Bad posture or something more?

[sunsetsandboardwalks]

I'm 35 and have had back, hip and pelvic pain on and off since my late teens. It's never been anything bad enough to see a doctor about, and any "flare ups" have been managed with rest and painkillers.

I know I have awful posture but I can't figure out if it the posture has caused the pain or if the pain is causing me to sit "off" and is causing posture issues.

I have visibly wonky shoulders and wonky ribs- my top left rib sticks out much more than my right and is much easier to feel, and vice versa at the bottom.

I've got a physio appt next week but was just wondering if anyone has had any similar symptoms?

Atlas misalignment
Scoliosis
Occult tethered cord
Craniocervical instability
Ehlers danlos

Look into these. May resonate with you.

Wondering scoliosis ?
Can I ask , did you do lots of sport as a child? Swimming, gymnastics? X

Physios don't deal with posture.

There are lots of things that could be going on - & as you suggested, a vicious circle (where you’ve been in pain so you’ve altered your posture then ended up “wonky” & it’s painful & round & round…) seems very likely.

Are you seeing a general physio, or a spinal specialist?

Whichever you see, given the visible (but honestly - & I mean this to be comforting/reassuring!) not horrific offset I’d expect they’ll check for scoliosis (you just bend over & touch your toes & they check vertebral alignment as you straighten up^); see where your scapulae are sitting; & check on which muscles you’re using to move your arms. Sometimes using the wrong muscles can cause that sort of misalignment. (I use the wrong muscles to work my arms. Different wrong muscles for each arm, naturally, because why make anything easy?)

Try not to stress about it ahead of your appointment - but it’s worth making a list for the physio so you can clearly explain the full duration of the problem (it having developed from adolescence, when you first noticed the misalignment etc); the issues it causes (you’ve mentioned pain, does it limit ROM at all? are you self-conscious about how it looks?); & any questions/concerns you have eg do they know what’s causing it; can it be fixed; do you need referring onwards?

Possibly random - is the pain linked to standing/being on your feet? Because if that causes/exacerbates issues, asking to be referred to orthotics to have custom insoles made for you should help.

Good luck at your appointment.

^ if they find anything significant they’ll probably want x-rays & an onwards referral to Ortho &/or rheumatology

Rather than a physio, I would see an osteopath.

I have a tilted pelvis and it makes my shoulders rest at different heights. It also makes my butt stick out and my belly stick out. After children my back became incredibly painful.

My brilliant osteo can manipulate me back in to alignment. It used to last a few weeks before I needed to see her again, but with time and specific exercises, I can now go over a year without seeing her. I do feel straighter and stronger after every visit even now though.

Are you seeing an NHS physio or private? I don't think an NHS physio would discuss osteopathy because the NHS don't offer the specialism, but if private then the physio is likely to be able to recommend an osteopath to see alongside the physio treatment,

Thank you so much everyone!

I have wondered about scoliosis as my boobs are visibly wonky too (and always have been), and the asymmetry of my chest fits with the way my shoulders and ribs sit, if that makes sense.

I was very sporty growing up but can't manage much now due to pain in my hips - I can walk for hours but standing still causes me issues, and I can't lie flat without it really hurting.

I did gymnastics and swimming but only in school so I never trained super hard or anything.

It's a private physio but I'm also going to see my GP to see if there's anything he can recommend.

While it's always good to get a GP to refer to rule out any significant medical issues, when I had similar sounding issues I didn't get anywhere with medical people. If like me your unbalance turns out to be 'postural' medics don't have much help to give and their physios tend to be about orthotics and splints.

Some 121 sessions with a really good yoga teacher who understands anatomy and how the body works got me started on finding out how to notice what I was doing to myself, ultimately to improve the alignment of my body and how the way that I use it was having a detrimental effect.

Often when you have trouble in one part, you body adjusts to 'avoid' that part and take the load elsewhere making the overall misalignment worst. Even just sitting for hours a day isn't that great for the bogey's proper functioning.

Not a quick fix by a lifetime journey. It helps a lot with staying active and mobile as we ultimately age.

This is way beyond what a doctor can deal with but also as you are finding not really 'well'. I hope you find someone who can help you develop that consciousness in your body so you can ultimately diagnose yourself

Definitely sounds as if a trip to the GP is indicated. My walking is now limited to toddleresque cruising - indoors only^ - but from my early teens standing still was agony while I could happily walk for miles until I couldn’t, obviously so I’ve lots of empathy for you there.

Good luck with getting answers - & hopefully A Plan to improve things, too.

^ I have multiple spinal & joint issues, so please don’t let that worry you!

Often when you have trouble in one part, you body adjusts to 'avoid' that part and take the load elsewhere making the overall misalignment worst. Even just sitting for hours a day isn't that great for the bogey's proper functioning.

Thanks @FinallyHere - I think you're bang on here.

