How to (Permanently) Fix Bad Posture

​Rounded shoulders, nagging headaches, constant lower back pain... sound familiar? All these symptoms are running rampant in today’s society, due to so many people living a sedentary lifestyle and spending most of their day sitting at desks or looking at smartphones.

​However, bad posture is correctable - and this is lucky, because with time it can lead to much more serious medical issues. For every inch the head moves forward, an additional 10 pounds of weight is straining the neck (in addition to an already 12 pound skull). This can eventually deform the spine, reduce the amount of air the lungs can hold, and even increase mortality rate. Intervertebral discs are also compressed in a dangerous way, which can lead to back pain and nerve damage.

Unfortunately, the fix isn’t as simple as daily stretching. While releasing chronically tight muscles is definitely beneficial, it will only provide temporary relief. Since the opposing muscles usually don’t have the strength to maintain this improved positioning, the body gradually contorts back into having rounded shoulders, forward head, and curved spine - and the aches and pains continue. 

Therefore, to reach a more permanent solution, it’s equally important to also be strengthening these opposing muscle groups with carefully selected corrective exercises. When this is done, it’s much easier to keep your body aligned throughout the day.

Below are some examples of both stretches and exercises that are effective in correcting rounded shoulders and forward head posture (commonly known as “Upper Crossed Syndrome”), as well as lower back pain, knee pain and tight hips (commonly caused by “Lower Crossed Syndrome”). Both of these syndromes are extremely prevalent in people who sit at a desk all day!

Note that, for best results, frequency is key. Try to perform the stretches every day if you can, and the resistance exercises at least 3 times a week. If you don’t have access to a gym, most of the exercises can be done at home with resistance bands (at least when you’re just starting out - it’s highly recommended to begin adding weights once they become too easy).

UPPER BODY MOBILITY

Before you begin strengthening weak muscles, it’s important to start working on mobilizing the chronically tight areas - otherwise, you likely won’t even have the range of motion to do the strengthening exercises correctly! This is especially true for the upper body. In particularly problematic cases, several weeks must be spent stretching and releasing the shoulders before significant improvement is seen.

Muscles which are usually tight include the pectorals, suboccipitals, upper trapezius, and levator scapulae. Here’s a few examples of drills you can use to loosen up these areas:

1. Chin Tuck with Lacrosse Ball

This is a great way to relieve the suboccipitals. These muscles are located at the base of the skull, and tighten when the head is held in a forward position - often resulting in headaches.  

Set-up:
- Lie on your back on a flat surface, with a lacrosse ball placed at the base of your skull (slightly to one side of the spine). 

How to do it:
- Slowly nod your head, focusing on the stiffest spots (you can use your hands to hold onto the ball if it keeps slipping away).
- Spend about 1 minute per side (or longer if needed).

2. Pectoralis Ball Roll

This drill is useful for releasing tightness in both the pectoralis major and minor (muscles responsible for pulling the shoulders into a rounded position).

Set-up:
- To target the right pectorals, place your right hand behind your lower back. 
- Stand facing a wall, with a lacrosse ball between the ride side of your chest and the wall.

How to do it:
- Start shifting your trunk around, focusing on the tightest spots (the pectoralis minor - located close to the armpit - is usually a good spot to target).
​- Spend about 1 minute per side (or longer if needed).

3. Scapular Wall Slides

This is a great dynamic stretch which also doubles as a strengthening exercise. It helps to mobilize the shoulders (by stretching chronically tight muscles such as the pecs and lats), while simultaneously strengthening muscles important for functional shoulder movements (such as the mid/lower traps).

Set-up:
- Stand several inches away from a wall, and lean your back against it.
- Flatten your lower back, and try to keep it in contact with the wall throughout the exercise. 
- Bring the back of your forearms against the wall (to make a “W” shape). 

How to do it:
- Begin to slowly slide your arms upwards along the wall, maintaining contact with your forearms the entire time. 
- Slowly go up as far as your shoulder mobility allows, pause for a moment, and slide back down.
- Repeat for 3 sets of 12 reps.

