Posture training for older adults

Why does posture change with age?

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Posture is alignment of the body parts whether upright, sitting or recumbent (lying). It is described by the positions of the joints and body segments and also in terms of balance between the muscles crossing the joints. Impairments in joints, muscles or connective tissues may lead to faulty postures; or conversely, faulty postures may lead to impairments in the joints, muscles, and connective tissues as well as symptoms of discomfort and pain.

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Posture changes with age in seniors primarily due to a combination of physiological, musculoskeletal, and lifestyle factors. These changes can result in alterations in body alignment, muscle strength, and overall posture.

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Common risk factors for posture change 

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Several risk factors can contribute to posture changes in seniors. These factors can result from a combination of physiological changes, lifestyle choices, and underlying health conditions. Common risk factors for posture changes in seniors include:

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• Age: The natural aging process leads to changes in muscle mass, bone density, and joint flexibility, which can all impact posture over time.
• Muscle Weakness: Muscle strength is necessary to maintain postural control. Sarcopenia, the age-related loss of muscle mass and strength, can lead to weakened muscles that are less capable of supporting proper posture.
• Bone Health: Reduced bone density and osteoporosis increase the risk of vertebral compression fractures and can lead to a rounded upper back (kyphosis).
• Joint Degeneration: Conditions like osteoarthritis can cause pain, stiffness, and joint deformities, altering posture as individuals try to compensate for discomfort.
• Flexibility Loss: Reduced flexibility in muscles and connective tissues can make it difficult to maintain proper alignment.
• Balance Issues: Age-related changes in the inner ear and sensory systems can lead to balance problems, influencing posture to maintain stability.
• Vision Changes: Visual impairments may cause individuals to adopt positions that allow them to see better, potentially affecting posture.
• Neurological Conditions: Conditions like Parkinson's disease, stroke, and neuropathy can affect muscle control and coordination, leading to posture changes.
• Spinal Conditions: Conditions such as scoliosis (abnormal curvature of the spine) can lead to noticeable posture changes.
• Inactivity: A sedentary lifestyle contributes to muscle weakness and imbalances that can affect posture.
• Faulty Habitual Posture:  Many musculoskeletal complaints can be attributed to stresses that occur from repetitive or sustained activities when in a habitually faulty postural alignment. 
• Psychological Factors: Stress, anxiety, and depression can affect posture by influencing body alignment and muscle tension.
• Social Isolation: Reduced social engagement and physical activity can lead to deconditioning and poor posture, especially if the person remains in the same certain position (e.g. sitting or lying down) throughout the day.
• Obesity: Excess weight places additional strain on the spine and muscles, affecting posture.
• Lack of Postural Awareness: Seniors who are unaware of proper posture or lack the motivation to maintain it may inadvertently develop faulty posture. 
• Previous Injuries: Old injuries, especially if they were not properly rehabilitated, can contribute to postural changes.
• Medications: Some medications can cause muscle weakness, dizziness, or changes in balance, impacting posture.

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Impaired posture may be the underlying cause of the patient’s pain or may be the result of some traumatic or pathological events. Recognizing these risk factors and addressing them through appropriate interventions, such as regular exercise, maintaining a healthy weight, using proper ergonomics, and seeking medical advice for underlying health conditions, can help seniors maintain better posture and overall musculoskeletal health. Consulting healthcare professionals like physical therapists or occupational therapists can provide guidance on posture-improving strategies tailored to individual needs.

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5 easy exercises to improve posture for older adults 

Here are five easy exercises that can help improve posture in older adults. These exercises focus on strengthening muscles, increasing flexibility, and promoting better alignment:

1. Chin Tucks: To decrease forward head posture.

- Sit or stand up straight with your shoulders relaxed.

- Gently retract your chin by pulling it in toward your neck, as if creating a "double chin."

- Hold the position for 5 seconds and then release.

- Repeat 10-15 times, aiming for controlled movements.

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2. Shoulder Blade Squeezes/Shoulder Retraction: To decrease rounded shoulders and improve the integrity of muscles around the shoulder blades.

- Sit or stand up straight with your arms by your sides.

- Squeeze your shoulder blades together as if you're trying to hold a pencil between them.

- Hold the squeeze for 5-10 seconds and then relax.

- Repeat for at least 10 to 15 times.

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3. Shoulder Rolls: To decrease rounded shoulders and relieve muscle tension.    

- Stand or sit up straight with the shoulders relaxed.

- Raise the shoulders upwards in a shrugging motion, then slowly rotate it backwards making  a big circle.

- Repeat for at least 10 to 15 times.

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4. Seated Cat-Cow: To stretch the neck, shoulder and spine muscles. 

- Sit up straight with the back unsupported and feet flat on the ground.

- Place the hands on the thighs.

- Inhale and arch the back, opening the chest and lifting the chin slightly.

- Hold the position for 5 seconds.

- Exhale and round the back, drawing the chin towards the chest.

