This month we introduce Rebecca Mooney who, along with Malcolm Hood, will continue to be our fitness and health coaches.
Rebecca was born in Pukekohe and spent her younger years here. She began gymnastics at the age of 4, at the Pukekohe Gymnastics Club, and her dedication to the sport led her to compete at national and international levels. Rebecca attended Auckland University of Technology, graduating in 2013 with a BHSc (Physiotherapy). She then continued to complete post-graduate studies in Musculoskeletal Physiotherapy (PgDipMSK). Rebecca has a passion for all things 'physio' — the acute and severe sporting injuries, spinal injuries/pain, the common but persistent “niggly” issues, and intensive rehabilitation. Her undoubted skills in sports medicine and fitness training complements Malcolm’s wisdom on staying well at home and work — combined they will provide us with a valuable coaching resource. Malcolm and Rebecca were to offer personalised fitness advice at our postponed Wairakei Weekend. If you would like an online consult, reach out to the team at admin@physiodepot.co.nz.
This month they talk to us about the effects of bad posture from Device Overuse Syndrome for the young and not so young!
When you read this article by Doctor Scott, Rebecca and Malcolm recommend, as background, to remember healthy posture is not so much nature, but much more nurture. As parents, grandparents, guardians, or just loving observers, few of us evolve to exhibit quality posture.
The first challenge is to make a judgment between what the difference is between ‘usual’ and ‘normal’? The answer is at the end of the article!
Dr Hannah Scott knows all too well the end results of poor posture in early life — and how you can prevent them. Slouching causes reduced concentration. Sitting up increases blood flow to the brain by up to 40 per cent.
Article from Dr Hannah Scott, published Oct 1, 2021 in The Times.
The other day I watched my son stoop over his iPad, then put on his heavy backpack and set off to school with rounded shoulders. My heart sank. He has bad posture already and he’s only eight years old.
As a consultant anaesthetist who has observed the end results in hospital pain clinics, I know all too well the consequences of bad posture. It’s not just back pain, but a raft of health problems that may lie in store for our slouching children, from headaches to poor concentration. Telling your kids to “Sit up straight!” seems rather old-fashioned. It’s something that your parents might have said to you when you were a child, but it’s more important for children today. We are fastidious about teaching our kids to clean their teeth and floss daily. We need to dedicate as much effort to their precious, irreplaceable backs.
Poor posture in childhood and adolescence is on the rise. The pandemic has, of course, exacerbated the problem, with children and teenagers spending hours in front of screens, for education and entertainment, while exercise was curtailed. But it existed before that. Back conditions are being diagnosed in younger and younger age groups, according to a meta-analysis of studies in the journal BMC Paediatrics. The same research found that 10 per cent of ten-year-olds have lower-back pain associated with posture, while another study found that 38 per cent of primary school children had bad posture.
Why is there such an increase? I believe there are several reasons. Childhood obesity is more common nowadays. According to the National Child Measurement Programme, 21 per cent of children aged 10-11 are obese and 14 per cent are overweight. That causes changes to weight distribution throughout the body, including a protruding stomach, a hunched upper back and a concave lower back. Children spend less time being active and more time being driven around in cars. They also spend a lot of time carrying heavy school bags around, thanks to laptops and giant text books.
And, of course, there is the ubiquitous problem of tablets and smartphones. I’ve seen the problems they can cause. Children hold their devices at chest level so they have to look down. They end up sticking their head forwards, beyond the centre of gravity in the middle of their shoulders, and can develop what’s colloquially called “tech neck” — where the cervical spine becomes curved. Children — and, indeed, adults — should always bring devices up to eye level.
Even before the pandemic children and adolescents were spending more than four hours a day on their screens. Unfortunately rates of exercise, which helps to offset the damage, are down. According to one (pre-pandemic) government health survey, most children in the UK do less than one hour’s physical activity a week.