UPPER BODY EXERCISES

​Next, it’s time to strengthen the muscles that are going to keep your back and shoulders in line! Areas that usually need targeting include the external shoulder rotators, serratus anterior, middle/lower trapezius, rhomboids, and deep neck flexors. That sounds like a lot, but there’s a couple exercises that are extremely efficient at hitting most of these areas:

.1. Face Pulls

Face Pulls are one of the single best exercises for postural correction and healthy shoulders. They strengthen the mid traps, rhomboids, rear delts, and external shoulder rotators all at the same time. The key, however, is to do them correctly:

Set-up:
- To perform the exercises, use a cable that is above the height of your head (a long resistance band can also be used if a cable is unavailable). 
- Use a rope attachment on the end - the longer the better, so if you have access to two at a time, go for it. 
- Hold one end of the rope in each hand, with your thumbs closer to your body. 
- Stand up tall, feet shoulder width apart, core tight, and chin tucked.
- Begin with your arms fully extended in front of you.

How to do it:
- Pull the ropes towards you, aiming for your face (hence the name “face pull”). 
- At the end of the movement, your arms should roughly be making a “W” shape (try to keep your hands far apart - this is why a longer rope attachment is better). 
- Take a second to squeeze the shoulder blades together, and pull your hands backwards as far as you can. 
- Slowly reach forward to the starting position, and repeat. 
- Aim for 3 sets of 12-15 reps (note that if you are doing this exercise properly, the weight will need to be fairly light!)
​- Once you feel comfortable with doing the exercise correctly, you can increase the weight so you are lifting in the 8-12 rep range.

Here's a great video from Athlean-X's Jeff Cavaliere outlining how to to Face Pull's correctly, along with some of the most common mistakes people make:

2. Y Raise

The Y Raise is a great exercise for strengthening the lower and middle trapezius. Most people have a lot of difficulty activating these areas, and not only are they important for posture, but they also play key roles in smoothly lifting the arms overhead. 

Set-up:
- Lie chest down on an incline bench, raised to 15-30º.
- Hold two light dumbbells, palms facing each other. Begin with the hands close to the ground.
- Elbows should be kept straight, and hands should stay at the ten and two o’clock position throughout the exercise. 

​How to do it:
- Raise the arms until they are in line with your body, pause for a couple seconds at the top, then slowly lower to the ground again.
- Initiate the movement by pulling your shoulder blades down, towards your hips (never let them shrug upwards).
- Make sure to keep your abs engaged and chin tucked throughout the movement - never let your chest raise up off the bench.

- If you can’t raise your arms all the way (even with the lightest dumbbells), perform the movement with a dowel instead (thumbs facing up).
- If you still struggle to reach the top of the movement with no weight, just go as high as you can, ensuring you maintain good form the entire time.
​- Perform 3 sets of 8-12 reps.

LOWER BODY MOBILITY

Sitting for prolonged periods every day usually results in an anteriorly rotated pelvis - think of the front side tilted down, and the back side tilted up. As you can probably imagine, over time this causes the hip flexors (including the quads) and lower back to become tight and sore. Here’s a couple of ways to focus on loosening up these areas:

1. Cat-Camel

The Cat-Camel is great for restoring motor control in the lumbopelvic region, and releasing stiff, aching muscles in the lower back caused by sitting for too long.

Set-up:
- Get on hands and knees, with hands directly under the shoulders, and knees direction below the hips.

​How to do it:
- In slow, controlled movements, transition back and forth between pushing your low back towards the ceiling (the “cat”) and then pushing your stomach towards the floor (the “camel”).
- You don’t need to spend too much time in either portion of the stretch, but spend a few extra seconds in the position which relieves the most stiffness (for most people, this will be the “cat” position).
​- Perform 2 sets of 5 slow, controlled reps.

2. Quad Foam Roll

The hip flexors (including the quads) are an extremely tense spot for many people, as they are in a constantly flexed position when sitting normally. Sometimes just stretching them isn’t enough, and manually releasing the knots of tight muscle provides more effective relief. 

