Poor Posture in Sitting

Over the years, I have had many runners come to me with neck and shoulder pain. It’s not uncommon for this pain to occur in runners while training for a 5k, half marathon, marathon or triathlon. Many of these patients experience neck, upper back and/or upper arm pain that can be achy, dull, or sharp. Tingling and/or numbness on one side or both sides can also occur, and symptoms are typically intermittent. The following is a list of factors that can lead to neck and shoulder pain while running:

  • Poor running form
  • Loss of cervical extension
  • Loss of lumbar extension
  • Weakness in scapula stabilizers
  • Weakness in core
  • Tight hip flexors
  • Tightness in chest musculature
  • Weak glutes

Many runners will have one, a few, or all of these deficits if they are currently experiencing neck and shoulder pain while running. Once these areas are addressed, the patient’s running form and posture have to be adjusted in sports, at home and at work. I think the athlete’s primary issue is poor postural awareness, especially during times of fatigue when overall running form can deteriorate.   This is further compounded by our daily activities and positions. Even though we’re talking about avid recreational runners, many of them have day jobs that are more sedentary.

Many of my patients get the best results from an ergonomic evaluation of one’s workstation. It’s been said that sitting is “the new smoking”; several studies show increased incidence of heart, spine and cognitive function issues based on extensive sitting. These studies additionally show that those who exercise and also sit for long periods have decreased health compared to people whose daily routines do not require extensive sitting. A great option is to purchase an adjustable standing desk for your workspace, which allows the body to attain a more neutral posture. In addition to a workstation evaluation, these patients have also greatly benefited from an assessment of their running form by a running coach and/or physical therapist.

Since we do live in more of a “C” society, we see certain patterns of tightness of muscles held in shortened positions and other muscles that are lengthened causing them to be weaker. Looking at our tablets, phones and desktop computers perpetuates these muscle imbalances, which are then brought into our performance in various sports. We need adequate range of motion and strength for optimal performance in many sports. Range of motion and strength are essential building blocks for maximizing your performance in running and jogging. The muscle imbalances are more related to our day-to-day, sedentary behavior, and have less to do with our more active pursuits. This requires a true maintenance program of stretches to ensure these imbalances (once corrected) don’t return. Ultimately, these imbalances are found at the root of a patient who has pain during running.

We have come a long way in understanding how stretching and strengthening exercises – specifically core exercises – can cause improvements in running efficiency and improve running times. However, I do feel that as a group, runners do not engage in enough fundamental strength exercises, predisposing them to certain sports related injuries. Those numbers are improving but aren’t ingrained in the culture as much as football, basketball, and soccer. Over time, hopefully this changes.

Once a person addresses these factors, he or she must also change their movement patterns in order to see an improvement in pain and function. Many of us have taken our current postural preferences, the way we walk and sit, as the norm since we have been doing it for so long. My best insights are gained from watching my patients walking in the parking lot or in the waiting room to see how they move when not being formally observed. My mantra is: if I could spend a day with every patient, I could figure out their faulty movement patterns and preferred postures rather quickly that might be contributing to their current condition. We don’t always have a mirror in front of us to see how we are moving or positioning ourselves, so having a physical therapist take a look at your movements can be quite revealing.