Often times in my line of work I feel like the posture police. One of the first things that I notice about someone when I enter a treatment room in my office is how they are sitting.  I often see parents and children displaying the same poor postures. 
 
What exactly is posture?

Posture is a motor habit, created by the way the muscles contract to keep the body in an upright or seated position. Posture is an indicator of the mechanical efficacy of the body to know where it is in space, as well as muscular balance and neural muscular coordination. The posture of the body changes continuously throughout the lifetime with the biggest challenge for posture  during periods of rapid growth. In these periods, the body tries to restore balance, and during this time postural deviations can emerge. Posture has an impact on how gravity is acting on the tissues of the body. With good posture, the force of gravity distributes down through the bony elements, the bones of the spine, the long bone in the legs, and through the joints. If posture is not properly aligned, more force is distributed through the soft tissues along with the muscles and ligaments surrounding the bones.

Effects of Poor Posture

As our society has modernized, a number of the physical demands that were required of us have changed. This change has made us more sedentary and we spend more time in a seated position. This is demonstrated in time spent playing video games, screen time, sitting at desks all day in school. This has led to weakening of the entire muscular system, influencing the spinal column. One of the primary causes of poor posture in children is muscle weakness of the back, chest, or abdominal region. When children are growing at a fast rate, weakness can lead to permanent postural disorders.  Lack of physical activity is one of the biggest risk factors. Studies have found that children who do not participate in physical activity have a higher risk of postural issues. Excess body weight it also a risk factor, with added weight it changes the centre of gravity in the body. To compensate for this change in centre of gravity the body changes its posture to keep the centre of gravity within the body’s base of support. Carrying a backpack on one shoulder and improper footwear also effect posture.

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​What Can We do to Improve Posture in Your Child?
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If we can have an impact on improving children’s posture, it can have long-term benefits for their health, and decrease the potential degeneration and pain they might experience. 
Poor posture will also have an impact on the organs of the body and it can have an effect on lung capacity.  Keeping the ideal weight by ensuring proper nutrition through eating a balanced diet can be the first step to helping your child have good posture.  Making sure that your child participates in physical activity, not necessarily organized sports, but time outside climbing, running, jumping, developing their musculature through play. Making sure your child takes time to walk, consider if possible walking to the store, school rather then driving. The short of it is being active helps keep a god body weight and also develop the muscles essential for good posture.
​Watch your child's activities at home that can cause slouching posture. Examples include: Limit time spent in front of the television/screens/video games and provide a proper place to do homework, seated upright at a table, making sure to take breaks and move around every 20 to 30 minutes. (Standing is also great way to do homework as it stimulates the brain, facilitating the ability to learn).
When choosing a backpack ensure it has two straps and encourage your child to use both straps. Weight of the backpack should be considered, however time spent wearing the backpack has a larger impact on posture, so minimize long duration of backpack use.  
One other important factor to your child’s posture is your own posture. Children learn many habits from their parents both good and bad, one of them can be postural habits. If you are always slouching in front of your child, they will learn to sit in the same way. If you are a new parent or expecting, correct your posture before your children learn it from you.

Conclusion
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​If you notice your child exhibiting poor posture, or any asymmetry in their posture vis-a-vi hunching over when seated, or have one shoulder blade more prominent then the other, have them checked by someone who specializes in the musculoskeletal system. In adolescents scoliosis can being to show up, a curvature or rotation of the spine. It is important to monitor this as it can progress quickly in adolescence.
 
Activity Fact: Kids in North America spend 6 to 8 hours a day in sedentary postures. This has a direct effect on their posture.  Get your children up and active!

