Posture is the position of your body when you’re standing or sitting. It describes how your spine is aligned with your head, shoulders, and hips.

There’s no “perfect” posture, just as there are no perfect bodies. Good posture refers to having a neutral spine, where your muscle groups, joints, and ligaments are aligned in a way that reduces stress on them, keeps your body flexible, reduces fatigue, and helps maintain your balance.

If your posture is out of alignment, it can lead to:

  • muscle or joint strain
  • neck, head, or back pain
  • possible injury during exercise, work, or other activities

Bad or out-of-alignment posture is common. It can affect your appearance, self-confidence, and general well-being. The good news is that you can improve your posture with exercises and, if necessary, posture aids.

Here are four common types of poor posture and what you can do to correct or compensate for them.

It’s easy to develop a habit of bad posture without thinking about it. You may spend a long time leaning over a small screen, slouching in a chair, or carrying a heavy backpack when you walk. Or you may use repetitive motions in your workplace.

After a while, all of these factors can lead to bad posture.

Being overweight or pregnant, or wearing poor quality shoes or high heels, can also lead you to develop bad posture.

You may be born with scoliosis (an abnormally curved spine) or one leg shorter than the other, which can affect your posture.

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Illustration by Wenzdai

Here are four common types of poor posture.

Forward head

Forward head posture is when your head is positioned with your ears in front of the vertical midline of your body. If your body is in alignment, your ears and shoulders will be lined up with your vertical midline.

Tech neck, text neck, and nerd neck are other names for forward head posture. It often comes from hunching over a cell phone or computer, or your steering wheel if you drive a lot.

It can also result from the aging process, as you lose muscle strength in your upper body.

Kyphosis

Kyphosis refers to an exaggerated curvature of your upper back (the thoracic spine) where the shoulders are rounded forward. It’s also called hunchback.

Osteoporosis (bone thinning) can cause the shoulders to round as your spinal bones weaken with age. It’s frequently seen in older women. Other age-related causes include degeneration of your spinal disks or vertebrae.

Younger persons may develop kyphosis as a result of diseases such as polio or Scheuermann’s disease, infection, or chemotherapy or radiation to treat cancer.

Swayback

Swayback, also called lordosis or hyperlordosis, is when your hips and pelvis tilt forward, in front of your body’s midline.

In this position, your lower back has an exaggerated inward curve. You look like you’re leaning back when you’re standing up, with your stomach and your rear sticking out.

You can develop swayback if you sit a lot, which tightens the muscles in your back. Sitting for prolonged periods can also weaken your abdominal muscles and glutes. In both cases, the core muscles that stabilize your back become weak.

Other causes may be obesity, injury, neuromuscular conditions, and abnormalities of your spine and vertebrae.

Flatback

Flatback is a condition where the normal curve of your lower spine loses some of its curvature. Your lower back looks straight and you stoop forward.

It can be present at birth, or it can result from some kinds of back surgery or degenerative conditions of the spine, including ankylosing spondylitis (inflammatory arthritis), disc degeneration, and vertebrae compression.

Flatback can make it painful for you to stand for long periods.

  • Poking chin. Sitting in a chair that’s too low and leaning forward to see your screen or looking up at a screen that’s placed too high can result in a chin that pokes forward.
  • Uneven shoulders or hips. You may tilt to one side when you stand if one leg is longer than the other. It may also affect your gait.
  • Military-style posture. Here your back is ramrod straight and your chest is thrust forward.

The optimal or efficient type of posture has your spine in alignment with your head and your limbs.

From the side, it should look like a plumb line from your head would go through the middle of yours ears and shoulders and just behind the center of your knee and in front of the center of your ankle.

It’s what’s meant by the phrase “standing up straight.”

Physically, proper spinal alignment means that your muscles and bones are in balance, protecting your body against injury or stresses that might cause degeneration of muscles or joints. It helps your body work more efficiently in keeping you upright against the force of gravity.

Bad posture can lead to many kinds of physical problems, from back pain to pain in your temporomandibular joint, to lack of balance and foot pronation.

Here are some specific effects for each type of misalignment.

Forward head posture

The effects of a forward head posture range from neck pain, stiffness, and headache to an association with higher mortality rates for elderly men and women.

Text neck tightens muscles and their supporting ligaments and tendons in the front of your neck, and at the same time lengthens the muscle structure at the back of your neck.

A small 2019 study of healthy college students found that a forward head posture decreases the lower thorax (mid-spine) mobility, leading to decreased respiratory function.

The more you lean forward, the more head weight and strain you exert on your spine. The effect can be dramatic.

A 2014 study calculated the force in pounds of flexing the neck forward to different degrees.

In a neutral posture, your head weighs 10 to 12 pounds. When your forward posture is 15 degrees out of alignment, the force on your spine increases to 27 pounds. At 45 degrees forward, it increases to 49 pounds, and at 60 degrees forward, it increases to 60 pounds.

Kyphosis

Kyphosis is a more extreme form of forward head posture. The degree to which you’re hunched over determines the amount of pain and dysfunction you’ll experience from this misalignment.

When you’re severely hunched over, it’s harder to walk, and you have an increased risk of falls and injuries. Older women with hyperkyphosis have a 70 percent increased risk of fracture.

Kyphosis affects mobility and mortality in older people. In our aging population, kyphosis is estimated to affect 20 to 40 percent of older men and women, and the angle of kyphosis continues to increase as you age.

Swayback

When your spine is in the swayback position, it may cause back pain that affects your ability to move.

Swayback also increases your risk of developing back and hip injuries and other musculoskeletal injuries, such as disc degeneration. You may have pain in your neck and lower back.

Flatback

Flatback syndrome may make it hard for you to stand up without pain in your thighs and pelvic area. You may also have neck and back pain.

Pain and fatigue can increase the longer you keep standing. Walking may also be difficult, giving you leg pain and a feeling of weakness.

A first step in correcting your posture is to become aware of everyday habits that may be affecting how you stand, sit, or lie down. In other words, pay attention and be mindful of what you are doing in your daily activities.

Sometimes the “cure” is simple:

  • Change the configuration of your work station.
  • Change your chair and the way you sit.
  • Change the position in which you look at your cell phone.
  • Buy a new mattress.

You can find some specific tips for avoiding or fixing tech neck here and here.

Other general fixes include:

  • Instead of high heels, opt for flats, wedges, or other more supportive footwear.
  • Breathe more deeply.
  • Practice walking properly.

If your poor posture is bothersome or noticeably problematic, see a doctor or other healthcare professional to determine what’s causing the problem. They may diagnose an underlying condition that can be treated, such as osteoporosis or arthritis.

Stretching

They may also advise you to see a physical therapist. A physical therapist can help you develop a routine of stretches and exercises for strengthening the muscle groups that will help you stand or sit properly. Yoga may also help.

A physical therapist can check your posture and monitor whether you’re doing the exercises correctly.

There are many exercises and stretching routines that have proven helpful for posture and balance. You’re likely to find some that suit your schedule and ability.

Posture correctors

For some types of posture problems, your doctor or physical therapist may advise you to use a posture corrector appliance. For example, a posture brace and taping may help reduce hyperkyphosis. Or a shoe lift can help equalize your leg length to improve your gait and help you stand straighter.

Proper spine alignment, keeping your ears in line with the midline of your body, is the most efficient posture for conserving energy and not stressing any muscle groups.

But developing habits that lead to bad posture is easy, especially for people who sit at a computer all day or spend hours looking at a cell phone.

The aging process also can lead to bone loss and posture problems as you lose the capability of support in some muscle groups.

Bad postures all involve taking the spine out of its neutral alignment position. Having a forward head is a common bad posture. Others include swayback and flatback.

Most posture problems can be solved by stopping poor habits and starting stretching and strengthening exercises that target the support muscles that are weak.