The Importance of Posture

I get asked often about why we have such a focus on a person’s posture as we work with practice members and speak with individuals in public.  The reason being is that posture is a direct result of skeletal alignment and balance.  You might say that posture is  a low tech way of evaluating spinal alignment and balance.

Balanced, (proper) posture should present a straight line, parallel to the ground, if a line is created by connecting the two endpoints representing the right and left sides, typically the eyes (or top of ears), shoulders, hips, kneecaps and ankles.   In the side view of the individual a plumb line would pass from the ear canal downward through the center of the shoulder, through the hip joint, through the center of the knee joint to just in front of the ankle joint at approximately the highest part of the instep of the foot.  Any posture where one of these “landmarks” deviates away from the visualized line will create unnatural, unnecessary and detrimental stresses to every tissue of the body.  Theses stresses (compression, twisting, stretching, changes in chemistry) will affect the way that the tissue functions which will lead to pathology and symptoms and eventually tissue destruction.  The stresses from the forward leaning posture is the most detrimental.

Over the past dozen or so years, several studies have been published that demonstrated the importance of proper postural balance. A 1994 study appearing in American Journal of Pain Management found that “posture affects and moderates every physiologic function from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture…..it appears that homeostasis (healthy balance of systems) and autonomic regulation are intimately connected with posture.”(1)   Another study in 2005(2) found that the posture of carrying the head or body forward of the above mentioned plumb line found “All measures of health status showed significantly poorer scores as [the] plumb line deviation (forward lean) increased.”  Translated, this says that the greater the forward lean, the greater was the severity and occurrence of reported health problems.  Sleep apnea has also been associated with a forward head posture.(3) It has also been found that “Older men and women with hyperkyphotic (forward bent) posture have higher mortality (death) rates.”(4)

This is only 4 of the many studies, but their implications of poor posture on an individual’s health are great.  “Despite considerable evidence that posture affects physiology and function, the significant influence of posture on health is not addressed by most physicians.”(1)  So don’t think that since your medical doctor didn’t mention it that it shouldn’t be a concern.

It is due to these far reaching effects of posture on the individuals overall well being that dictates the necessity of not only looking at the pain pattern of our patients but also their overall posture and its potential effect on their future well being.

The individual may choose to only address the symptoms, but we believe that they should also be aware of circumstances that could jeopardize their future health and what can be done about them through chiropractic care.


Yours in health,

Dr. Heller


1.   Lennon J., Shealy C., Cady R., Matta W., Cox R., Simpson W. Postural and Respiratory Modulation of Autonomic Function, Pain, and Health. AJPM 1994; 4:36-39.
2.   Glassman, Steven D. MD; Bridwell, Keith MD; Dimar, John R. MD; Horton, William MD; Berven, Sigurd MD; Schwab, Frank MD  The Impact of Positive Sagittal Balance in Adult Spinal Deformity, Spine, Volume 30(18), September 15, 2005 pp. 2024-2029
3.   M. Murat Özbek, Keisuke Miyamoto, Alan A. Lowe and John A. Fleetham,  Natural head posture, upper airway morphology and obstructive sleep apnoea severity in adults,  European Journal of Orthodontics 20 (1998) 133–143.
4.  Journal of the American Geriatrics Society, 2004