Bad posture can cause a number of immediate health issues in children. One issue is headaches: maintaining an abnormal head position leads to a build-up of tension in the neck muscles. Then there’s fatigue: hunching reduces lung capacity, meaning the body doesn’t get as much oxygen, and slouching causes reduced concentration, but sitting up straight increases blood flow and oxygen to the brain by up to 40 per cent. Research has also shown that children who slump release more stress hormones and are more tearful, hostile, nervous, quiet and passive. In contrast, standing up straight is directly related to better mood.
What’s more, the unhealthy positions that children adopt as they grow become their default positions in adulthood. And this, most importantly, can contribute to degenerative back conditions — put simply, wear and tear of the joints. To give an example, I’ve seen how long-term slouching places abnormal strain on the cartilage pads that lie between the lower backbones. This can lead to disc degeneration, where the pads thin down and bulge out. Chronic slouching stretches and weakens the long stabilising muscles that run down either side of the spine. This contributes to hyperkyphosis, an extremely humped upper torso.
The list of complaints related to degenerative back conditions in adults is long. It includes osteoarthritis of other joints, gastric reflux (as a scrunched lower back compresses the stomach, pushing gastric acid upwards), poor balance, falls and fractures. The latter is because changes in normal curvature of the spine offset the centre of gravity and stiff back joints hinder the small movements important for correcting imbalance.
Correcting such conditions is much more challenging than correcting posture. I’ve seen patients in chronic pain clinics with a lifetime of suffering and failed treatments behind them. Or presenting for surgery — a very last resort. Prevention really is better than cure.
In Europe they seem to take posture in children much more seriously. In Italy and Germany, when children start school, as a rite of passage, it is not uncommon for parents to spend more than £250 on an ergonomic backpack. It’s a purchase that is given the same importance we give to buying car seats and buggies. The Germans have the AGR, the Aktion Gesunder Rücken, an association made up of professionals dedicated to back care, which includes posture, core movement and prevention of injury. The AGR awards products with a seal of approval when they comply with back-protection standards; tables, chairs, car seats, straps and bags are examined and reviewed yearly. Consumers look out for the AGR-approval logo in the same way that we look out for the organic logo when buying food.
I don’t believe there is anything to compare here in the UK, however much kids may love their fashionable backpacks. The best I’ve seen are from Ergobag, available on Amazon, which come in various designs. They’re expensive, though — at least £100. There are things parents can look out for when choosing a backpack. Make sure the straps are wide and that the bag has a bit of structure. Try to buy one that is designed so the weight is carried in the centre of the child’s back, not in any side pockets.
The good news is that teaching good posture is effective. There is evidence to show that posture can improve all the way through childhood and adolescence, so even if your child is 16 it’s not too late to do something about it. Although repetitive and boring, it is well worth putting the time in to encourage your child to sit up straight or stand with shoulders back. Research shows that to create a postural habit takes about 300-500 repetitions, but to correct a faulty habit takes about 3,000-5,000 repetitions, so it’s worth getting them into good habits early. It takes time and effort, but correcting your children’s posture can profoundly change their lives.
7 ways to help young backs
Encourage children to bring their devices up to eye level. You want them looking straight ahead, which keeps the neck and spine in correct alignment.
Ensure tables, chairs and computers are set at the correct height for your child. Their backs should be straight and their feet flat on the floor. They should be positioned to allow them to look straight ahead at the computer.
Get them moving. Any exercise at all is better than nothing.
Buy a backpack with wide, well-padded straps — ideally at least 4cm wide — and make sure your child uses both shoulder straps.
Encourage stretch breaks. Every 20 minutes during homework or on screens of any kind, get your kids into the habit of standing up and stretching.
When you see bad posture, remind them to stand or sit up straight. Physiotherapists use a red-dot technique, placing red stickers around the house as a visual trigger. When the child sees them, they remember to stand tall.
Get your child to do five minutes of back-strengthening exercises a day. One good one is lying on their front, extending the arms forwards and lifting the arms up in a superman pose.
The answer to the question of what is usual and what is normal?
Usual is the posture we most often see in youth.
Normal is the posture seen when standing back against the wall, head against the wall, butt against the fall, feet against the wall. Try it!