Perfect Posture myth
Remember being reprimanded as a child for slouching? Parents and teachers would instruct us so often to sit up straight that it became a deeply ingrained belief slouching would inevitably lead to back problems.
Are you sitting up straight now? Can you feel the strain of trying to maintain that rigid, upright, apparently perfect posture? If so, relax, because health experts are saying not only is it fine to slouch, but it might actually help with some forms of back pain.
Contrary to popular belief, there is no scientific evidence to suggest an upright sitting or standing position is the perfect posture, or that there even is such a thing.
“We used to talk about sitting up straight and balancing a book on the top of the head, having a nice curve in the back and staying in that posture all day but the general gist of the current research is that posture variability is much more important, so to be changing postures throughout the day is better for you than remaining in one fixed static rigid posture,” physiotherapist Scott Murray says.
Specialist musculoskeletal physiotherapist Peter O’Sullivan, a professor from Curtin’s School of Physiotherapy and Exercise Science, says his research and clinical experience reveal no relationship between slouching and back pain.
“To say that (back pain) is caused by a certain posture, we don’t have evidence for that.
“What we do know is that those people who sit with back pain are more likely to be working harder than those without, we know that, so actually they’ve got more muscle tension than less so that would suggest that they’re not relaxed in terms of how they’re holding their backs,” Professor O’Sullivan says.
“Clinically, the most common thing that I would see in my practice would be that the majority of people, when they come in with back pain, are holding very upright postures and they have a strong belief that holding their posture is good for their back but when you examine them, it’s actually very often painful and when you give them permission to relax, they often feel better,” he adds.
Chiropractors Association of Australia WA president Joshua Tymms says while there is probably a lot of debate on what a perfect posture actually is, he thinks there’s certainly good posture and poor posture.
“I would definitely see a correlation between poor posture and incidents of discomfort whether it’s back pain or just general discomfort,” Dr Tymms adds.
“What do you feel when you’re slumped in your middle back? You feel pressure in your rib cage, you feel maybe some pressure in your middle back and your neck sits really far forward, so if you’re in a position like that for a long period of time, you’re going to possibly experience some discomfort.
But the other thing you notice when you’re really slumped and forward is that try and take a deep breath, it’s really difficult, it’s not a really strong functional position for your body.
MYTH: Sit up straight or you’ll get a back ache
The idea that sitting up straight is best for our back is more of a cultural belief than a scientific one, says Professor O’Sullivan.
“We get given these messages really early in life and in fact most of the patients we see were told as kids to sit up straight and how you’ve got to hold this so-called perfect posture and if you look at the basis of a lot of this stuff, it really comes down to culture — we have this whole belief system around postural desirability and we’ve then attached these health benefits to it,” he explains.
Mr Murray reveals once he gave a female patient permission to relax from her upright position, her back pain eased.
“She was physically active outside of work, she loved exercise but her job involved her sitting down at a desk,” he explained.
“She didn’t change her posture because she had this belief she had to stay upright and she had pain developing over many months. Getting her to get out of her chair every hour was all she needed to fix her issue. No more need for physio.”
Mr Murray added he gave his brother similar advice, when he noticed he rarely deviated from an upright posture.
“My brother has a long history of low back pain and it improved vastly as a result of simply being given permission to slouch. He was too stiff and tense in his back.”
Professor O’Sullivan says the notion of an upright posture being the best one didn’t take into account spine variation.
“I think it is really unfair on the population as there are some people whose spines are naturally very curved — they will never physically be able to hold that posture so we’re asking some people to do stuff that they can never actually do. It’s like saying all human beings should do the same thing and it just ignores the variability of people, basically.
“It’s very unhealthy but it’s everywhere — it’s in schools, it’s in gyms, it’s in ergonomic training, it’s a really common belief and it’s very hard to shift,” he adds.
MYTH: Bending is bad for the back
Keeping your back straight while bending may feel a little awkward and uncomfortable but we do it because bending our back is really bad for us, right? Maybe not.
Bending is very good for backs, it’s a very relaxed thing to do but we’ve kind of created a whole belief around being careful when we bend and keeping our backs straight but what that tells you is you’re holding your back stiff and not relaxing it. That’s not very comfortable.
“We commonly see a lot of fear around bending and that kind of tips into body posture. We don’t do it with any other body part but we do it with the back.”
Mr Murray agrees, saying the new (and evidence- based approach) is to allow the spinal muscles to relax a little more.
“For years, it’s been drummed into us about keeping your back straight and not allowing it to bend with sitting or lifting,” he says.
“The spine is one of the most robust parts of our body. Retraining new movement patterns and allowing it to bend and relax while we lift, and drive the lifting through the strong leg and buttock muscles, is a really useful way to help most people with stiff and painful backs improve their situation.”
MYTH: The perfect posture
Professor O’Sullivan’s own research on postures further supports the idea that there is no one size fits all when it comes to identifying the perfect posture.
One study he was involved in asked 295 physiotherapists in four European countries to choose a perfect sitting posture from nine options ranging from slumped to upright, and while 85 per cent chose one of two postures, these postures were vastly different from each other.
Even between trained physiotherapists, there is a disagreement on what is the best posture and that’s another bit of evidence that shows there really isn’t a perfect posture.
“We’ve also done some research looking at the adolescent population to examine whether if you sit slumped it predicts your likelihood of getting back pain years later and we didn’t find any relationship with that either, so there’s an absence of evidence to support the common beliefs around slumped sitting and back pain,” Professor O’Sullivan adds.
“The big story we would say to people who are involved in sedentary jobs is to have an ergonomic set-up that just allows variability but the rules that we have created are not well supported by evidence.”
Your next posture is your best posture
A sedentary lifestyle is not healthy for the body and the same rule applies to your spine, says Professor O’Sullivan.
“One specific posture doesn’t make sense — a variety of postures makes a whole lot of sense so creating variability of movement is actually more sensible than sitting upright,” he explains.
“We use the analogy of clenching your fist all day and wondering why you’ve got a sore forearm, if you’re always holding your belly in and trying to sit up straight, it’s actually very tiring and for some people that could be uncomfortable.”
Mr Murray agrees, saying posture variability is critical.
“The idea that we should remain fixed and rigid in one particular sitting posture both isn’t helpful and isn’t supported by the evidence that is emerging on sitting posture,” he adds.
Physiotherapist Scott Murray offers the following tips:
- A person who slouches all day and complains of pain should be encouraged to try changing their pelvic posture to sit in a more upright and more neutral posture, particularly if this reduces their pain.
- A person who is rigid and upright and is complaining of pain, may well benefit from slouching and relaxing back in their chair, and as a result reducing the over-activity of their spinal muscles. Both should be encouraged to take regular breaks and move more.
- Sit in comfortable postures with low levels of muscle activity around your spine and trunk i.e. don’ t tense your core during sitting.
- Move often. This means changing postures while in your chair. Don’t be afraid to slouch for a while and relax those muscles if this feels good.
- Also be active in the workplace. Get out of the chair, move from sitting to standing to walking etc. The more movement, the better.
- Consider there are other things that are more likely to be contributing to your neck and back pain in the office than simply posture. These include poor sleep patterns, stress, unhealthy lifestyle, lack of regular physical activity, and also your beliefs about neck and back pain.
- If you’re having trouble overcoming your pain, seek the help of a trained clinician who uses an evidence-based approach.