One of the most common questions I get as a physio working with children is how to encourage better posture. The question often comes from a Mum or Dad with a history of neck or back pain and a standing weekly appointment with the chiro, keen to direct their offspring down a different path. As teens hit high school, aches and pains can start to present, and incessantly nagging “sit up straight” is mostly met with an eye roll and a half-hearted wiggle of the shoulders.
What is good posture?
Good posture is the position where your joints and muscles are aligned properly to work efficiently and reduce stress and strain on the body. Good posture requires muscles that are balanced in strength and length, and have the endurance to keep working throughout the day and against stress and load. Maintaining good posture naturally faces some challenges as our children grown towards adolescence:
Growth spurts lead to changes in muscle strength and length, causing imbalances and temporarily impairing proprioceptive feedback about where the body is in space.
Activity levels slowly change, with many teens either becoming more sedentary, or specialising in a particular sporting activity that may use the body unevenly.
As the work load of school increases, longer periods of time are spent sitting at a desk. Poor posture when studying due to poor ergonomics at home/school, insufficient breaks or fatigue can cause weakness and tightness to emerge over time.
Heavy school bags (particularly slung over one shoulder) place additional load
Increased screen time, particularly on lap tops, tablets and phones, leads to increased time spent in slumped/flexed postures
Some children face additional challenges from their body composition and genetics. Children who are hypermobile, low tone, have chronic respiratory issues, neurological changes or inflammatory conditions will have additional challenges to maintaining good posture and ideally require a physio assessment to look at their own unique strengths and weaknesses and be managed accordingly.
Below are a few exercises to help your primary school or high school aged child improve their posture and get back on track to a balanced body.
Step 1 : Lengthen
Tight muscles can pull the body out of alignment, placing strain on joints and placing the muscles in a less efficient position to function. Daily stretches can help keep these muscles long and limber.
Hip Flexors – These muscles get tight from lots of sitting and lead to the pelvis tilting forward and an exaggerated curve in the lower back.
Hamstrings – Show me a teenage boy and I will show you some tight hamstrings. Tight hamstrings are extremely common during adolescence due to growth spurts in the long bones, and due to over compensating for a weak core.
Muscles of the neck and upper back – Weakness of the stabilising muscles of the back and shoulders, and sitting at a desk slouching with the chin protruding lead to tight, sore neck muscles.
Anterior Chest – Rounded shoulders can be combated with stretches to open up the front of the chest.
Spinal mobility – Poor posture can lead to a stiff and immobile thoracic spine.
Step 2: Strengthen
For good posture we need a balance of strength throughout the front and back of the body. Areas to target – weak bums, weak tums, weak back extensors/shoulder muscles, and turning them on at the right time and in the right way, building stability muscles that can work all day and keep your body upright and strong.
Ideas for younger children to work these muscles
High kneeling with vertical work. Good activities require reaching and pushing, for example doing a jigsaw puzzle on the wall with blu tack or doing a collage on an easel. Activities that require control like painting are also good for shoulder control – make sure there is no leaning on the wall!
Animal jumps and walks. Set up an obstacle course with pillows to go over and items to go around and practice bear and crab walks. Add a balloon and play crab soccer, or use a stop watch for time trials
Climbing structures at the park
Self-propelling on the swing is a great work out for the whole body
Push and pull play – wheelbarrows, tug a war, digging, sweeping and raking
Ideas for teenagers
Arm and leg lifts on hands and knees to strengthen extensors and core. Add nose touches or leg kicks to increase the challenge
Clamshells and single leg bridges for a strong bottom.
“Swimming” on tummy with chin tucked
Wall push ups with shoulder blades back and down
Roll outs into a high plank on a fit ball
Lateral bear walks - on you hands and knees with your knees just off the ground and "walk" sideways. Great for control through your whole core!
Step 3: Change your habits!
Improve your workstation set up. This can be trickier at school, but there is no excuse at home! Work Safe Queensland Guidelines for Ergonomic Set Up
Sit on a fit ball, or study prone on elbows. Take regular breaks when you start to fatigue.
Put down the technology and get more active.
Gentle prompting when posture starts heading downhill– take a break, have a stretch, go for a quick walk, change positions. Old habits die hard, and a gentle reminder is particularly useful to teenagers studying hard and forgetting to look after their bodies.