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This photo was used to advertise a back brace on Instagram and the way the girl stands is something I see a lot of especially in young females.  Probably more so now than back in the 80’s when I first started out as a physio – and I’m guessing this is because there’s so much talk about the value of good posture.

I haven’t tried the back brace and the purpose of this post is not to comment on how effective it may or may not be in helping people stand up well. It’s about the photograph.

The power of a photograph

We are social animals and will instinctively mirror what we see. If we are using images and videos or demonstrating ourselves, we have a responsibility to be correct otherwise we do a great disservice to our audience and potentially cause them more problems than we prevent.

So how will will know whether what we are looking at is helpful to  our understanding of good posture?

A good place to start is with the plumbline.

The plumb line corresponds with the line of gravity as shown by the arrow in the above photograph. Ideally it passes through the tragus of the ear (the nobbly bit at the front of the ear canal) the aromion process of the shoulder blade that extends over the top of the shoulder joint, the greater trochanter which is the large bony prominence on the side of your thigh in line with your hip joint, the middle of the side of the knee joint and the same with the ankle.

See how the acromion process at the side of the shoulder is way behind the plumbline – in this case due to over extension of the thoracic (middle) part of the spine which lifts the chest and the lower ribs.

This will have implications for the whole length of the spine many associated muscles which have to hold and accommodate this unnatural posture.

It is not helpful to sit or stand with what can rather crudely be described as a “tits up” posture. It changes the very foundations of our physicality and can lead to all sorts of problems including tension and pain of the neck and jaw as well as the middle and low back. Further it affects how we breathe since the diaphragm is attached to the lower ribs.

Standing well does not have to be this hard. Start with the plumb line and see how you get on.

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