​Chair

The most important piece of equipment in the office is your chair.  The average person with a desk job can sit up to 120 hours a week and it is essential that your chair fits you properly. A chair that isn't set up properly can contribute to spinal pain and muscle fatigue. The more adjustable your chair is the better. Here are some tips for your desk chair:
- Make sure the seat pan height is adjustable to 42 to 51 cm (standard seat)
-The seat pan tilt is adjustable +3° to -4°
-The lumbar support height is adjustable 15 to 25 cm above seat
-The angle of the backrest to seat is adjustable 93-113°
-Upper edge of backrest is 45-55 cm above the seat pan (standard back)
-Your thighs should be roughly parallel to the floor
- Your feet should be flat on the floor, or a footrest is provided when necessary
​-Your chair must have adjustable arm rests

Desk

Your desk is the most standard, and usually the least adjustable, piece of equipment in your workstation. Most desks are made at a height of 28 to 30 inches tall, which is a good sitting height for most people between 5'8" and 5'10"  who use a conventional task chair. When sitting at your desk your feet and arms should be at roughly a 90 degree angle. If you are taller or shorter, be prepared to change your work surface height by adding or subtracting desk leg height.  A foot stool can be used if you need to raise your chair so that you are sitting appropriately at a desk that is too high for your height. 

Mouse and Keyboard

Wrist and elbow overuse conditions can arise from an improper keyboard and mouse set up. Your keyboard should be located directly in front of you so that you are not twisted or straining to use it. Here are some tips when setting them up:

-Upper arms hang relaxed at side during computer use
-Elbow joints are at about 90°
-Hands are in line with forearms when using keyboard and/or mouse
-Forearm is supported when using a mouse or other hand-held device
-Both keyboard and mouse height allow appropriate arm postures

Monitor
Monitors come in all sizes now and often work stations have two of them.  It is important to make sure your monitor is not reflecting a lot of light coming through a window or from nearby light fixtures.  Other important  factors when setting up your  monitor  include:
-The top of the screen is at eye-height (bifocal and trifocal wearers excepted)
-Viewing distance (eyes to screen) is 40 to 74 cm (about an arms length away)
-Monitor should be placed directly in front of the user

Conclusion

There is no perfect work station that fits everyone.  It is important to be constantly adjusting your station and making sure that you get up and away from your desk. The addition of a stand up desk can be a great addition to help eliminate postural fatigue. A great  link to a complete guide to setting up or changing your work station is:
https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0006/83067/guide-ergo-comp-workstations.pdf 

Activity Fact: People who sit for more than 8 hours a day have a 64% higher rate of heart attacks, 2 to 3 times the rate of heart disease and diabetes. Keep Active!

With the development of electricity, our environments went from 12 hour days of light, reliant primarily on sunlight, to 24 hours of available light in our indoor spaces. This has increased further with the development of the internet and our use of computers, television, smart phones, etc. The industrial revolution also has given us shift work that disturbs our sleep.  We all know how important a good nights sleep is but what exactly is sleep and why is it so important for optimal function? 

Stages of Sleep
Stage One – The lightest stage of sleep. Eye movements will be slow. This is the drowsy stage where you can easily be disrupted. Muscle tone and brain activity begins to slow from the awake stage. In this stage, people can experience the sensation of falling or hypo-tonic muscle jerks.

Stage Two – In this stage, awaking does not occur as easily. Slow eye movements stop and brain activity slows further with bursts of rapid activity. The rapid activity bursts are thought to protect the brain from awakening. In this stage body temperature decreases and heart rate slows.

Stage Three – This is deep non REM sleep, known as “dead to the world” sleep. This consists of slow brain waves called delta waves. This is the restorative stage of sleep where the body heals both physically and psychologically. In this stage waking up is rare. Sleepwalking, sleep talking, and night terrors occurs in this sleep stage. During this sleep, stage the body release growth hormone to help repair the stresses of the day.

Rapid Eye Movement Sleep – This is the dreaming stage of sleep. The brain activity is increased when compared to that of stage two and three. Awakening can occur more easily in this stage. Waking up in this stage leaves you feeling sleepy and groggy. During this stage heart rate and blood pressure increase. Body temperature become harder to regulate. This is when vivid dreams occur. If woken during this stage you are able to recall dreams easier. Muscle paralysis occurs in this stage to prevent the body from acting out dreams and injuring ones self.

