Stand actively.

Standing for long periods can be tiring. As the body fatigues, it automatically tries to find the easiest way to stay upright. The body uses as little energy as possible by placing the load on joints and ligaments instead of muscle. This results in less energy expenditure when standing, but it can also lead to prolonged strain on vulnerable structures and eventually to discomfort. Passive standing usually involves locking the knees back, supporting the lower back with the hands, hanging on one hip, and folding the arms while rounding the upper back.

By changing our posture to engage various muscles throughout the body, we can reduce the load on joints and ligaments and reduce symptoms. These adjustments will feel strange at first but will become more comfortable as the body adapts.

Start by adjusting your feet so that your weight is spread evenly across the heel and ball of the foot. This emphasizes the muscles in the feet and toes to support you as you stand.

Next, make sure the knees are bent just enough so that they are not locked back. Adjust the knee position so that they are pointing in the same direction as the feet, rather than pointing inwards towards each other. This will engage muscles in the hip that can help to stabilize the knees, hips, and back during movement.

The next step is to encourage the movement of the pelvis and spine. Try the Standing Pelvic Tilt exercise to encourage movement in the lumbar spine and activation of the lumbopelvic musculature. It’s normal for this movement to feel limited and unnatural at first. Doing supplementary exercises like the Kneeling Hip Stretch and Banana Stretch can help to loosen the stiff structures that lead to immobility of the lumbar spine. After you have mobilized this area, try to maintain a neutral pelvis with slight activation of the lumbopelvic muscles, as discussed in the Drawing In exercise.

Now that we have adjusted the foundation, try to finish by staying active through your upper body. The ears, shoulders, and hips should make a vertical line when viewed from the side, with the pelvis in a neutral position.

If the upper back and neck are hunched and stiff, it is common to compensate by arching the lower back excessively when trying to stand up straight. To maintain a neutral low back and pelvis while standing up straight, you will need to maintain mobility in the mid-back. Try the Fulcrum Extension and Head Retraction exercises to help with this.

You have probably noticed that standing with the feet, knees, hips, pelvis, and spine engaged requires some effort. This will become easier over time, as you become more mobile and strong. The important thing is to employ the strategies that you find useful when your symptoms come on and keep working to improve mobility and strength over time.