Set-up:
- Lie face down, near the edge of a foam roller (placed perpendicular to the body).
- If your right leg is the target, rest this one over the foam roller (with most of your weight held in your elbows and left knee).

How to do it:
- Slowly pull your body around so your entire right quadriceps is dragged over the foam roller, stopping to focus on the tightest areas (usually the upper/outer part of the thigh is especially tight).
- Make sure to let your quadriceps relax and sink into the foam roller as much as possible.
- If you find a spot that is particularly painful, it’s important to pause and take a few deep breaths to relax your central nervous system. If the pain exceeds 7/10, take a little pressure off the muscle.
- Continue the drill for about two minutes per leg, taking a little extra time to work out any extra tight areas.

LOWER BODY EXERCISES

As with the upper body, it’s also important to focus on strengthening the stretched out and weakened muscles of the lower body. In this case, it’s mainly the job of the glutes and abdominals to pull the pelvis back into the correct position. When these muscles are working efficiently, back and knee pain are often alleviated, as the trunk, pelvis, legs and feet are more properly aligned.

1. Dead Bug

The Dead Bug is great for teaching you how to keep your abdominals engaged, which prevents anterior pelvic tilt (often the cause of chronic back pain). Having strong abdominals is also extremely important for full-body stability and alignment.  

Set-up:
- Lie on your back, with your arms and legs extended straight up into the air, knees bent at 90º.
- Make sure your abdominals are fully engaged - this is done by squeezing your ribs and pelvis together. - Your lower back should be in firm contact with the ground at all times.

​How to do it:
- Making sure to keep your abs squeezed the entire time, slowly lower one arm and the opposite leg until they hover just above the ground.
- At this point, it’s very likely your lower back will arch up off the ground if your abs aren’t fully engaged. To help avoid this, it’s helpful to place a stretched resistance band under your lower back (tie one end around something a few feet away). If the band slips, squeeze your abs and push your lower back harder into the ground. 

- Bring your arm and leg back up to the starting position, then repeat with the other arm and leg. 
- Repeat for 8-12 slow reps on each side. If you find it too difficult to keep your abs engaged the entire time, start by not lowering your legs quite as close to the ground.

2. Banded Hip Thrust

Popularized by Dr. Bret Contreras, the hip thrust is arguably the best exercise available for strengthening the glutes. Adding a mini band around the knees has the extra benefit of involving the glute medius as well (an often ignored muscle, which plays a crucial role in stabilizing the legs and alleviating knee pain).

Set-up: 
- Rest your back against a bench, with your feet on the floor, and a mini band just above your knees. 
- The bench should be contacting your back about 1/3 of the way down. 
- Your feet should be far enough away so that your shins are vertical at the top of the movement, and far enough apart that a moderate stretch is felt in the band.
- Placement of your arms doesn’t really matter, as long as they don’t get in the way of the movement (you can extend them and rest them on the bench - just make sure your elbows aren’t supporting any of your body weight).

How to do it:
- Push through your heels to move your hips towards the ceiling, while stretching the band at the same time. Pause at the top of the movement, before slowly returning to the starting position.
- It’s important to keep your abs and glutes engaged, to avoid arching your back throughout the exercise (especially at the top). If you don’t feel your glutes working, or you begin feeling tension in your lower back, it probably means your pelvis is rotating anteriorly. Squeeze your abs and glutes a little harder, and don’t push your hips quite as high.
- If you struggle to lock out your hips at the top of the movement, it’s probably because your hip flexors are too tight. Make sure to spend time mobilizing these areas when you can.
- Perform 3 sets of 12-15 reps.
- Once you can perform this exercise easily while activating your glutes the entire time, you should start adding some weight. This can be accomplished by placing a barbell across your hips (I’d recommend using a thick pad on the barbell). 

Here's a video of Bret Contreras explaining some of the do's and don't's of the Hip Thrust: