Carried Away Spring 2015 - Page 10

Babywearing: A Physio’s Perspective Part 7: Posture for Babywearers By Stephanie Cox, BSc (Physio), APAM As a physio who has worked in Orthopaedic Outpatients, Paediatrics, Women’s Health, Occupational Health and more, I doubt that a single work-day has gone by without me advising a patient to attend to their posture. And we’ve all heard about it, in various forms. Your mother: “Stop slouching!” Your embarrassing Aunt: “Pull your shoulders back – stick out your boobs!” Your Grandmother: “When I was a girl, I had to walk around with the Bible on my head...” Teachers: “No-one will ever offer you a job if you sit like that in an interview!” The new car salesman: “And this is the button for the electronic lumbar support...” OH&S representative at work: “Here’s your brand new ergonomic workstation, let me show you how to adjust everything perfectly for yourself.” Ok, so that last one has never actually happened. But what does posture mean? What makes it good or bad? Does it really matter? And where does posture come into babywearing? What does posture mean? Posture is simply the official term for the position that your body is in. It 10 relates to the whole body, not just the spine, and we use it particularly when we are talking about sustained (or held) positions. What makes it good or bad? As with many things in life, there is no defining line bet ween good and bad posture. It is a continuum on which we can almost always improve, but knowing what you are aiming for helps you to see where that improvement can occur. You are aiming for a balanced position in which all of your muscles have to work the least possible amount in order to maintain that position AND no joint is at the end of its range of motion. As an example, ‘locking’ your knees would push your knees backward from this vertical line, so it’s not ideal. Although it reduces how hard your quadriceps (front of thigh muscles) have to work to hold you upright, your knees are fully hyper-extended, i.e., at the end of their range of motion in that direction. This puts carried away | Spring 2015 | Babywearing: A Physio’s Perspective standing with locked knees down towards the ‘bad’ end of the ‘posture continuum’. Add an extra load, like a baby on your back, and your knees might start to give you pain after some time. Even the classic directives like ‘chin up, shoulders back, chest out’ can result in bad posture too, as shown in the picture below. The most common ‘bad posture’ we regularly see around us is a common sitting posture... it involves chins poking forward, shoulder-blades rolled forward, upper back rounded, lower back slouched, feet up on a stool with ankles crossed and knees locked. Sound familiar at all? An evening in front of the telly, anyone? Sitting up in bed using your tablet? Put your feet down on the floor, and suddenly it looks like feeding a baby, or how many of us sit at our computer desks. Poor sitting posture and how to correct it. How bad your poor posture is for you depends on how long you hold it for, how often you do it, and how much extra load you’re carrying at the time. Slouching for 20 seconds to thread a needle isn’t too bad, but spending 8 hours a day at your laptop in the same position is likely to lead to problems pretty quickly. Leaning forward to scratch your knee is totally fine, but holding that forward-bent position for several minutes while you wrangle a wriggly toddler on to your back while learning to back carry might cause pain and strain. ‘Repetitive Strain Injury’ type pains, and many more. Poor posture can cause pain and dysfunction in the short term, but also contributes to problems over the longer term, which are often harder to address. Often enough, it is the activities in which you have poor posture which are most likely to be limited by those problems. Where does posture come into babywearing? One way or another, babywearing is going to change your posture. Placing a load on your front, back or hip is going to alter the position in which your joints and muscles are in the best balance. If you already have any postural faults, adding the weight of a baby might well be enough to make these faults start causing problems. Firstly, take the strain off your lower back. Make sure that when you bend forward, you hold your back the same position as when you are upright, ie, with a gentle inward curve in your lower back. You do this by keeping your knees slightly bent and tilting your pelvis like you are sticking out your tail. This allows the muscles to work more efficiently, it reduces strain on your joints, including the discs and ligaments, and also means you’re more likely to have tensioned things correctly when you stand up again. And of course, you should be actively engaging your core muscles - back, abdominals, and pelvic floor, along with breathing. A poorly adjusted SSC or a sloppy wrap job might pull your body into a poorer posture, which you might tolerate for a short period of time, but for the longer term, you are much better off learning to adjust your carrier correctly or to wrap with good technique. Let’s look at some specific examples of where you might need to improve your babywearing posture. Getting baby on your back is a common time for babywearers to notice some muscle fatigue, which Aim to keep a gentle inward curve in your neck and lower back, a gentle outward curve in your upper back, and your shoulders, elbows, hips and knees in a loose, comfortable position which is not fully bent or fully straight. Does it really matter? Yes. There is a very strong correlation between poor posture and certain musculoskeletal conditions, including headache, neck pain, back pain, can quickly degenerate into strain, tissue damage and pain. ‘Poor posture with loss of the inward lumbar curve Good posture with the inward lumbar curve maintained Secondly, don’t spend longer that you have to bent forwards! Become familiar with your carrier by practising front carries first. Know where to reach to adjust all the buckles, and which way they pull. If you are wrapping, you need to master strand by strand tightening, making a seat, etc, in front carries, before tackling these challenges in a back carry. Practise the carry with a doll or teddy until your body knows exactly how to move, and what sequence to go through to complete the carry. All of this minimises the time spent in a forward bent position. Continued page 12 11 Babywearing: A Physio’s Perspective