Good vs Bad Posture??

As i was putting my thoughts for this blog, I was sitting with my legs up on the table (don’t tell the boss!), leaning back into the office chair, facing 45 degrees to the left. Now, as I’m writing this, I have taken my legs off the table, facing straight at the computer screen with a slight slump. In a minute I’ll sit up straight, then probably a few more positions before I stand up for a stretch.

The reason I am telling you this is that there is no such thing as bad posture. Yes, I know, our mothers will be having a fit reading this, as we all remember the days of “Sit up straight!” “Pin your shoulders back!” and “you don’t want to end up like the hunchback of Notre Dame!”

At Como Physiotherapy, we see several clients with neck pain or low back pain, resulting from prolonged sitting at work. Most of them believe that it is because of their “bad posture”, however the answer is not as simple.

We are seeing more evidence emerging that there is no such thing as perfect posture. The evidence shows that, there is nothing wrong with any posture you adopt, but it’s a matter of how long you are in that self selected posture for. Office workers are a common demographic who suffer from constant neck pain, from prolonged sitting and staring into a screen. In addition, these clients also do not have a regular exercise routine!

If you tried to sit in, what we used to believe is the “perfect posture” all day, you will feel sore by the end of your shift. The issue isn’t the position you choose, but the fact that you are constantly holding the same position and fatiguing your postural muscles. You actually need to spread the load and change to give those postural muscles a break. Hence the term we now use, your best posture is your next one.

Here is an example of a patient I had a few years ago. She came in with significant neck pain. She told me that her job had been really busy and stressful lately, that she was sitting in the same position all day and hardly got out of her chair. She was always working through her lunch break and not doing any exercise. After discussing what her normal day was like, we worked out that she was sitting or lying down for a large proportion of the day. (At work – 8.5 hours, driving – 1.5 hours, dinner – 0.5 hours, watching TV – 2-3 hours and sleeping – 8 hours) That’s A LOT of nothing!

Her management plan was simply this – GET MOVING. I told the client that she needed to take a strict lunch break. I asked for her to go for a walk during the lunch break. I also told her not to sit any longer than 30 minutes, either go get a drink or to the toilet. Even a walk to the printer helps! Above all, She had to make the time to move. During those 30 minutes I encouraged the client to keep changing her posture. I also said she needed to do some more exercise at home – Walking.

The next time I saw this patient, she reported a significant reduction in her pain. She also said she was feeling less worn out. It didn’t matter what treatment I did for her, simply moving around at work was the best treatment for her. If my advice had been just to “sit up straight the whole time you work”, she would not have been able to alleviate her pain.

On a personal note, I have a history of low back issues, which still flares up from time to time. Whilst studying at university, I found that if I constantly adjusted the height of my chair whilst studying, helped.

The body is made to move. And if you are one of the unlucky people with a sedentary job and not exercising enough, you are not giving your body a chance to use its muscles. If you don’t use it, your body isn’t going to maintain the integrity of your muscles because you are not using them. It’s important we keep the body strong so that you can cope with sitting for long periods during the day. As physiotherapists, we are extremely lucky that we are constantly on the move, changing from sitting to standing when treating clients all day (although our thumbs are not so lucky!)

There are plenty of strategies at home and work that can help with ergonomic back/neck pain. Sit-stand desks are a popular thing these days. Just like prolonged sitting, staying still in a standing position can cause discomfort as well, so it is important that you are continuously changing your posture and moving around. If it takes 30 minutes of sitting to get sore, get up at 20 minutes, and sit back down before you get tired in standing. Some clients tell me they set alarms on their phones or watches to remind them to move.

So there are three main things to take out of my sharing today:

1. Firstly your best posture, is your next one. Rather than trying to sit up all day, keep changing.

2.Sit up straight, then slump, then lean to the left, change the height of your chair and simply keep moving. Most importantly, take time to get out of that chair! Always remember, your body was made to move and needs to have a break from sitting all day.

3. Thirdly, you need to balance your sedentary job with exercise after work. WHO guidelines recommend 150 minutes of moderate intensity exercise a week (that’s roughly 5x 30 min brisk walks).

If you do experience neck or back pain at work, check in with your physio, who can diagnose the issue and come up with an individual management plan to manage your posture, ergonomic strategies and appropriate exercises.

Ok I have been sitting for too long now and my smart watch is telling me to move, time for that strategic coffee break!

References
1. https://academic.oup.com/ptj/article/96/10/1576/2870247
2. https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/

This blog was contributed by Physiotherapist, Nick Wrenn.

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