719-359-9169 DrBen@cosmovement.com

Key points

1. There is no perfect way to sit, stand, or walk. But it certainly helps to have many ways of doing these things.

2. Studies show that posture and pain are not well correlated, and almost certainly has many more factors at play. More relevant is the time spent in static positions.

3. The longer you spend in the same posture without experiencing others, the less options you will have when you are in pain. If your positioning causes pain, but you also cannot change your position, pain will be hard to manage.

If you have ever seen a physical therapist, chiropractor, massage therapist, or personal trainer for any body pain you have had, odds are you have had your posture evaluated. They told you your right shoulder is higher than your left, you have forward head carriage (welcome to the human race…), you are hyperlordotic, and your taxes are not done for the year. It’s a great exercise in feeling crappy about yourself.

To “correct” this, they tell you to sit up straight, shoulders down and back, 90 degrees at the hips, and tuck your chin you barbarian! Whatever position they put you in, try holding it for any length of time: it’s uncomfortable, taxing of your energy, and impossible to pay attention to if you have actual work to get done. If there was a “perfect posture”, it should feel perfect, right?

Despite the fear mongering, many old myths remain and new myths arise. For example:

Text Neck – “There is no association between neck posture, assessed by self-perception, and neck pain, nor between neck posture, assessed by physiotherapists’ judgment, and neck pain.There was also no association between neck posture, assessed by self-perception, and frequency of neck pain, nor between neck posture, assessed by physiotherapists’ judgment, and frequency of neck pain.”

Posture and Pain – “There was no significant difference between participants with and without LBP for lordosis angle.”

Ergonomics – “There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for upper extremity musculoskeletal disorders and symptoms.” Interestingly, this study did find one thing that did help with pain: “There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms.”

As I have discussed in previous posts, the body responds to the stresses placed upon it by reinforcing and strengthening those areas. For example, I have many patients that can tolerate long bouts of sitting much better than I can because that is what they have learned to tolerate, and I have not. I can deadlift 300lbs, but writing this article with my laptop on my lap is next to unbearable after 10 minutes.

The problem comes when your postural options are limited either because the space you are in (just ask a fighter pilot), the task you are performing (long hours of desk work), or because you body does not know of another option. Our bodies are driven on efficiency, and many times slumped postures are assumed BECAUSE THEY ARE MORE EFFICIENT!

What if you don’t have the “software” to know what other options you have? If I told you that you have a ton of options to move around at your upper back to change the stresses on your body, would you be able to access them? After years of not using those ranges, odds are you just… can’t do them anymore.  Instead of moving at your upper back, you do your habit: you move by extending your low back and bringing your shoulders back, which is taxing and likely no more comfortable. You continue to do the habits you have developed because it is what you know, but now what you know has become painful, and we need to access some other options so that you can stop picking that pain scab.

Now, there are habits that we tend to gravitate toward, and common areas that tend to be neglected with present-day activities. Next week I will show you some easy exercises that can help you increase your postural options. See you then!

Sources

1. Damasceno, G.M., Ferreira, A.S., Nogueira, L.A.C. et al. Eur Spine J (2018) 27: 1249. https://doi.org/10.1007/s00586-017-5444-

2. Laird, R. A., Kent, P., & Keating, J. L. (2016). How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain?. BMC musculoskeletal disorders, 17(1), 403.

3. Van Eerd D, Munhall C, Irvin E, et al. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med 2016;73:62-70.