“ As your desire is, so is your will. As your will is, so is your deed. As your deed is, so is your destiny." - Upanishads
We all know that poor posture is not good for us, nor is it aesthetically pleasing, but can it also hasten our demise? That is, can poor posture kill you? This question may sound like a crazy internet headline that makes you wonder if this blog has taken a downward spiral. But the claim is not as bombastic as it seems. There is credible evidence that the way in which we hold ourselves upright is critical to our wellbeing in later years. Since the muscles in our neck are designed to move the head in coordination with the eyes, our posture reflects how and what we focus our attention on, as well as the strength and symmetry of the musculature in our upper body. It has been said that we become what we pay attention to; this is true in a very physical sense when it comes to the health of our spine.
Text neck syndrome describes a repetitive stress injury to the neck that develops from holding the head in a forward position for extended periods of time. Although not an official medical diagnosis, text neck generally refers to the strain caused by excessive texting or overuse of mobile devices. But any situation in which we remain immobile while staring at something in front of us for long periods can lead to a forward head position. Considering a good deal of modern life happens in front of us—on a screen, driving a car, reading a book, knitting, gardening—anyone is vulnerable to neck strain. Chronic forward head position can literally become a pain in the neck, as it leads to the development of painful trigger points or a general achiness that spans from the bottom of the neck and into the shoulders. Over time, the muscles in the neck, shoulders, and upper back become stiff and weak, causing bone spurs and damage in the cervical vertebrae. The long-term consequence of neck strain can be serious, as it is the first step in a slow progression toward the development of kyphosis—the hump that appears in the upper back that many associate with old age.
In many ways, we experience the world through the soles of our feet and the palms of our hands, accessing our world from the outside in. Perched on the base of the cervical spine, the neck muscles take our head where our gaze leads us. Our shoulders, arms, and hands allow us to reach and grasp what is in our field of vision, and, due to their anatomy, are directly impacted by what happens in the neck. Movements in the shoulders are supported by a structure called the shoulder girdle, a series of bones that depend on several muscles to move our shoulders so that the arm and hand can manipulate the world with precision. The shoulder girdle includes the scapula, or what we call the shoulder blade, and the clavicle or collarbone. It also includes two bones that are projections of the scapula, the acromion and coracoid process. The glenoid cavity is also part of the shoulder girdle. It is the socket portion of the ball and socket configuration of the shoulder joint and is where the upper arm bone--the humerus—connects to the shoulder girdle.
The movement and health of the shoulder girdle relies on a series of muscles that connect it to the spine and the rib cage. Its lack of boney attachments to the spine offers the shoulder a wide range of motion, but the health of the joint is dependent on the precision of the muscles that support its movements. More importantly, because the clavicle is an attachment point for jaw muscles, the shoulder girdle is profoundly affected by movements of the head. It also has a sensory-motor connection to the brain, which moves our arms and hands in coordination with our eyes to provide accuracy and coordination to what we reach for and what we grasp, examine, and manipulate, as well as what we push away, change, and modify in the world around us.
The connection of the shoulder girdle with the head makes it highly sensitive to the way the activities in the mind create strain in the neck. The tension in the jaw and neck that is associated with stress, anxiety, worry, or anger frequently show up in the shoulders. As the neck tenses, the shoulders elevate and curl in while the upper arm and chest converge. This leads to a shortening of the chest and rib cage muscles, which not only causes shoulder dysfunction, but changes how we breathe. And the relationship between our breath and emotions runs deep, frequently going unnoticed but exerting a good deal of influence over our posture.
To understand how breathing can impact posture, it is helpful to start with what happens in a natural, relaxed breath. This pattern of breathing starts in the belly just below the ribs. As we inhale, the diaphragm presses into the abdominal cavity, the lower ribs expand, the collarbones roll upward, and the shoulder rotates outward. The ribs expand, allowing the incoming air to flow freely to the lower lobes of the lungs. Here the air finds a rich supply of blood that picks up and distributes the incoming oxygen throughout the body. On the exhale, the belly, chest, and ribs relax as the diaphragm lifts back to its dome position tucked under the heart. During the exhale, the muscles of the neck and skull soften which releases tension in the shoulders.
Breathing patterns are partly regulated by regions in the brain related to emotions. When we are stressed, fearful, or experiencing a negative emotion, our breathing will change before our awareness of the emotion. Stress shows up first as a shallow breath, one in which we use neck, head, and the upper chest muscles rather than the diaphragm, a pattern referred to as “chest breathing”. Chest breathing draws air primarily into the top lobes of the lungs, which are not as efficient as the lower lobes in exchanging oxygen and carbon dioxide. The result is a poor mix of oxygen and carbon dioxide, which changes the alkalinity of the blood, triggering feelings of apprehension and anxiety. These emotions trigger more chest breathing, perpetuating the tension. The smooth muscles of the blood vessels constrict, reducing the blood flow to the neck and shoulders. These muscles become stiff and painful; we get stuck in a cycle of tension, anxiety, and chest breathing which reinforces poor postural patterns.
On paper, chest breathing seems like a dramatic event, but in practice it is subtle, one that can be maintained for long periods of time without our awareness. Frequently we only notice the apprehension and anxiety that it creates, so we search to build a story around the emotion: our job is stressful, a coworker is irritating, worry about our children’s future, rush hour traffic. Changes in our breathing patterns can be so subtle that it is hard to know what comes first—the emotions or the breathing. Do negative emotions trigger our shoulders to curl in, collapse the chest, and create tension in the neck, thus initiating chest breathing? Or is it poor postural dynamics that make chest breathing more likely, thus making us more sensitive to experiencing the world as stressful, threatening, dangerous, and full of hassles?
There is an axiom in the yoga tradition that tells us that the most profound truths in life are right under our noses, fully present in what is most obvious, but they go unrecognized as we search for elaborate theories and extensive storylines. We are reminded that what is important is not to figure out why something happens but noticing what is happening in the moment. Sometimes emotions are sneaky and hard to identify, but we can always notice the breath and our posture. With noticing comes the opportunity to change, to exhale slowly, put down the phone, lift our head, and draw our attention to something new.
Can poor posture kill us? Kyphosis, the distant cousin to forward head position, has been shown to be a risk factor for fractures of the hip, which is a leading cause of decline and mortality in the elderly. This risk is independent of bone density, suggesting that kyphosis is a separate risk factor for suffering fractures. More importantly, studies are showing that the stooped forward position of kyphosis puts tremendous pressure on the chest cavity, decreasing one’s lung capacity and creating shortness of breath. And studies show that shortness of breath is a critical factor that leads to the deterioration of health in later years, as the lack of oxygen undermines all the body’s vital functions.
I leave it up to you to decide if poor posture is the path to an early demise. We certainly know it can make us miserable. But it is also something we can work to change. We simply start by expanding our focus, broadening our attention, holding our head up, extending our arms and spreading our collar bones wide. Do this often and see what happens. It is so simple that it might just be the key to a long and healthy life.
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