James Marshall takes a look at the different postures an athlete uses – not just in competition, but in everyday life – and explores why they might affect performance.
In order to perform almost all sporting movements, an athlete switches from position to position at varying speeds and for varying duration. The underlying component that allows them to do this is posture. This may be static but it is mostly dynamic. In order to move fast, or to maintain those positions for longer, the athlete’s posture must be correct. This allows efficiency of movement which then becomes economical.
Efficient and economical movement means that the athlete can move faster and can conserve energy for later in their event. Inefficient movement means the athlete has to move more to compensate for poor posture; this takes time and requires more work. Less energy is then available for later in the event.
However, athletes do not live in a vacuum. They train around work, education and family. Professional athletes may not have work or education pressures, but they did before they turned professional. Activities of daily living such as driving, writing, eating, studying, playing computer games, texting and hours spent on social media sites affect the posture of athletes before they even turn up to the training field.
The coach has two choices: they can either start to correct the underlying problem; or to train the athletes as normal. The first takes time and is another thing to add to the list of training priorities. The second is fraught with risk; prolonged overload of inefficient or weak positions will likely lead to injury.
What is posture?
Posture is often assumed to be a static standing or sitting position. This may come from diagrams or still images that show a fixed point in time or place. However, ‘good posture is the state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude in which these structures are working or resting.’ (1)
The important point of this definition is that it is “irrespective of the attitude”. So that means you can have good posture in running, jumping, diving, tumbling and tackling, for example.
The subtle adjustments necessary to maintain correct form are sometimes called postural sway (2). This means that the body constantly has to adjust to the demands of the surrounding environment in order to maintain a correct posture. The most challenging demand which we face all the time is gravity. But, in sport, it can also be opponents, equipment, surfaces and technical requirements. For example, a rugby union player going to tackle an opponent has to be able to maintain the correct posture to ensure they protect their head and make the tackle. They have to adjust according to the surface and the speed, direction of travel and size of the opponent.
Two types of 'bad' postures
How lifestyle affects our posture
Lifestyle has a major impact on posture. Inactivity is prevalent in the Western culture (3). Adults and children will spend the majority of their day in a seated position i.e. at work hunched over a desk or computer, at school slouched in the chair or again over a desk and driving or being driven (4,5).
While the cardiovascular health and obesity problems caused by sedentary lifestyle are well researched, the effects of prolonged sitting also affect posture (4,5,6). Poor posture can then lead to low back pain and the incidences of this in school children range from 20 to 51% (7-10).
Risk factors for low back pain include: weak abdominal muscles, prolonged sitting, faulty spinal posture and having school furniture that is the wrong dimension for the child (8,11-13).It is quite obvious that having low back pain will limit sporting participation, let alone sporting performance.
Standing posture is affected by lifestyle too. Weakness in the postural muscles means that children often adjust their standing position so that gravity and biomechanical alignment do the work instead (31). I see young athletes who rest their weight on one leg with the knee fully extended most of the time in standing. This results in an imbalance of the hip position, and one side of the back is shortened, whilst the other is extended. Over time, this becomes their “normal” posture in standing. Whether this is a result of their sport or a transfer from their poor sitting postures depends on the individual. Add to this the standard phone texting and it often results in a hunched shoulder and craned neck position. What is apparent that when asked to stand straight with good posture, the young athlete finds it difficult to maintain at first. Their postural muscles have become deconditioned.
Impact on sporting performance
In developing athletes it is important to be aware of the demands of repeated and prolonged exposure to asymmetrical or similar training. Gymnasts are an example of early specialised athletes who practice extensively in one sport from four or five years old. Their common posture is more lordotic due it being ‘practised’ a lot, i.e. after landings and during dance on the floor. Also, due to their flexibility, a lot of gymnasts will stand badly, i.e. with bowed or locked out legs. An excessive flexible lumbar region of the spine emphasises the lordotic posture further. Lower back pain (along with wrist pain) is a common injury or source of complaint in female gymnasts (14).
The question is whether this injury problem is due to the prolonged training or due to their poor posture. Is it the repeated loading of jumps, landings and supporting other people’s bodies, or is it due to standing and sitting in poor positions? This is a difficult question to answer due to the problems designing such a study. It is difficult to isolate the contributing factors. One study looking at whether gymnastics affected growth and maturation rates found it likely, but could not prove it substantially, due to the many other possible contributing factors (15).
Poor posture can affect your endurance capacity too. The trunk muscles that are responsible for postural control and trunk stabilisation are also used for respiration (16). One study on rowers looked at how different postures affected lung function (17). The researchers compared respiratory pressure within the lungs (P Emax) and also maximal expiratory pressure (FVC) in both supported sitting and unsupported sitting positions. There was a 3–9 % decline in P Emax in unsupported recumbent postures compared to upright seated and a 4–7 % decline in FVC.
