People often come to me telling me that they have “bad posture.” But what is “bad” about it? For example, someone may stand with rounded shoulders and head bowed and many would deem this “bad,” yet the owner of this posture may be very shy and feels very uncomfortable standing with head held high and looking someone in the eye. So then what is “good” or “bad” in this instance? Depends on whether you are an observer seeing that person as a structure to be modified to a norm, whatever that is, or whether you are the person who is functioning as they feel comfortable in their world. Conversely someone else may hold their self with what many would call a beautifully erect posture, yet this may have been a result of several childhood admonishments to “stand up straight!”, the outcome, structurally, may be an upright posture, but it may be an upright but rigidified posture rather than one that is upright yet flexible. These are just two scenarios but the point is posture goes beyond structure, it is the embodiment of a person's history.

Posture is a dynamic process, we have only to notice this in ourselves with fluctuations in our mood or general well being, or to do some people watching and see the varying ways that people carry themselves. Some of these postural attitudes become more set over time and this is a reflection of the life of that individual, both physical and psychological. Posture, in my view, is more complex than a reduction into “good” or “bad”. This is not to say that the possibilities of playing with postural attitudes, or trying a different posture on for size should not be attempted, which is part of how I understand the Alexander technique to be applied; invitations to explore different patterns of holding rather than an instruction to move from a “bad” position to a “good” one. Amy Cuddy, an American social psychologist, who came into the limelight as a result of her extremely popular TED talk about her research into how different poses influence how we feel about ourselves, is another example of how we can modify our posture.

So by all means explore different body postures and develop your body awareness if it leads to an improvement in how you function, but try not to allow for a label to be attached to your posture, rather, use the comments as a guideline to try a different pattern of holding yourself.

When patients start to recover they often ask about exercise. Should I do yoga, swimming, pilates, Tai Chi, Zumba, cycling, gym? The list is endless and confusing because they have all been told that this is good but that is better and you shouldn’t do that by some expert in the local pub.

My view is this. If you are not in the habit of regular exercise but would like to do more then I suggest the following:

• Get checked by your G.P to make sure it is safe for you to increase exercise if you have any doubt
• Choose an activity that you enjoy. You are more likely to stick to it if it’s fun
• Build up gradually. Overdoing it will risk causing as much trouble as not at all
• Keep consistent activity going. Bursts of activity followed by months of inactivity followed by another burst are more likely to stress joints and tendons and risk injury. Hence the benefit in doing something that is your cup of tea because it will then become part of your lifestyle rather than a prescription that you have to make yourself take.

If you feel you have a more specific problem that needs advice regarding rehabilitation then speak to your osteopath about this. For example you may have arthritis in your knees and want some advice on the best ways to manage them.

This is by no means the answer to all questions regarding exercise but if there is one thing that consistently crops up regarding exercise it is that of choosing activity that you enjoy.

A common consideration when people have back or neck problems, particularly when they wake with them, is “Perhaps I need a new bed/mattress/pillow.” Several hundred pounds later they may be no better off for the latest pocket sprung, turbo charged, water cooled, space age adjustment to their sleeping arrangements. I say may be because many people do feel better for changing some of these things. Frequently this is not the first thing I would advise looking into.

It is natural to think if you are waking with aches and pains that it may be something to do with your sleep, so logically your bed and pillows come under scrutiny. However, in my experience, there are other factors that more frequently disturb sleep quality and these involve looking at what is going on in your mind.

• Have you had more on at work and been more stressed?
• Have you any family or relationship concerns?
• Is your sleep pattern altered by having young kids?

These are a few pointers but often when people have a look at the pattern of their lifestyle they can usually relate a change to it which coincides with the change in sleep quality.

If you have looked at lifestyle stuff and drawn a blank then maybe it is time to look at your bed / mattress / pillow combination.