standing posture

Why Does Everyone's Right Shoulder Droop?

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What do you notice in the above picture? At first glance it just looks like three boys hanging out during a soccer game. They're all wearing different clothes and are different heights. Two of the boys are leaning on one another while the third stands independently. Despite their differences, they are all standing with the same postural pattern. 

Take a look at them, no matter how they are leaning, they are all standing on their right legs, crunching or shortening the right sides of their trunks, and lowering their right shoulders. Doesn't this seem weird considering two of the boys are leaning in opposite directions so they can lean on one another? How does that happen?

This common pattern is due to our naturally-occurring anatomical asymmetry. It begins with the asymmetrical attachment of our diaphragm. This primary muscle of respiration attaches to the back part of our lower ribcage and onto the front of our lower (lumbar) spines. The attachment sites are bigger and more robust on the right side. As this side has more attachments, it is "stronger" and tends to pull our lower spines into right rotation. Eventually this will pull our pelvis into right rotation as well. When our pelvis' and lower spines are oriented toward the right, our right hip joint is in a better, more functional position to weight bear. Therefore, we all tend to put more weight on our right leg than our left. 

Additionally, this muscle is asymmetrically domed. Because of our heart, the left side of our diaphragm tends to flatten which flares our ribcage and weakens our abdominals on that side. The liver, on the right side, helps to preserve the muscle's domed shape here. This makes the right side of our abdominals stronger than the left. Due to this and the flared ribs on our left side, our trunks tend to lean to the right. This gives us the classic lowered right shoulder. Complicating matters, when our trunks lean slightly toward the right, more weight is displaced onto the right leg. This further ingrains our postural asymmetry. 

In PRI language, this is called a Left AIC (anterior interior chain) position and it is the most common postural pattern. As our bodies spend more time in this position and our compensatory strategies we use due to this pattern break down, we tend to go further into compensatory patterns and this Left AIC pattern can degrade into others. To read more about this, check out our blog post What's Your Postural Pattern. This poor postural pattern, and therefore problematic loading on our muscles and joints, can lead to pain and dysfunction. A PRI trained therapist evaluates the entire body and it's systems to look for musculoskeletal position and function. We can then intervene on not only the area of pain, but also all of the surrounding areas that are feeding into the problem. Because of this more holistic approach, we are able to bring relief to many patients that have "failed" with physical therapy before, no matter where the site of pain is.

Next time you're at the mall, restaurant, or airport, watch people as they stand. Typically, no matter where they are looking, what direction they're learning toward, or what side they may be holding a heavy bag or purse, they'll likely be standing on their right leg with their right shoulder low. 

Are Standing Desks All They're Cracked Up To Be?

Image from Google Images "standing desk"

Image from Google Images "standing desk"

Lately there has been a lot of information that sitting all day puts us at a much higher risk for obesity, diabetes, pain, and other potentially life-limiting issues. Therefore, one would think that standing for a portion of the work day would be a great way to combat this, right?

Although merely changing your position and burning a few more calories while standing are good things, the standing desk may not help with low back pain or sciatica that you've been feeling after a few hours at work.

If you are planning on getting a standing desk to help with pain you may be experiencing, keep in mind that simply standing up may not be enough to ease your discomfort. Most of us, pain or no pain, have postural abnormalities. Chances are, if you do experience pain, yours are a little worse than most. In order to make the most out of standing at work, you need to be sure you do so without falling into these postural problems.

When we stand, most people tend to have too much arch in their lower back, a forwardly tipped pelvis, and stand with our weight on our toes (especially if you're wearing heels, ladies!). These issues cause our weight to be put onto our lower backs causing low back pain. When this happens, our stabilizing muscles are not able to work efficiently and we must compensate with others, such as our piriformis, causing possible sciatica and other discomfort.

How can you make the most out of your standing time?

Shift your weight- When we try to stand "correctly," with equal weight on both feet and standing erect, we tend to fall into the pattern described above. Try shifting your weight from side to side throughout your standing time, but be sure to share time between legs as most of us will "pick a leg" and stand on just that side for a majority of the time. Let's say you pick your left leg to stand on: pretend you have a quarter under your left heel and try to center your body weight over it. Placing your right foot slightly ahead of your left, with your toes pointed forward, will help accomplish this. If you're doing this correctly, you'll notice your pant zipper is aligned over your left big toe. This will keep your weight on your heel and your back in a more neutral position.

Pick the right shoes- Sure, many of us have certain dress codes we have to meet which usually means uncomfortable dress shoes for men and heels for women. No one said you have to wear them every minute of every day. Either bring a pair of tennis shoes to work, or buy a pair that you keep under your desk. When you want to stand, switch your shoes. This will not only make your feet more comfortable, it will help keep your weight on your heels appropriately.

Don't do it too long- Our bodies were just not made to hold a static position for more than 20 minutes. Even if you're shifting your weight from side to side, try to take a break every 30 minutes and walk a few steps around your office/cube, go to the bathroom, or refill that cup of coffee. No amount of will (or stubbornness) can beat anatomical and biomechanical design.

Change it up- Whether you're sitting or standing, we tend to set up our desks/work stations and leave them that way permanently. This is a problem because you are causing repetitive movements to take place which cause microtraumas to our tissues as well as possibly feed into our poor postural habits. Try moving your water or coffee to the left of the computer and the stapler to the right this week. Keep things interesting for your body so it doesn't begin to wear out!