How to Help Clients With Poor Posture

As we age, it is not uncommon for our posture to deteriorate. Often the head moves forward and the shoulders round, which can cause chronic back and neck pain. Our once swift and sure stride is replaced with a sort of shuffle (Griegel-Morris et al. 1992). Sadly, this kyphotic posture (characterized by extreme convex curvature of the upper spine) can increase the risk of falling. Often, people who develop these physical characteristics must rely on a cane or walker to ambulate.

Years of inattention to how the head and shoulders are positioned can lead to tight pectoral muscles and weak upper-back and neck muscles, which can result in postural kyphosis. At the same time, the Achilles tendons and hamstrings become tight, and the feet begin to shuffle and scuff the ground while walking, which can lead to a higher risk of falls. This “senior shuffle” is unsafe. As the forward-tilting shoulders shift the center of balance frontward, older people become less steady on their feet and have a greater tendency to fall.

Unless your older clients suffer from advanced osteoporosis, this unattractive way of standing or sitting is a learned behavior. Fortunately, you can help to set straight what has become crooked! By incorporating several stretches and strengthening exercises into your clients’ routines and instructing clients on proper posture, you decrease their risk for debilitating pain and for nonfatal or fatal injuries resulting from falls.

Postural Stretches and Strengtheners

Teach your clients these stretches and strength exercises for better posture and gait. Have them hold each stretch posture for 30 seconds and breathe deeply as they hold the pose.

Stretches

The “W” Stretch (for upper back and neck). Back is against a wall; knees are slightly bent. Step about 12 inches away from wall with both feet. Contract abdominals with shoulders, back and buttocks against wall. Without lifting chin, try to touch back of head against wall. For some this will be difficult; bring head back as far as possible and improvements will occur. Bring arms up to make the letter “W.” Bend elbows at shoulder height, wrists above elbows and palms facing forward. Keeping body against wall, draw arms back until elbows, wrists and hands touch wall. Tight pectoral and deltoid muscles may prevent elbows from touching wall.

Pectoral Stretch. Stand approximately 12 inches from wall. Face wall and lift right elbow to side, wrist above elbow, palm facing frontward. Turn slowly to left, allowing elbow and forearm to come into contact with wall. Continue to turn to left until you feel slight stretch in right pectoral muscles. Repeat with left arm.

Trapezius Stretch. Stand tall and cross right hand behind you as if putting that hand in left back pocket. Slowly bend to left side, bringing left ear toward left shoulder. Do not lean forward. Repeat with left hand.

Standing Hip and Thigh Stretch. Do this exercise only if you can support yourself properly and have adequate balance. Hold onto wall or backrest of chair. Bend right knee, and grasp right foot with right hand. Do not arch the back. Keep knees side by side. Repeat with left leg.

Standing Hamstring Stretch. Place right heel on low step so leg is almost straight. Supporting left leg should be slightly bent at knee. Slowly lean forward until you feel slight pull in back of right thigh. Repeat with left leg.

Standing Calf and Achilles Tendon Stretch. Stand with hands on wall or other stable object. Keeping right leg straight with heel flat on ground, step forward approximately 24-30 inches with left foot, then lean forward, bending left knee. Repeat with other leg.

Strengtheners

Neck. While seated in car or in chair with headrest, press hips back in seat and lean back slightly, pressing back of head gently against neck support. Hold for 5 seconds. Repeat 8-15 times.

One-Arm Row; Seated Row; Double-Arm Row; Lat Pull-Down; Reverse Flye; Weighted Shrugs. These exercises strengthen upper- and middle-back muscles (trapezius, rhomboids, latissimus dorsi, rear deltoid) that have become weak and stretched. Strengthening these muscles will help properly reposition shoulders that have been rotated forward.

Dorsiflexion; Ankle Eversion; Ankle Inversion. Use elastic resistance band to increase strength of anterior tibialis.

Gluteals. Lie supine with knees bent at 10- to 15-degree angle. Squeeze buttock muscles. Hold for 5 seconds. Repeat 8-15 times.

For more information on helping older clients improve their posture, plus photos of many of the exercises described here, please see “Repositioning Poor Posture” in the online IDEA Library or in the November-December 2010 issue of IDEA Fitness Journal.