- Repeat for at least 10 to 15 times.

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5. Pelvic Tilts: To stretch and strengthen the abdominal and lower back muscles as well as to  improve posture. 

- Lie on your back with your knees bent and feet flat on the floor.

- Gently flatten your lower back against the floor by tilting your pelvis upward.

- Hold the position for 5 seconds and then release, allowing a slight arch in your lower back.

- Repeat 10-15 times, focusing on controlled movements.

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Remember to perform these exercises within your comfort range and avoid any movements that cause pain or discomfort. Consistency is key; performing these exercises regularly can help improve your posture over time. Additionally, it's a good idea to consult with a healthcare professional or physical therapist before starting any new exercise routine, especially if you have underlying health conditions or concerns about your posture. They can provide personalized guidance and recommendations based on your individual needs.

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How can physical therapy help? 

Faulty posture underlies many spinal and extremity disorders and functional restrictions. Often by simply correcting the underlying postural stresses, the primary symptoms can be minimized or even alleviated. Physical therapy can be highly effective in improving posture for older adults. A skilled physical therapist can provide personalized assessment, guidance, and exercises to address the underlying factors contributing to poor posture. Here's how physical therapy can help:

• Assessment: A physical therapist will conduct a thorough evaluation of your posture, joint mobility, muscle strength, and any related issues. This assessment helps identify specific areas of concern and tailor treatment accordingly.
• Individualized Treatment Plan: Based on the assessment, the physical therapist will create a customized treatment plan designed to address your unique needs and goals. The plan may include a combination of exercises, stretches, and manual therapy techniques.
• Stabilization and  Strengthening Exercises: Impaired muscular strength can cause additional mechanical stress on the joints, specifically on the spine. Physical therapists will prescribe stabilization exercises initially, to develop neuromuscular control. As the patient improves, dynamic trunk strengthening exercises are utilized to help increase postural muscle strength, endurance and performance. Targeting key muscle groups such as the core muscles, will help you maintain better alignment and stability.
• Flexibility and Mobility Exercises: Initially, range of motion exercises such as active range of motion with or without assistance are prescribed to prevent stiffness and maintain joint mobility. As the patient improves, manual and self-stretching exercises as well as joint mobilization techniques are utilized to increase mobility in restricting muscles and joints,  making it easier to maintain good posture.
• Kinesthetic Training: Physical therapists help patients to develop awareness and control of spinal posture. Kinesthetic training includes, cervical and scapular (neck and upper back)  motions, pelvic tilts and control of the neutral spine when sitting, standing, walking and performing targeted functional activities.
• Postural Education: Physical therapists educate the patients about proper posture, its importance, and how to maintain it as well as the relationship between faulty posture and symptoms. They also guide them in practicing positions and movements to experience control of symptoms with various postures. 
• Ergonomic Guidance: It is critical to help patients adapt postures and activities that are performed on a sustained or repetitive basis at work, at home, recreationally, or socially if they are contributing to postural stresses and musculoskeletal problems. Physical therapists can assess and modify ergonomics in your home, work and recreational environment to relieve postural stress. 
• Manual Therapy: Techniques such as joint mobilizations, soft tissue massage, and myofascial release can help release tension and improve musculoskeletal alignment.
• Muscle Relaxation Techniques: One of the important components of a rehabilitation program for posture training is to teach the patients how to relax tense muscles and relieve postural stress. Muscle relaxation techniques are incorporated to increase patient awareness and control over tension in the muscles.
• Breathing Techniques: Proper breathing can enhance posture by engaging the muscles that support your spine and ribcage. Physical therapists can teach you breathing exercises to promote better posture.
• Balance and Coordination Training: Improved balance and coordination reduce the risk of falls, which can affect posture. Physical therapists design exercises that challenge your balance and enhance your ability to move safely.
• Progressive Plan: Physical therapists will gradually progress your exercises to ensure continued improvement and prevent plateaus.
• Feedback and Corrections: Physical therapists provide real-time feedback on your posture and movement patterns, helping you make necessary adjustments.
• Home Exercise Program: Your therapist will design a home exercise program tailored to your needs and will teach you how to effectively incorporate it into your daily routine to reinforce the interventions and for optimal recovery. 
• Motivation and Support: Physical therapists provide motivation and encouragement to help you stay committed to your posture improvement goals.
• Monitoring and Adjustments: Physical therapists regularly assess your progress and make adjustments to your treatment plan as needed.

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Improving posture requires consistent effort, and physical therapy can provide the knowledge and tools to make lasting changes. Remember that results may take time, but the benefits of improved posture extend beyond aesthetics – they contribute to better overall musculoskeletal health and a reduced risk of pain and injury. If you're considering physical therapy to improve your posture, consult with a healthcare professional or physical therapist to determine the best approach for your specific needs.

Trust PeteHealth for posture training

Looking for a physical therapist to help with posture training? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

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Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

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