The researchers surmised that this was probably due to the co-contraction of the postural muscles needed to support the body in the recumbent posture. This meant that these muscles were less able to help with respiration. This shows in part how posture can affect respiration. Further research might be warranted on how postural training could improve these rowers performance by putting them in more efficient positions whereby the trunk muscles could be used more effectively in respiration.
Athletes that participate in sports that involve throwing, striking or hitting things with a bat or racquet are also affected by poor posture. Shoulder mechanics alter due to changes in standing posture (18). The serratus anterior (the boxers’ muscle) is less active and often lengthened, and the scapulae have greater internal and upward rotation in overhead tasks (19). Whilst this posture can lead to (or is caused by) a lengthened serratus anterior muscle, allowing a great range of mobility in the shoulder, this can be compensated by having a tight thoracic spine.
This is important for athletes for two reasons: 1. Reduced activity of the serratus anterior and greater internal rotation of the scapulae lead to a greater risk of shoulder impingement (20,21). 2. A tight thoracic spine can mean that when performing throwing or striking actions that involve rotation (such as a tennis forehand), the athlete can’t rotate their trunk to generate power and range of motion, so instead use their excessive shoulder mobility to get into position.
In order to throw or hit harder, the athlete will then be relying on the mobile and relatively weak shoulder joint rather than the strong and powerful trunk and back muscles to generate power.
An easy way to understand the importance of range of motion of the trunk is to hold a pen at one end and move it very slightly left and right: you will see the other end of the pen move a much larger distance. A small increase or decrease in the trunk rotation has a very big effect on the overall lever length and arc of the arm and hand.
Physiotherapists recognise the importance of understanding the connections between the body parts when an athlete is injured. This has been defined as regional interdependence (22). An athlete may complain of shoulder pain, but the cause could be elsewhere in the body. Poor posture can lead to muscular adaptations in the body that could result in pain or injury elsewhere such as the neck or shoulder. Conversely, repeated movements such as swimming strokes can cause poor posture, which then leads to other types of pain (23).
The relationship between posture, training and s p o r t i n g performance i s very much interconnected. We cannot always ascertain whether poor posture causes training problems or is the result of training, but we do know that it has an impact on performance.
Prevention is better than cure
Developing athletes that have poor posture and develop back pain will carry this into adulthood unless the postural problems are identified and corrected (24,25). Rather than spend a lifetime on the physio couch (or out of sport together) it is far better to put into place a training and lifestyle programme that prevents poor posture.
This does not mean just doing “corrective exercises” but rather doing exercises correctly. For example, if the thoracic spine is tight, then doing bench presses and front squats will get you stronger. But they will also be working in positions that exacerbate the thoracic spine tightness. Doing behind-the-head presses and back squats will mean that you can get stronger whilst not inhibiting movement of the thoracic spine.
This is my preferred option as a coach, mainly because time and energy are limited with athletes. Doing an exercise to “get strong” and then doing another exercise to “get mobile” means you are spending more time doing “stuff”. A lot of Pilatestype work that is done in lying down positions does not transfer to standing posture (26,27). I would rather the athlete do exercises that enhance performance and then have them rest.
The same applies to the technical training in sports; it is better to invest in quality of movement when learning a new skill, rather than getting a short-term improvement in results and having to rectify this later.
However, as I said earlier, athletes do not live in a vacuum and we have to deal with the situation at hand. If they have been sitting at a desk all day, or driven an hour to training, then they will be suffering from acute postural problems, let alone chronic ones. This means putting in place an exercise programme that helps counter the stresses and strains of lifestyle and sports-specific training without compromising training.
In fact, as long as the athlete is pain-free, there is room for a few exercises in the warm-up or cooldown that encourage the athlete to move freely which may then enhance their training session. I use exercises that encourage movement, control and balance, and get the athlete warm at the same time (hence the term warm-up). Posture and movement are interlinked parts of motor co coordination, it makes sense to improve posture through movement in warm-ups, which then also helps with the skills to be rehearsed in the main session (28).
Remember, if the athlete has pain or is severely restricted then they need to see a doctor or physiotherapist to get it treated properly. For example, there is evidence in non-athletes with “impingement” that cervical and thoracic manipulation impact shoulder symptoms without the glenohumeral joint being treated (29). That might support mobilisations for thoracic spine to aid shoulder pain, but this has to be supervised.
It is often said that gravity is our enemy and that we are not designed to be bipedal, so poor posture is inevitable. However, what if it is just that our movement is restricted, and if we moved properly our posture would be corrected? These were the thoughts of Dr Robert Martin, a gymnast, chiropractor and medic in the 1960s (30). He surmised that we spend almost all our time in three common postures that cause us to be compressed and that we need to counteract this by spending time in three uncommon postures (Figure 1).
