Back problems are a frequent concern for adults and are becoming increasingly common for children and teens. One major contributing factor is poor posture, which can include slouching, rounding of the neck and shoulders, or exaggerated arching or hunching of the back.

These positions put an incredible amount of pressure and wear and tear on your spine, ligaments, tendons, and muscles. The tension can also lead to headaches, chronic fatigue, and an irritable or depressed mood–they can also impact how others see you. Poor posture can even compromise a person’s ability to breathe deeply as a stiff, hunched-over back can cause chest muscles to tighten, making it harder to expand the chest when inhaling.

While everyone benefits from good posture, it’s especially important for children. If kids develop healthy habits early on, they’ll be more likely to practice them later in life, leading to fewer back problems and other complications when they’re older.

What does good posture look like?

When you were a kid, did anyone ever tell you, “Stand up straight!”? That’s good posture in a nutshell. When standing, your chin should be parallel to the floor with your shoulders aligned directly above the hips and your weight centered over your feet. A helpful tip for understanding what this feels like is to roll your shoulders up, back, then down. You can also imagine a straight line running down your side perpendicular to the floor that passes directly through your ear, shoulder, and hip.

It’s the same principle when sitting; strive for tall and straight rather than slouched over. When you sit down, bend forward, scoot your bottom to the very back of the chair, then sit up to help relieve pressure on your tailbone. Relaxing your shoulder muscles and using your core abdominal muscles will help maintain strong posture. Good posture has many of the same benefits as exercise: it strengthens muscles, improves breathing efficiency, decreases chronic pain, and helps a person come across as confident and resilient.

What causes bad posture?

More than a hundred years ago, along with the physical education movement, American schools enthusiastically taught good posture and even exercises similar to today’s physical therapy routines. Children were taught about ergonomics, how to sit properly at a desk, how to evenly distribute the weight of the books in their backpacks, and how to walk up and down stairs with good posture.

Unfortunately, teaching about posture has fallen out of popularity. It’s too bad, especially with the increased time children (and even toddlers) are spending hunched over laptops, phones, and other screens. When kids spend too much time bent over looking down at a tablet or computer, it can cause neck or back pain and develop bad habits that last a lifetime. A lack of exercise, obesity, unfavorable ergonomics at school and at home, and heavy backpacks also contribute to poor posture.

Take your kids to see a doctor if they experience difficulty sitting or standing upright without assistance, persistent pain, numbness, weakness, or worsening symptoms.

How to practice proper posture

There’s no quick fix for bad posture, and nagging your kids doesn’t usually work. Guidance, gentle coaching, frequent practice, and setting a good example at an early age all go a long way toward turning good posture into a daily habit.

Kids should get at least an hour of vigorous exercise a day and avoid prolonged periods of sitting. Exercises that promote strength, flexibility, and balance, such as yoga and Pilates, can significantly improve posture. Screentime is part of modern life, but minimizing the time in front of screens, taking more breaks, and placing the screen at eye-level can help.

Make sure your children are wearing their backpacks properly and keeping the load light — no more than 10 percent of their body weight. Carrying a backpack over just one shoulder, which kids like to do, can stress the back, neck, and spine. Encourage your child to use both straps and keep them tightened so their pack sits high on their back instead of sagging low and away from their body. They should pack books and other heavy items close to their back and make frequent locker stops throughout the day so they only have to carry the books they need.

Working on good posture in childhood is a commitment, but the long-term benefits are well worth it: fewer injuries, a decreased risk of chronic pain, and improved breathing, mood, and self confidence. Not bad for the simple act of standing and sitting up straight!

Casey Johnston, MD, is a pediatrician at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.