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Posture problems

05 December 2017

The human body has evolved to enable us to perform the tasks we need to do on a daily basis and thrives on symmetry and balance.

In fact many people who come to a physiotherapy appointment with pain, often show signs of asymmetry or imbalance around the area of pain.

As physiotherapists we will often assess the relevant joints for their mobility, looking for restrictions in certain ranges of movement. We will also look for movement control, balance and strength in the joints.

When there is an imbalance across a joint, we often see a combination of loss of mobility (movement) and loss of strength and control during movement. Once we identify these discrepancies, we then try and work out why the imbalances have occurred so we can prevent them from happening again.

Imbalances often occur in people with neck, shoulder or back pain who tend to carry a heavy bag over one shoulder. Lots of people use laptop bags or messenger bags and many women carry a handbag on a strap over one shoulder, and if the bag is light and not carried for long then normally it isn’t a problem. The problems arise when the bag is carried for prolonged periods of time such as commuting on a train or walking to work or school.

The problem is made worse when the bag contains large or heavy items such as laptops and chargers. A heavy bag on one shoulder for a prolonged period of time will cause changes to your standing and walking posture. Carrying a heavy bag puts stress on your shoulder which means the muscles in your shoulder and into your neck work hard to keep the bag in place. To help these muscles out, your spine will adjust its position accordingly, so you may lean you head away from the bag which will have an impact on the rest of your spine that has to adjust position to keep you upright while you walk.

This adjustment of position is made by the many muscles that cross your neck, shoulders, ribcage, spine and pelvis which will all be affected. Pain can be felt anywhere across any of the joints and muscles affected and is caused by the abnormal stresses put upon them.

Abnormal stress can lead to fatigue which means the muscles can’t function to support the altered joint positions. The stress is then directed to the ligaments that hold the 2 bones of each joint together. Many ligaments in the spine are not strong enough to cope with this stress and therefore are easily sprained. Small repeated joint sprains cause pain in the form of chronic aches and muscle spasms which stop people sitting or standing comfortably. This is a common complaint for many patients with repetitive strain type injuries to the back and neck.

Tips to avoid neck and shoulder pain

  • Go for the smallest and lightest bag possible
  • Only take the essentials to keep the bag as light as possible – aim for a maximum of between 8-12% of your body weight
  • If it is a shoulder bag, switch sides regularly
  • Ideally go for a backpack style with thick straps or use a wheelie bag

Our Perform Physiotherapy team can provide full treatment planning for any condition affecting your muscles, tendons, joints or nerves. We can offer fast referral to scans and orthopaedic surgeons.

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