COVID-19 Posture Pandemic

During the pandemic an elevated cohort has found themselves working from home in less than ideal ergonomic situations. Many sit for prolonged periods due to their occupation, often in poor desk situations. We have identified an increased rate of postural dysfunction during this time, with a high incidence of mid-back and neck pain. This pain is often associated with an increased thoracic kyphosis (rounding of the back) and lordosis (excessive extension in C-spine) . During my research here at Aktiv Coast Healthcare I have found the following exercises to be beneficial in correcting this postural dysfunction and combatting symptoms.

Before working on the exercises let’s bring our attention to our posture. Relax the shoulders, “tuck the chin” and if necessary, move your computer further forward on your desk. It is important to bring the neck back, into a neutral position, to relax tight muscles in your upper back and neck. Dr. Linn recommends setting a timer to go off routinely and/or a visual cue posted on the wall behind your computer (such as below) to remind you to stay aware of your posture to ensure you are not beginning to hunch forward. This is especially helpful when you become entrenched in your work and begin to subconsciously stray away from healthy body positioning.

The cat-cow stretch works to mobilize the spinal joints, increasing the viscosity of the joints, and helps re-establish a healthy neutral spine. To work into the cow pose, inhale deeply and let your belly drop, extending your mid-back, bringing your chest/eyes to the ceiling. At the peak of this pose you can squeeze your shoulder blades together, appreciating the stretch. Ideal positioning displays an arched back. At this point, to move into the cat pose, exhale slowly and round your back, dropping your chin to your chest. Bring your belly to the ceiling, let your head naturally drop and enjoy the stretch!

To recondition a kyphotic posture one needs to reestablish a healthy force couple in the shoulder. A tight chest pulls the shoulders anteriorly, contributing to neck and back muscle strain. To stretch anterior muscles, use a lacrosse/tennis ball: Place the ball on your chest, and roll until you find a tender spot called a “trigger point”.  Hold the spot until the tension and soreness gradually fades after anywhere from 30 seconds to 2 minutes. Repeat on both sides a few times a day.

Another great stretch for tight chest muscles is the doorway stretch. With one hand as a fulcrum, work on bringing your shoulder posteriorly, feel the stretch running up your armpit from your chest. Once you can feel chest tension begin to decrease (usually after 60 seconds to 2 minutes) you can relax and repeat.

Two of the main muscles that work to retract the scapula are the lower trapezius, and the serratus anterior. These are muscles commonly weak in postural syndromes.

The Reach, Roll, Pull, Lift Exercise is extremely beneficial when working on bringing your scapula back to your midline. Begin this exercise by placing your palms on a wall. Now, reach maximally skyward with your palms sliding up the wall. At the peak of your reach, roll your palms towards each other and pull your arms down the wall a few inches. Be sure to avoid shrugging your shoulders during this motion. In this posture, lift your arms skyward while feeling your retracted  scapula (towards your midline). Return to the starting positioning in a controlled manner, appreciating the feeling of a retracted scapula. Repeat this exercise daily in a 3×10 routine with an emphasis on the quality of the exercise as opposed to quantity.

To further stabilize and keep the scapula from drifting forward it’s important to work on the rotator cuff because it works in conjunction with the scapulothoracic muscles detailed above.

To rectify the weak posterior muscles, conduct exercises that retract your scapula: side lying external rotations are a superb exercise to achieve this. Side lying is superior to standing because gravity acts away from your deltoid (giving you the ability to activate weak external rotators). Lay on your side, with your elbow flexed to 90 degrees bring your hand into an externally rotated position to the ROM before your forearm is perpendicular to the floor. Focus on moving through your shoulder joint solely, feel your teres minor and infraspinatus doing the work as opposed to the strong deltoid. If your hand is drawn towards your head the exercise is being conducted incorrectly. Complete this exercise for quality reps as opposed to quantity as you are training a likely weak muscle group. Once fatigue sets in, switch to the contralateral side. Train your external rotators for endurance to ensure the ability to retract the shoulder blades is maintained unconsciously.

By following the steps above, you can work towards correcting this postural dysfunction attributed to increased sedentary time in association with a non-ideal ergonomic situation that has plagued many, including myself, during the pandemic.