As physical therapists, we witness how “bad posture” is a common complaint and characteristic among our patients. Even if patients come in for different reasons, they frequently benefit from posture correction in order to avoid pain, or re-injury. During treatment, we frequently correct our patients’ posture, and they often ask: “what the best trick to maintain good posture?” Although the real answer is practice, there are some reminders that can greatly help. As I talk to my patients about posture, I find myself going back to my ballet training. Some of the basic commands that ballerinas receive during class are not much different than those physical therapists use.
First, the famous “tuck in.” This is probably the main characteristic of ballet posture. The idea is to engage your abdominal muscles and try to “pull” your belly button towards your back. For everyday posture it should be a small contraction that slightly reduces the curve of your low back (lordosis). Although it can be performed during sitting and standing it takes a lot of practice to maintain for long periods of time. If performed constantly, it can help with core strength and back pain. Second, “shoulders back.” Many shoulder and neck problems can be rooted in a rounded shoulder posture (shoulders are shifted forward). Shoulders should be kept “back” as if moving the shoulder blades together, and it should be subtle. When done correctly, it helps to eliminate the slouched posture seen during sitting. Finally, the “elongated neck” adds to the beauty of a ballerina posture, and it’s a great tool against neck pain. Due to the frequent use of computers and cellphones, neck pain has increased in incidence. This “elongated neck,” which in physical therapy we might refer to as a chin tuck, would be the opposite of the forward head posture typically experienced when sitting in front of a computer. My first ballet teacher described this as imagining we are holding an apple between our chest and chin. Although helpful, it might be hard to imagine, so in reality it is achieved by keeping the chin parallel to the floor and slightly pushed back so the neck is straight.
These three techniques that are used in ballet are identical to those taught in physical therapy to correct posture, alignment and increase strength. For postural re-education to be successful, we need to teach patients strategies so they can remember and carry these commands with them for the long term. These small changes can provide great benefits when used every day in order to engage postural muscles, and decrease pain.