Preventing Kyphosis: Maintain a Healthy Posture as You Age

January 28, 2009

Posted by Maggie Spilner

Poor posture can be evident at any age, but a person with rounded shoulders and a curving upper back is a caricature of old age we all recognize. Called kyphosis, which simply means a curve in the thoracic (mid to upper) part of your spine, this stooping posture can be due to many factors. One common cause is the collapse of the spine due to multiple small fractures that occur as bone density is lost. This effect, due to osteoporosis, is sometimes referred to as dowager’s hump, as women are more likely to suffer from kyphosis. However, the condition can affect men as well.

Osteoporosis: It’s in Your Bones

Most people have heard of osteoporosis, which makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As many as 50% of women and 25% of men older than 50 will suffer a broken bone due to osteoporosis. Most at risk are Caucasian and Asian women over 50, particularly those with a family history of the disease.

Osteoporosis sneaks up you. There are no symptoms to let you know your bones are thinning. Often people don’t know until they break a bone. Tiny fractures in the spine can occur without creating pain. A bone mineral density test is the best way to check your bone health.

To keep bones strong, eat a diet rich in calcium and vitamin D, exercise regularly and do not smoke. (Small women may need to wear a weighted vest or carry a backpack in order to stimulate increased bone mass.) Though medications like Fosamax have been promoted in recent years to prevent bone loss, research is showing that in the long run, they may actually cause fractures. Nutritional supplements are also an important part of a sound strategy to prevent osteoporosis.

Poor Posture: Prevention Is Key

Poor posture can really age you, but isn’t just an image issue. It affects your heart, your circulation, your breathing and your nervous system. And over time, poor posture can lead to chronic pain in your head, neck, upper back, lower back—even your legs. Prevention is key, because once tissues and bone adapt to poor posture it can be difficult if not impossible to reverse.

Improving your posture isn’t just a matter of trying to stand tall or sit up straight, especially after years of poor postural habits. It involves a rebalancing of many muscle groups. A curve in your thoracic spine must also be addressed by repositioning your pelvis. When tight or weak muscles cause your pelvis to either tuck under the body or tilt forward, the upper back will compensate by increasing the upper thoracic curve and jutting the head forward.

People have a hard time assessing their own posture and it’s good to work with a physical therapist, experienced yoga instructor or personal trainer. What feels normal and upright to you may actually be poor posture. Good posture will feel uncomfortable until your musculature adjusts to new habits. If that’s not possible, have someone take your picture when you are standing in a relaxed, normal posture.

Posture Perfection: An Anti-Aging Workout

Generally speaking, if your pelvis tends to tuck under, your upper abdominals and hip flexors muscles are too tight. The following stretches should help:

Lunge Pose for the Hip Flexors

Get down on all fours.

Bring one leg forward, knee bent, foot flat on the floor.

The other leg stretches back behind your, knee to the floor.

Hands support you on either side of the front foot.

Press forward with your body so that you feel the stretch in the front of the hip.

To make this easier, place yoga blocks or stacked telephone books under your hands.

Standing Back Bend for the Upper Abdominals

Stand tall, knees soft, feet hip width apart

Place your hands on the small of your low back

Inhale as you lift your sternum and try to create space between your breastbone and your belly button. (Lift the chin but don’t let the head fall back. Hold for three breaths if comfortable.) Release back to standing tall.

If your belly drops forward and your tailbone is lifted, then your lower back and hip flexors are tight. These stretches will help loosen up your low back:

Cat-Cow Pelvic Tilt to Stretch the Low Back

Get down on your hands and knees on a comfortable surface

Inhale as you arch your back, drop your head forward and your tailbone down and forward.

Exhale as you lift your head and tailbone up and let your belly expand downward.

Repeat several times, inhaling and exhaling with each move.

Modified Downward Facing Dog

Stand in front of the seat of a hard chair surface.

Bring your hands down flat on the chair seat

Walk your feet back a few steps

Release your head downward and relax letting your back ‘hang” from your hips.

Hold for several breaths as you continue to release the back.

Step towards the chair and roll up slowly.

In most cases, your hamstrings, butt and abdominal muscles (especially the oblique muscles—those that allow you to twist your upper body) are most likely weak. Try these exercises:

Squat to Toes

Stand with your feet hip width apart

Bend your knees and “sit back” as though you were going to sit in a chair.

Then stand, squeezing your butt muscles as you rise up on your toes.

Repeat 8-10 times.

If this is very easy, added 5 pound hand weights.

Ball Crunches

Lie on an exercise ball (which makes crunches feel way more comfortable!) with the ball resting about mid back and with your hands crossed over your chest.

Lift your upper body by tightening your abs. You’ll have the additional benefit of using extra muscle power to stabilize on the ball.

To work the oblique muscles, focus on bringing one shoulder towards the center line of your body. Alternate sides.

When you have rounded shoulders and a curved upper back, your upper body is basically tight in the chest and front of the shoulders, and weak and overstretched in the upper back and neck. The following exercise helps to address both areas at once. I call it Wall Butterfly.

Wall Butterfly:

Stand with your mid back, shoulders and butt up against a wall.

Walk your feet out about a foot. Don’t try to flatten your low back, keep the natural curve.

Raise your arms out to the side, parallel to the ground.

Bend your elbows and place your elbows and wrists on the wall. (If you can’t reach, get as close as you can. (For instance, I can get my elbows back, but my wrists don’t quite touch.)

Imagine you are grabbing a bar and, keeping your wrists and elbows to the wall, pull down, bringing your elbows downward as you focus on bringing your shoulder blades together.

Keep your stomach contracted so that your back doesn’t arch while you do this.

(As a warm up for the Wall Butterfly, stand tall, pressing your belly button toward your back bone. Clasp your hands behind your back and press your shoulders back as your stretch your clasped hands toward the floor.)

Walking and Sitting Tall All Day

You can undo the efforts of your stretching and strengthening exercises if you forget about posture the rest of the day. Here are some quick tips for sitting and standing tall as you walk, drive and sit.

When walking, imagine your head is lifting towards the sky or ceiling. Press your belly button toward your backbone and turn your thumbs outward, which will automatically bring your shoulder blades closer together.

In the grocery store, grab the cart handle from underneath, which again, turns your thumbs outward, forcing rounded shoulders back.

When you sit in your car, sit tall and adjust your mirror to that height. If you look to the mirror and you can’t see—you know you’re slumping. Reposition your body, not your mirror!

Sitting at your computer, sit towards the edge of your chair and rock your pelvis back and forth until you find your neutral position—the belly is not forward, nor is the back slumped over. It can help to place a wedge in the form of a folded towel on the seat to help keep you there.

These books can also help you age more gracefully:

The New Yoga for Healthy Aging: Living Longer, Living Stronger and Loving Every Day, by Suza Francina. This book is geared to older folks and has many modified poses using chairs, straps, blocks and other accessories. Truly inspirational.

Prevention’s Complete Book of Walking by Maggie Spilner and Suki Munsell PhD. The last section of this book features Suki Munsell’s Dynamic Walking program with lots of help on how to evaluate your posture, improve it with stretches and solidify it with proper walking technique.

Posture. Get It Straight! By Janice Novak, MS. Straightforward and concise with great illustrations. There’s a companion DVD available.

The Anti-Aging Bottom Line: Small fractures of the upper spine (caused by osteoporosis) combined with a lifetime of poor posture, can lead to the hunched posture known as kyphosis often associated with old age. Fortunately, there are steps you can take with nutrition and exercise towards maintaining strong bones and a vital, healthy looking posture as you age.