Posture and Your Balance

Changes to your posture maybe a normal part of aging, however, a bend over hunched back or stooped posture called Kyphosis or Hyper-Kyphosis is not normal and increases your risk for balance problems and falls.

Often with kyphosis, there are no symptoms or just mild discomfort, however you should be aware of possible problems developing including:

• Breathing problems

• Increased risk for choking

• Balance issues and increased risk for falling, fracture and disability

• Problems performing daily activities of living due to pain, discomfort, and/or fatigue

  
  

Aging affects three main systems responsible for your posture:

(1) Bones (vertebrae) in your spine

(2) The disks that act as cushions between your vertebrae and

(3) Your muscles

Bone loss and fracture risk: As we age we often lose bone density. Low Bone Density is called Osteopenia (T-Scorse -1.0 to -2.5) and Very Low bone density is called Osteoporosis (T-Scores -2.5 and less) which can cause the bones in your spine to lose calcium, become less dense, shrink a little and change shape. With bone loss there is an increased risk for fracture in the event of a fall, even a cough or sneeze can cause spinal fracture, a spontaneous spinal fracture can happen due to poor posture and when the vertebrae just becomes too weak. These spontaneous fractures don’t always cause pain and you continue everyday life, however when these spinal fractures heal in a misaligned position your hunched back may become a permanent issue and can cause increasing health issues such as problems with swallowing, breathing, and problems with balance and increasing fall risk.

When you receive a bone density scan of the lumbar spine (L1, L2, L3 and L4) you do not always know the T-Scores of the individual lumbar vertebrae and you receive the average. When this is the case some of the 4 vertebrea maybe at a normal bone density and the remaining at the level of osteoporosis. This makes you unaware of risk for spinal fracture and you may find out after you experience spinal fracture you did not know you were at high risk for.

Disk shrinkage: 
As we grow older, spinal disks which have a rubbery exterior and squishy interior that starts to dry out and shrink. As a result, the bones in your spine creep closer together, which affects the way you move including your gait or the way you walk. This can also lead to spinal compression fractures when your spine is bend or flexed. Spinal compression fractures can also happen when you move the wrong way such as rotating when your back is bend.

Muscle loss: On average people lose around 3 to 8% of muscle per decade after age 30, and the rate of decline is higher after age 60. Your muscles help support your spine and keep your torso upright, but you tend to lose muscle mass as you age. This process can be slowed with continued exercise, specifically appropriate resistance training and good nutrition. Even at adanced old age (at 90+ years) you can still make improvements in strength, balance, mobility and stamina.

Preventing postural problems as you age:

To avoid problems related to posture you may be able to make lifestyle changes or discuss the issue with your healthcare provider. Kyphosis may not develop as you age. Keeping your back, chest, and core muscles strong can help prevent postural problems. Think about your posture as you go about your daily activities and correct your posture when you find yourself bending over by sitting up straight, and by taking breaks from activities that cause poor posture. Walk tall and keep eyes directed forward as you walk and look down only to scan for obstacles in your environment.

Consider strengthening exercises that focus on your shoulders and your core. There are posture correction exercises and more targeted exercises that help load the hip and spine to preserve and boost bone density, and muscle strength around hip-, lumbar-, thoracic- and cervical-spine. Think of exercise as a reliable, drug-free option to improve your posture and the discomfort that goes with it.

You maybe able to reverse postural kyphosis before it becomes a permanent problem. See how far a commitment to not slouching will take you before considering other options. Exercises such as stretching the muscles of the front of your body (such as chest muslces and hip flexors) and strengthening muscles of the back and rear shoulders which may improve posture before permanent changes happen in the spine. Consider a chair or couch that is supportive and fits you. Seats that are too low, too soft and too deep may cause slouching and require your to bend over too far in order to get up, a firm mattress on your bed may also help. A change in lifestyle and, when appropriate, treatments may improve symptoms and help keep problems from getting worse.

Positive lifestyle choices for posture:

The lifestyle choices that improve age-related posture problems can benefit anyone with or without orthopedic issues.

1. Get regular exercise, this is a drug-free option to improve muscle strength, bone density, posture, balance stamina, and can prevent frailty, falls and injury. A Certified Personal Trainer and/or Corrective Exercise Specialist can design an appriopriate exercise program for you.

2. Eat a plant based diet and avoid added sugars and foods that contribute to chronic medical conditions such as heart disease, hypertension, diabetes, .obesity, etc.

3. Ask your doctor about calcium and vitamin D supplements.

4. Limit alcohol use and avoid tobacco, which weaken bones

5. Medication is often prescribed for osteoporosis, always consider the side effects when you outweigh the pro’s and con’s.

6. Physical Therapy is another drug-free option to correct posture, for example if you suspect a spinal fracture or sudden back pain. When a spinal fracture heals in a misaligned position the chance of repeated spinal fractures increases due to worsening posture. Additionally, the hunched over the walker posture increases risk for spinal fractures when osteoporosis is present in the spine. A physical therapist can adjust your walker to the correct height and teach you how to correctly use the walker.

When you receive regular personal training or physical therapy from the health and fitness professionals with Fitness & Function you are receiving posture correction cues during your exercise or treatment session. We often include posture correction exercises in your exercise program regimen and can thus prevent postural problems from happening, slow down progression or reversing the problem.

Let us know when you have additional or specific questions or concerns regarding your posture.