thoughts on “You Probably Have Bad Posture [Here’s How to Tell]”

  1. I have every one of these bad posture issues but mine come from not sitting but standing all day as a hairdresser. I’m twisting and turning my back and looking down at people’s heads as well as constantly having to lean forward over people because THEY won’t sit straight even after I’ve asked them a million times to straighten up!!! My shoulders roll forward, my neck is always hurting i have chronic pain in between my shoulder blades, my hips hurt, my ankles ache and let’s not get into my feet and the years of pain I have had. I suffer from muscle cramps in my hips and sides no matter how much water I drink. I really hope these exercises help me!!!

    1. thewhitecoattrainer

      Hi Mary
      Sorry to hear this, but it sounds like you have figured out the source pretty well. Definitely give the exercises a try as well as the posture resets shown in the videos!

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