Posture (American Posture Institute)

If you’re reading this, you are probably a woman experiencing some kind of back pain. If so, you have come to the right place. We have written many blogs about posture, but now we will dive into the posture of women specifically and the likely causes of back pain in women. Things you likely do on a daily basis can negatively impact your posture. What about this one thing specific to women that no one has told you about? If you want to learn more about your posture, what you are doing wrong that’s contributing to your pain, and how to get lower back pain relief continue reading!

What Causes Lower Back Pain? 

Lower back pain can be the direct result of an accident resulting in injury, or it can have a chronic onset. A chronic onset means that it did not occur suddenly but this pain is a result of something that has developed over time. As a chiropractor, of course, I see many many patients who complain of lower back pain. The posture of these patients tends to look very similar in that they have an excessive curvature in their lower back. This is called lordosis. You may identify this better when termed “sticking the butt out”, as seen in the photo.

This lordotic posture results in compression of the lumbar spine, which over time can become painful. So what causes improper posture? A postural decline can be the result of an initial injury, a sedentary lifestyle, sitting behind a desk all day every day and even exercising with bad form. Because the entire body is connected and functions together as a whole, what starts as lower back pain, can lead to neck pain, knee pain, foot pain and vice versa! 

Women’s Posture

Correct posture looks the same for both men and women. Using a plumb line, we can see if a person has a good posture when standing still. A plumb line is a rope with a weight tied to the end of it, so if you hang it from the ceiling it will create a straight line. When a person is standing, there are 5 points that should fall on this straight line from a side view:

Side View Plumbline

Side View Plumb-line

Front View Plumbline

Front View Plumb-line


Side View:

  • Ear Hole (not shown on the pic)
  • Middle of the shoulder
  • Greater Trochanter (of the femur)
  • Middle of the knee
  • Lateral Malleolus (outside bone of ankle)

Front View:

  • Front of the shoulders
  • Side of breasts on the rib cage
  • ASIS (Bony part of the pelvis on the sides)
  • Knees
  • Feet

My blog on good posture explains above in more detail. 

Women’s Shoes and Lower Back Pain 

I know you have heard this before but I am here to tell you that this is no joke! Stop wearing high heels! Put them on for the photos then take them off. Ladies, you may not be feeling it now, but wearing those heels every day will catch up to you. Please note, this is not only affecting your feet! The feet are very important for posture, given that they are our contact with the ground when walking and standing. This means that the condition of our feet impacts the entire body. 

Women’s shoes, in general, are not designed well for the health of our feet and therefore our posture. A high heel automatically puts us in the lordotic posture we talked about above. The Glutes sticks out and sure your outfit looks cute, but all at the expense of your lower back spine! Imagine this day after day, year after year, it’s no wonder you have back pain. It’s not only the high heel that’s an issue but the narrowing design towards the toes as well.

Feet and Back pain

Feet and Back pain

Our feet are naturally designed that the widest part of our feet is the toes. If you look at baby’s feet, their feet are widest at the toes. If you look at adult shoes, the widest part is at the ball of the feet and then narrows towards the toes. Why? For fashion and aesthetics, I assume, but it’s not harmless. We actually need to take our shoes off as often as possible and allow our feet to have contact with the ground. This is not only good for your feet but your brain and posture will benefit. You see, the bottom of feet communicate a substantial amount of information to the brain for postural balance and coordination.

If you have to wear shoes for the majority of the day, shop around, make a smart choice. If you can have your shoes off at the office, take advantage of the opportunity. Here is an exercise you should do every day to prevent lower back pain and relieve some pain you may already be experiencing.


Is Your Purse Causing Your Pain?

In addition to footwear, another thing that separates women’s posture from men’s is purses. I’ve picked up some of my patients’ purses out of curiosity and I was shocked at how heavy they are! I know what you’re thinking and the answer is yes, your purse is affecting your posture and here’s how. You have this heavy bag and wear it/hold it on one side of your body. It’s safe to say your posture is already imbalanced so this is an added weight to an already uneven structure. Then you add some high heels to the mix and you have the perfect recipe for bad posture and back pain, to say the least. Here are some purse tips:

  1. Make it as light as possible
  2. Get a backpack purse and actually wear both straps
  3. Don’t carry a purse if possible 

For moms, apply these same tips to diaper bags. Use a backpack, so at least the weight is evenly distributed. 

The Hormone Relaxin and Back Pain in Women

Relaxin is a hormone released by the ovaries, so this is very specific to women. This hormone affects the musculoskeletal system by relaxing (hence the name) the ligaments of the pelvis, but it also affects ligaments elsewhere like the knees and the lower back. You only really hear about Relaxin during pregnancy, yet it is seen monthly in women following ovulation and/or menstruations. The levels of Relaxin released can vary from woman to woman.

So that means that if structurally you are not sound and the biomechanics (mechanics of movement) is relying on ligaments and tendons vs the actual alignment of the skeletal system and the strength and flexibility of the muscles, then you are in trouble. An extra relaxed tendon and ligament that is relied on (not as an original design but as a straw to hold on to!) for stability, is not going to be strong enough to be reliable. Just as a point of interest, the discovery was made in female athletes because it was noticed that they were injured or the extent of their injuries was more during ovulation and/or menstruation.

Lower Back Pain Relief

So you have this lower back pain, but what are you gonna do about it? While most offices, chiropractic and/or physical therapy use one or a combination of the procedures below,

What really gets to the root of the problem is not just any rehab!! Think about it, if the ‘standard’ rehab. exercises worked, why do people keep having the same issues? It’s because that is not the complete answer!

Think about it, if there is a map of your body parts (when it comes to movement and sensation) in the brain and that map is altered based on use, then what happens when someone hurts or does not move certain parts of the body (due to pain or injury or lifestyle) to that map? If the map is the blueprint of how to move, then isn’t it fair to say that if the blueprint is compromised, then the action will be compromised?! That is what Brain Based Neurology and posture is about  but that is not where the effective treatment ends. Now we need to put the body through movement and scrutinize the ‘chiming in’ of the joints and muscles IN movement. If movement is a concert, musicians need to know their musical instruments for sure BUT they need to know when to chime in to make the perfect concert happen. All babies, no matter where they come from go through the same developmental stages, why? Because that is how we are designed to move just like number 2 comes after 1 and before 3!! This is better explained with  Dynamic Neuromuscular Stabilization also known as DNS or Functional Movement.


Bottom line is that we don’t have to suffer from pain to know the importance of posture on our overall health. After all, we are the Designer and the Director of our own life so let’s design and direct it the way we wish to live it.

Dr. Shakib