“Stop Slouching!”

Why is my kid’s posture so poor?

THE PROBLEM

Do you get sick and tired of telling your child to sit up straight? Do you ever wonder why so many kids these days have slouched posture and often complain of back pain?

Let’s take a moment to think about a child’s typical day during the week.

1. They spend six hours a day at a desk in school. Most of this time is spent writing notes or typing with their hands in front of them and their head looking down.
2. When they are not in school, much time is spent playing video games, playing on their smartphones, surfing the Internet on the computer or texting. Again, arms are in front of them and head is down
3. They carry around a backpack that often weighs almost as much as they do and often times wear it low, resting on their low back or bottom. Backpacks should weigh no more than 10 percent of their body weight, be worn on both shoulders and fit snuggly to their back.

In April of 2012 – Archives of Pediatric and Adolescent Medicine published an article stating that only 51 percent of children went outside to walk or play per day with either parent.

Another national study found that the average American age 8-18 plays video games for greater than 13 hours per week. Studies also show that children today spend half as much time outdoors as their parents did when they were young. These kids prefer to stay inside to watch TV, surf the Internet, listen to music and even do their homework, rather than go play outside.

How it affects the kids

The positions discussed above, which kids are in for a large majority of their day, place the muscles on the front of their chest into a shortened position. After a while, it is difficult to stretch those muscles back out to attain proper posture independently. Tight muscles on the front of their chest cause them to continue to sit with their shoulders rounded forward and thus the cycle continues. The muscles in the front of their neck also become tightened, pulling their head forward. A forward head can also cause the muscles at the base of the skull in the back of the head to become tense.

Unfortunately, the inactivity caused by the increased time spent indoors also contributes to a poor core. The core consists of the muscles around the center of your body that help your back stay up straight. Without an active core, it is very difficult to maintain good posture and fatigue will set in quickly. A weak core in combination with prolonged periods of inactivity will likely lead to a cycle that is difficult to break, causing poor posture.

What to do

Have a homework station set up for kids. Doing homework on the bed or floor often makes posture worse and increases the curvature of their back while they are sitting. Kids should sit in a chair where their feet can touch the floor and their hips and knees are at 90 degrees. The table height should be so that their forearms are able to rest comfortably while they are working so that their shoulders can relax.

They should be in the same sitting posture for the computer and the screen should be at eye-level to keep their head in a good position as well. There are shelves made to lift computer screens up to eye-level, however, a large dictionary will often do the trick, as well.

The American Heart Association’s recommendation for physical activity for children is at least 60 minutes of moderate-vigorous intensity aerobic activity at least every day. As a parent, try to encourage your child to be active for at least one hour a day, either at school or at home. If you cannot find the time for your child to perform 60 minutes of straight activity, try to perform at least 30 minutes of activity twice per day.

It is never normal for a child to experience back pain or consistent headaches. If your child is experiencing either of these symptoms and is not actively being treated by a healthcare provider, please discuss these concerns with their doctor. Physical therapy can assist with improving posture and core strength to eliminate back pain.

Related information

• Cook Children's Sports Performance Orthopedic Rehab Team Specialists (SPORTS)
• Dynamic stretching
• The basics of sports injury prevention for kids
• The essential backpack 

The role of warming up and its impact on performance is debated regularly. Sometimes the coaches of our kids’ sports teams do not find the time to have the athletes perform an appropriate warm up prior to practice. They may not see enough benefit to use precious practice time for warming up. However, participating in sporting activities, practice or competition, without an appropriate warm up can not only decrease performance, but also place the athletes at risk for injury.

Much of the recently published evidence shows that static stretching (i.e. holding positions for set amounts of time) can decrease the muscles ability to respond to the stresses it experiences during activity. Static stretching may be of more benefit post workout or when only focused on increasing muscular length for improved flexibility.

A dynamic warm up or dynamic stretching is a method of warming up in which the athlete moves throughout available range of motion with stretches in a controlled manner. It has many benefits that are not seen with static stretching such as increasing blood flow to the muscles, increasing internal temperature, and preparing muscles for the sport specific movements they will need for the activity. This sort of warm up increases blood flow to the muscles and stretches them through specific motions that will be used while participating in their sport. In addition, most dynamic stretches target large muscle groups or multiple muscle groups together.

To successfully complete a dynamic warm up, athletes should follow some important steps. An appropriate warm up usually takes approximately 15 minutes.

1. Perform light aerobic activity to increase cardiac output and blood flow.

2. Follow with dynamic stretches to stretch muscles that will be needed for participation.

3. Optionally follow up with agility drills as desired. Examples include: butt kicks, high knees, skips, etc.

When performing dynamic stretches, it is important to monitor form and control. If dynamic stretches are performed without appropriate control, muscles can be stretched too far too quickly and pose a threat to injury. If you have an injury or need further guidance, please see a medical professional, such as your primary care physician or pediatrician.

Related articles

• Does your child play one sport?
• Cook Children's Sports Performance Orthopedic Rehab Team Specialists (SPORTS)
• Dynamic stretching
• The basics of sports injury prevention for kids
• Rise of overuse injuries in school-age athletes 
• Top 10 questions parents have about sport injuries
• Young athlete’s injury prevention guide

About the author

Amanda Stukey, PT, DPT, is a physical therapist for the SPORTS program at Cook Children's. Our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete's bones, muscles, body and mind.