When I try and sit or stand perfectly straight so everything is "aligned", I find it really painful. But I'm not sure whether I'm naturally "off" and therefore sit how I do to avoid pain, or whether I just have bad posture and that's caused weak muscles and pain - it's the whole chicken and egg thing.

If I stand in my "natural" way, my shoulders and ribs are asymmetrical. One shoulder is lower and then it's almost like I have a slightly twisted ribcage. The left side twists slightly upwards almost - and while I can "force" it straight, it's very painful to maintain it for longer than a few minutes.

Same when I sit down, if I maintain proper posture it really hurts me and I struggle to stand up after, so I naturally sit "slouched" as it hurts less but it's probably also exacerbating the issues...lol.

Thanks @RosaMayBillinghurst - I've never been able to run or do anything high impact without being in a lot of pain after. Walking uphill is also very painful afterwards but I can (and do) go all day on the flat without an issue.

It's definitely gotten worse in the last year or so. I've managed it with painkillers and deep heat etc. until now but it's now getting beyond that unfortunately!

Glad that chimes with you @sunsetsandboardwalks

My issue was always 'tightness' in the lower back. Not immediately, but at one point my yoga teacher suggested I relax my breast bone. The first time I couldn't do anything with that suggestion but eventually I could feel that softening the breastbone dropped my ribs down, my shoulder blades slide down my back and hurrah my pelvis settled in a much more neutral position, will still some but less curve in the lower back.

It was a major step for me which reduced the pain of just standing and importantly built confidence in my body's ability to be aligned.

Still a work in progress but I feel much more hopeful about the whole process of 'undoing' the 'bad posture' I've been doing pretty much all my life.

A lot of the 'good posture' advice we get is actually wrong or at be least misleading. Working one on one with someone who knows really what they are doing got me started. Hope you find what you need.

Hmm, these sort of issues are common in my family, we have a genetic CTD, causing scoliosis and early onset arthritis.
Do either of your parents or any siblings have similar issues?

Thanks again @FinallyHere you've been really helpful. My mum always nagged me about my posture growing up but it's genuinely painful for me to sit or stand "straight" - the pain is in my hips/lower back but obviously expects my entire spine.

I think I probably need to work on my core strength but at the moment I have pretty much no flexibility in my lower back or legs - which is the same as my dad, so it's possibly a bit genetic too.

One clue is that you can cope with walking on the flat, but the additional effort required by your calf muscles when going uphill (and down again) is uncomfortable.

There are few circumstances in which calf stretches are bad for you, I'd encourage you to start there

Oh, but of course, that only works if so long as you can fell the difference between real stretches of the calf muscles and (as I did for years) adjust my pelvis (entirely unconsciously) to reduce the effort on the calf.

Good luck

My mum has issues with sciatica (only recently in her sixties) and my dad isn't remotely flexible but he's never been diagnosed with any spinal issues. Both my grandmas were pretty "crooked" too but again not sure if they had any diagnoses.

Thanks @FinallyHere I'll have a look and see. My appointment is in 10 days so hopefully I'll get some answers soon!

it's possibly a bit genetic too.

Even if there is a genetic component, there is still plenty of scope for you to improve your flexibility and alignment. It's also entirely possible that you have albeit unconsciously adopted your father's posture which drives some of the misalignment.

Hope you find a way to untangle everything.

One place to start is among the writings of https://www.nutritiousmovement.com/

I did need some outside input because I often was doing the opposite to what I thought I was doing. The body is brilliant about adapting the circumstances so I doing them takes a lot of effort and can't really be done 'consciously'.

As someone with scoliosis it’s sounds like scoliosis to me, especially with you saying you can’t lie flat and you have rotation of the ribcage.. See your GP and request an X-ray. And try the simple ‘bend forward’ test at home and ask someone to have a look for you. But you deffo should have an X-ray for sure.

Thank you!

There's definitely rotation there - my left side is definitely higher than my right - my shoulders and ribs are definitely "off" - you can see it at the top of chest and the bottom of my ribcage when I (try!) and lie flat down. It's not massively obvious when I walk or anything but my tops and bras do sit "off" too.

@sunsetsandboardwalks
Oh God running - absolute agony. I have to make a conscious effort to remember that is not the case for most people, so running can indeed be a fun hobby & not a complicated form of self-harm 😶🤦🏻‍♀️

My dad is a keen runner and totally doesn't understand the pain it causes me - he thinks I'm just lazy 😂

My son has mild scoliosis and his shoulders are like this. As a previous poster has suggested bend forward as if you are touching your toes and see if you have a visible hump on your back. This would be your first indication.

Thanks, my back is a bit uneven when I do that but I'm not sure I'd say there was a visible hump - it's hard to see on yourself though and DH is useless!

You'd be looking for some unevenness like this. Could your DH take a photo?

I had this and I have mild scoliosis. Only diagnosed in late 20s.
The key signs were one rib sticking out more than the other, uneven waist, shoulders, breasts (basically, everything is wonky 😂). And pain in the back and shoulders.