Having good alignment is important for so many reasons, especially for someone with osteopenia or osteoporosis. Good alignment can improve posture, reduce pain, reduce your risk of spinal compression fractures and improve your overall function. Combined with a good strengthening program, good alignment sets you up for better balance and improved overall well-being as you age. But what exactly is good alignment? And how does one achieve it?
Defining Good Alignment
Alignment refers to how the head, shoulders, hips, knees and ankles relate and line up with one another (BHOF, 2022). In other words, it is how your body is stacked vertically. When you’re standing, there are certain anatomical markers of good alignment that can help ensure that you are maintaining an optimal position for your body to function safely and efficiently. It’s important to have an exercise program that considers posture and alignment.
How your body is stacked vertically affects the forces going through your bones. Good alignment ensures that the force distribution throughout your joints is appropriate for each body region. For example, if your upper body is rounded and forward, a position known as kyphosis (or thoracic flexion), this can lead to increased pressure on the front of the spinal bones which, over time, can lead to spinal compression fractures.
This is one of the many reasons having and maintaining good alignment of the spine is important not just while exercising, but during activities of daily life. For people with osteopenia and osteoporosis, the stakes are even higher. With weaker bones, the chances of developing fractures is higher. Good alignment sets your body up to function more efficiently. It can also help prevent a shift in your center of gravity that can make you more prone to falls.
Practicing good alignment and doing exercises to strengthen the muscles that help you stay in better alignment can have a protective effect on your body and your overall health.
Exercises for Posture and Alignment
While there are many exercises to strengthen the muscles that support good alignment, it's important to start with comfortable and basic exercises that allow you to feel what better alignment is before adding any type of resistance.
We’ve put together 5 simple exercises you can do at the start (or end) of every day to set your body up for a year of better alignment. These exercises are all performed in the supine (or lying down) position so that you can find good alignment without the challenge of adding forces from gravity. They are focused on lengthening the body, which helps reduce pressure on your spine. Try these before translating your newfound length into a standing position. The exercises should make you feel taller, lighter and ready to take on the day (and year!).
5 Exercises for Better Alignment:
1. Supine Arm Lengthener
Supine arm lengthener is a great exercise to promote shoulder mobility while also improving upper body posture.
Begin lying on your back with your legs straight and arms down by your sides. Slowly reach one arm up over your head keeping your elbow straight until it is above your head, resting on the floor. Gently reach that arm higher, making it as long as possible without changing the position of your spine and hips. Hold for 5 seconds. Then return to the starting position and switch sides. Start with 5 repetitions on each side.
- If you can't bring your arm all the way over your head, you can put a pillow under your arm to support it and fill in the space between your arm and the floor.
- Maintain a neutral spine — do not arch your lower back.
- Draw your belly in and exhale as you reach your arm away from you. Inhale as you relax.
2. Supine Leg Lengthener
The supine leg lengthener exercise focuses on lengthening the body through the leg and hip to reduce pressure on the spine and help improve posture.
Begin lying on your back with legs straight, arms down by your sides. Bend your left knee. Pull your toes and forefoot towards your nose as you reach the heel away from you. Hold for 5 seconds. Relax then repeat. Start with 5 repetitions on each side.
- Draw your belly in as you reach your leg away from you.
- Think about trying to make an impression of your foot in the far wall.
- Exhale as you reach your heel away from you. Inhale as you relax.
3. Supine Shoulder Press
Like the arm and leg lengthener exercises, supine shoulder press helps improve posture by opening up the shoulders and chest. It does this by gently strengthening the muscles behind the shoulders and arms.
Begin lying on your back with both knees bent, feet flat on the floor, and arms down by your sides with palms facing up. Gently press the backs of your shoulders downward towards the floor. Hold for 5 seconds. Relax. Start with 5 repetitions on each side.
- Relax your neck. Imagine opening up your collarbone area.
- Exhale as you press down, inhale as you relax.
4. Supine Morning Stretch
Supine morning stretch, as its name suggests, is an excellent first-thing-in-the-morning exercise you can do to open up the body and elongate the spine.
Begin lying on your back with legs straight and arms down by your sides.
Reach both arms up overhead. Lengthen both legs away from you, reaching with the heels while pulling your toes up towards you. Stretch as if you are trying to elongate your body, reaching your hands and feet away from each other. Hold for 5 seconds. Relax. Do 5-10 repetitions – whatever feels right for you.
- You should feel lengthening through your spine as you reach.
- Try not to arch your back.
- If your hands don't touch the floor or you have pain in your shoulders with overhead reaching, try placing a pillow under your arms to support them as you reach.
- This stretch should not be painful. If you feel pain, try focusing on just your arms or just your legs stretching rather than both at the same time.
- Exhale as you reach your hands and feet away from you. Inhale as you relax.
5. Supine Head Press
The supine head press targets the muscles in the back of the neck which are important for good posture and head alignment.
Begin lying on your back with both knees bent, feet flat on the floor, arms down by your sides. Feel the weight at the back of your head. Gently press the back of your head into the mat. Hold for 5 seconds then relax. Begging with repetitions.
- You should not feel pain during this exercise.
- Keep your chin neutral — do not tuck or stick it outwards as you press the head backwards.
- Exhale as you push your head into the mat. Inhale as you relax.
For more ideas, try Wellen's exercise program for osteoporosis and osteopenia.