Sleep begins in stage one and then cycles into stage two then three and back through two then one, followed by REM sleep. This cycle can take 90 to 120 minutes to progress through. Adults will have about five cycles through the night. In earlier cycles stage three, deep sleep takes more time in the cycle. Later in the sleep cycles (earlier morning) stage two and REM dominate.

Sleep and Optimal Learning​

Procedural Skills:
Many studies have revealed a relationship between memory, learning and REM sleep. When learning procedural memory tasks such as math, sleep can have an impact on how you retain that learning. When you learn new complex procedural memory tasks, the night after you learn, there will be an increase in brain activity during REM sleep. This also occurs in the third and fourth night after learning but not in the second night of sleep.  Interrupting REM sleep in the first, third and fourth night can therefore have an impact on one’s ability to recall and perform new learned tasks. 

Physical Skills:
When learning new physical skills such as, how to tie your shoe, skate, ski, any sport, or musical instrument, stage two sleep is most important for learning. Stage two sleep is concentrated in the latter half of sleeping, so early morning. When learning new athletic skills waking up too early in the morning can have a negative impact on retention of new skills.

Causes of REM Sleep Disturbance 

Now we know how important sleep is for the brain to learn, here are some main causes of REM sleep disturbance:
Alcohol
Booze is a substance known to directly disrupt REM sleep. It affect learning new information and alcohol consumption can interfere with retention of information. Studies show that students consuming alcohol on the weekends when learning in post secondary institutions will have decreased  learning and retention.

Shift Work
Another impact on REM sleep, and thus learning, is shifting your sleep schedule. If you delay going to bed by 4 hours, you will not have the same REM sleep. We are creatures of habit and sleep routine is no different. Your body gets REM sleep when it expects it. People who have shifting sleep schedules will have challenges when learning and processing new complex information.  When learning new physical skills such as, how to tie your shoe, skate, ski, any sport, or musical instrument, stage two sleep is most important for learning. Stage two sleep is concentrated in the latter half of sleeping, so early morning. When learning new athletic skills waking up too early in the morning do to shift work can have a negative impact on retention of new skills.

Activity Fact: There is also a strong relationship with sleep and pain processing. People with poor quality of REM sleep have a higher chance of also experiencing chronic pain. 

If you sleep for the recommended 8 hours a day and you keep your mattress for the average of 9 years, you will spend 3 of those years in your bed.  It is therefore one of the most important pieces of furniture you can buy.
Choosing a mattress can be an overwhelming experience. With all of the options available in firmness, top covers, cooling materials, and spring vs foam, it is hard to have a starting point.
I often get asked, "what is the best mattress?".  And the answer is: there isn't one.  People come in all different sizes, shapes, and all have different preferences when it comes to sleep.  This article will give  you some tips and ideas to consider when you are purchasing that next mattress for your bed.

What is Your Sleep Position?
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Some of us love to hug that pillow and sleep on our tummy or curl up in a ball and sleep on our side.  Each different position that we sleep in causes different pressure points on the mattress. 
Side sleepers often feel a soft to medium mattress is more comfortable so that the hips and shoulders do not get excess pressure and the small of the back is supported. The basic principle is you should feel that the mattress is contouring to your body.  Back and tummy sleepers benefit from a firmer mattress to help distribute the pressure throughout. Tummy sleepers will get back pain if the mattress is too soft as the most pressure on the bed is through the torso.  This area will drop into the bed if the mattress is too soft and cause over extension of the spine. 

How Much Do You Want to Spend?

Like most purchases, cost sometimes does not mean a better product. Don't go for the retail price. Mattress prices are often well inflated and go on sale for up to %50 off or even more.  You can even negotiate a price with most Mattress retailers.  There is also a large online industry for mattresses and the prices are significantly lower than going to a retail store.
Be cautious if a sales person is telling you that the bed will last longer if you pay more for it.  This is true if the material in the top cover and fabric are of higher quality but not true regarding the structural materials that make up the mattress. Most mattresses regardless of price only last around 10 years. 
Also do not pay more for a mattress that is endorsed by a group or association or is marketed with gimmicks such as "orthopedic", or "medically approved".  This is simply a marketing ploy.