Figure 1.
The three uncommon postures not only allow the spine to decompress, they also help with spatial awareness because you have to get used to these positions. If you think of a Fosbury flop in high jump, or a pole vaulter, or a judoka getting thrown, you can see how inverted and extended postures happen in sport too.
But when you look at your training programme, how much time is spent in the common postures versus the uncommon postures? A few simple changes could be made that allow you to train in these positions.
For example:
*Instead of bench press (horizontal, flexed) you could do handstand press-ups against a wall (inverted, extended);
*Instead of lat pulldowns (erect) you could do pull-ups (brachiated);
*Instead of bent-over rows (flexed) you could do bench hyperextensions (extended);
*Instead of ab curls (horizontal, flexed) you could do hanging leg raises (brachiated).
This type of training has gone out of fashion in today’s world: look at schools that have taken out ropes, wall bars and balance beams and replaced them with “fitness suites” comprising seated machine weights and benches for dumbbell exercises. Children who have spent all day sitting, lying and flexed are then encouraged to spend their time doing more sitting, lying and flexing!
Summary
Most people have good posture early on in life and then lifestyle has a negative effect before sport does.
Posture is both dynamic and static and they are interrelated. Poor static posture can develop incrementally over time and this leads to adopting inefficient positions such as having hyperextended knees(31). This is a less than optimal position for dynamic movement to take place. Loading young people in poor positions will compound problems and continue into adult life.
By making an athlete aware of posture they can then start to work on it. Daily activities must be addressed, such as not spending prolonged time sitting or lying down. Desk ergonomics at work and school must be optimal for back and hip health rather than convenient. No five-minute warm-up can counter eight hours of sitting, it is better to move often and well throughout the day.
Finally, your training must also enhance correct posture and balance, not inhibit it. When you can move well and efficiently in the gym and on the track, it will enhance your sporting ability when it matters: on the pitch, track or court.
James Marshall MSc, CSCS, ACSM/HFI, runs Excelsior, a sports training company
References
1. Posture Committee of the American Academy of Orthopedic Sugeons. Posture and its relationship to Orthopedic disabilities: a report of the Posture Committee of the American Academy of Orthopedic Sugeons. Evanston, Ill: American Academy of Orthopedic Sugeons: 1947:1.
2. Functional Training for athletes at all levels. James Radcliffe. Ulysses Press: Berkley CA. (2007)
3. Food and Nutrition Research, 48 (3) 108-113 (2004).
4. British Journal of Sports Medicine 43(2) 81-83 (2009).
5. Medicine & Science in Sports & Exercise, 41(5) 998- 1005 (2009).
6. Chiropractic & Osteopathy 15:1 (2007)
7. Rev Rhum Engl Ed 66 (7-9) 381-388 (1999)
8. Eur Spine J. 8(6)429-438 (1999)
9. Am J Public Health 82(4) 606-608 (1992)
10. Spine 22(10)1132-1136 (1997).
11. Eur Spine J.13(8) 663-679 (2004).
12. J Adolesc Health 24(4) 265-273 (1999).
13. Ergonomics 38(9) 1932-1940 (1995).
14. Gymnastics Injuries Caine D., Nassar, L., in Caine DJ, Maffulli N (eds): Epidemiology of Pediatric Sports Injuries. Individual Sports. Med Sport Sci. Basel, Karger, vol 48, 18–58 (2005).
15. Pediatric Exercise Science 15, 360-372 (2003).
16. Med Sci Sports Exerc. 23,186–193, (1991)
17. European Journal of Applied Physiology. 99(5):457- 66. (2007)
18. Journal of Electromyography and Kinesiology 20 (4), 701–709 (2010).
19. Diagnosis and Treatment of Movement Impairment Syndromes . Sahrmann SA. St.Louis: Mosby, p. 460 (2002).
20. Phys Ther. 80:276–91 (2000).
21. Phys Ther. 86:1075–90 (2006).
22. J Orthop Sports Phys Ther. 37(11):658-660 (2007).
23. Br J Sports Med 44: 376-381 (2010).
24. Eur Spine J. 5(5):312-318 (1996).
25. Eur J Pain. 8(3):187-199 (2004).
26. Journal of Strength & Conditioning Research 24 (3) 661-667 (2010).
27. Spine 34 (10) 1046-1051 (2009).
28. J Neurophysiol 104, 1090–1102 (2010).
29. Manual Therapy 14(4) 375–380 (2009).
30. Martin, R.M. (1975). Cum gravity- Living with gravity. San Marino, CA: Essential Publishing.
31. Phys Ther. 77,629-645 (1997).