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The proper balance

Health experts back good posture as a way to offset the risks posed by today’s technology-driven and deskbound lifestyle

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By Deborah Kotz
Globe Staff / May 23, 2011

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Ballet dancers have it. So do serious practitioners of pilates, tai chi, and yoga. Those who sit parked in front of computer screens all day? Not so much.

The “it’’ is good posture, and many of us aren’t practicing it these days; posture-related muscle aches and injuries — serious enough to cause missed days of work — occur in more than 600,000 Americans a year, according to the Occupational Safety and Health Administration. And anyone who spends more than 95 percent of their workday sitting is at risk.

Sure, the days of balancing books on our head went by the wayside along with finishing schools and castor oil, and parents now focus more on their children’s grades and after-school activities than their carriage. But some experts yearn for a return to those previous times.

“We should remind ourselves and our kids to stop slouching,’’ contends Emily Keshner, chair of the department of physical therapy at Temple University in Philadelphia. “Maintaining good posture yields better health outcomes.’’

A report published last week in the British Journal of Sports Medicine found that tai chi — which uses slow, repetitive movements — was effective at lowering the risk of falls in the elderly in half a dozen studies, most likely by improving their posture and sense of balance. Straightening our spines also enables us to breathe more air into the lungs — just try taking a deep breath when you’re in a slouch — helping to circulate oxygen to vital organs and tissues.

And, well, we look taller, thinner, and more confident when we put our spines in that ideal neutral pose: belly in, pelvis tucked under, shoulders relaxed, neck in line with hips — and back straight but not arched, as if a string were suspended from the ceiling to hold the head upright.

Maintaining this position for sitting, standing, and walking, the latest research suggests, might even affect how confident we feel about our ideas and power to persuade others. A January study from Northwestern University found that volunteers who were told to maintain a straight posture when sitting not only projected more of a leadership ability to others, compared with when they were told to slouch, but also said they felt more powerful even when assigned the role of a subordinate in a role-playing situation.

While that’s great in a study setting, many of us have become habitual slouchers, thanks to all the time we spend in front of computer screens that we crane our necks to see. More than 9 out of 10 college freshman now sit hunched over notebook computers during the course of their day, compared with a few years ago, when the vast majority worked on desktop computers with screens at eye level, according to Boston University and University of Massachusetts researchers in a February study published in the journal Ergonomics.

“With this increased use of notebooks [computers] comes the increased risk for students to develop upper extremity musculoskeletal disorders,’’ the researchers wrote, like shoulder, neck, and upper back pain.

Study author Karen Jacobs, a clinical professor of occupational therapy at Boston University, says she frequently sees chronic muscle tension in older adults as well as students who massage their shoulders and neck during classes.

“I can immediately tell you who is having problems,’’ she says. “We were not designed to use notebook computers and PDAs all day.’’ And even if you work at a desktop computer, the amount of time you spend sitting and the stress of a deadline can trigger muscle pain, which if it becomes chronic, can cause a restricted range of motion and loss of muscle strength.

Office adminstrator Terri Mellen, 40, knows what that’s like. For the past eight months, she’s had a nearly constant ache in her right shoulder, which started after an extra monitor was added to her desk at Boston University. She thinks that small change caused her to push her computer mouse a bit farther away, forcing her to shift from a straight posture to a slight forward lean to her right every time she clicked. “I’m managing OK, but I can’t use my right hand to lift heavy objects off of a high shelf.’’

Experts are particularly concerned about poor posture habits in still-growing children and teens, who put themselves at risk for developing curved spines — called postural kyphosis — from spending too much time hunched in front of electronic devices. “Parents are prompted to bring kids in because they look terrible, like Shaggy from the “Scooby-Doo’’ cartoon, or because they have back pain,’’ says Dr. Brian Grottkau, chief of pediatric orthopedics at MassGeneral Hospital for Children.

Treatment often involves physical therapy with stretching to loosen tight hamstrings, which can cause postural problems by forcing the pelvis to tilt upward and the spine to curve. But Grottkau says one of the best fixes is personal awareness: He tells his patients to stand in front of a mirror for five minutes a day. “I tell them to stand straight with their shoulders back and see how that sends a different ‘Don’t’ mess with me’ body language than their slouch. Teens appreciate that.’’

Unfortunately, there’s no quick fix for breaking poor posture habits, but physical activity is a good first step. “Our bodies are like machines; they need to keep moving,’’ says Keshner. “Taking a static position — even one with the proper alignment — for too long can cause muscle strain.’’

She recommends setting an alarm on your watch or computer to remind yourself to rise and move about once or twice an hour. These mini-breaks may also lower your heart disease risk. A January study of 4,800 American volunteers — who agreed to wear accelerometer devices to measure how much time they spent sitting and how many breaks they took to get up and walk around — found that those who sat the least had smaller waists and lower levels of cholesterol and heart-damaging inflammation compared with those who sat the most.

While it may be tough to always think about standing tall with shoulders relaxed, exercises that specifically work the abdominal core muscles, like yoga or pilates, can help improve your posture automatically by both strengthening muscles that support your spine, and increasing your body awareness. In a 2009 study from UCLA, researchers randomly assigned 118 people older than 60 with severely curved spines — which can occur with age-related bone loss — to attend either a one-hour yoga class three days a week for six months or have no active therapy. They found that those who took the yoga class had a significant straightening of their spine compared to those who didn’t take the class.

Sometimes, though, the solution may be more complicated. Jacobs has been working with Mellen, the office administrator, to fix her ergonomic issues as part of a study she’s conducting. Several weeks ago, Mellen was fitted with a new chair with better lumbar support and an adjustable arm rest, and she was instructed on how to rearrange her computer monitors and position her mouse to reduce neck and shoulder strain.

“It’s helped a little but not that much,’’ says Mellen. No matter how close she puts the mouse to her, it keeps inching farther away on her desk. “I guess it’s just hard to break the habit.’’

Deborah Kotz can be reached at dkotz@globe.com.

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