Stand normally. What exactly does that look like? What exactly does that mean? Does it mean stand as you would on a typical day? Does it mean stand following what you think is good posture?
Yes. The answer is yes. All of these questions and resulting standing postures give good insight into how your body reacts to how you move. There is not a one size fits all fix to body pain. It takes a keen sense of observation, what a physical therapist is trained to do, to tease out what makes your body move the way it does.
That being said, there is an “optimal” posture to try to achieve. Ribs over hips, nipples straight forward, pelvis neutral. This describes a typical stacked posture. Benefits of a stacked posture include a more accessible pelvic floor excursion, diaphragmatic excursion and rib cage range of motion. Will this posture fix everything? No but it will allow your muscles a good starting length to promote the best contraction AND relaxation. Think trying to open a door while holding groceries in one hand and a toddler in the other. It’s hard to generate that force to pull a door open because you are trying to engage something that is already taking on too much. That’s where compensation comes in. You use your hip or foot or knee to hold the door to squeak through. Then, bam, you have a bruise on your hip from trying to stop the door from crashing closed and instead crashes into you. Let’s break this down into PT parts.
Why not just put the groceries down? Why not put the toddler down (rule #2465 never put down a rambunctious toddler down because he will ransack the very grocery bags you are trying so hard to balance on your arm)? Why not go through an automatic door or a garage door? All of these are modifications versus the compensations that resulted in the hip bruise. Modifications are super useful when rehabilitating any part of your body. Modifications can help you achieve your end goal in a stepwise fashion and open that door. Here’s a guided check on how to achieve a stacked posture:
Ribs over hips: Are your shoulder blades behind your sacrum? Are your shoulders in front of your hips? Can your shoulders land right in the center? Your ribs should be over your hips.
Nipples straight forward: Look in a mirror. Are your nipples/breast tissue looking straight at you? Are they looking up to the ceiling? Or are they pointing down to the ground? Aim for them to be straight ahead drawing a straight line to the horizon.
Pelvis neutral: Can you tuck your butt under and make your low back flat? Can you point your hip bones down and make more of an arch in your back? Can you try and find a midpoint in between? Pelvis neutral means finding a place where you are in between arched and flat allowing for your pelvic floor to be most accessible.
Posture is tricky but it can be a helpful tool to start to address some of your painful symptoms. Physical therapy can help you find what your normal is. Physical therapy can help you get moving and back to whatever grocery shopping, toddler racing or mom-ercising you need to do.
Corinna Lau is an experienced senior physical therapist at New York Presbyterian-Columbia University Irving Medical Center and small business owner of Perspectives Physical Therapy as well as a Pregnancy and Postpartum Athleticism Coach. She is in the process of completing her Obstetric Physical Therapy certificate and specialization in Pelvic Floor Physical Therapy. You can follow her on Instagram @activemotherhooddpt, email her at [email protected] or call her at (516)243-7041 with any questions or interest in working together.
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