Is Perfect Posture Practical From A Pain Prevention Perspective?
Stop slouching, sit up straight! We've heard it all our lives from parents, teachers, coaches, bosses, spouses, and chiropractors (me included). The idea is that sitting up straight is good and slouching is bad. Is there evidence or is it simply a myth? I think slouching is very much like knuckle cracking- annoying to the observer but harmless (and possibly helpful!) to the perpetrator. Is perfect posture a social aesthetic? Certainly. Is slouching bad for us? Can perfect posture save us from the evils of sitting too much? Not likely.
In a recent post in BBC Science Focus Magazine Dr Kieran O'Sullivan explains how to sit. He observes: "If I ask a room of people to show me the right way to sit, they'll all sit up straight. If I then ask them to stay like that for a while, they'll tell me they can't because it's uncomfortable. We all realise this, yet we're quick to suggest that sitting upright is the best thing to do. I think this has a lot to do with aesthetics. Sitting upright is more socially acceptable than slouching."
I have observed this firsthand when presenting a course for medical students or chiropractors. Very soon into the presentation everyone is slouching to one degree or another.
The reality is that prolonged sitting, perfect posture or otherwise, is simply not good for us. We naturally explore various positions to change the load our tissues experience. Our sedentary habits are causing an early decline in our musculoskeletal and general health and have caused a worldwide public health crisis. Musculoskeletal complaints are the biggest non communicable disease burden on the health care systems of industrialized countries, exceeding cancer, diabetes and heart disease.
But I have the perfect chair you say! Waterfall seat pan, adjustable arms, six way adjustable lumbar, tilt, cup holder…. Cost me $3000.00. I even had the ergonomics team come in to measure, calibrate, analyze my workstation. O'Sullivan: "We've looked at lots of types of chairs, including wobbly versus stable, and with and without backrests. Others have looked at regular desks versus ergonomic work stations. None of these things make much of a difference. If they do help, the effects tend to be short-lived as the novelty soon wears off."
You still need to get up and move! Craig Liebenson, DC, author of Rehabilitation of the Spine: A Patient Centered Approach emphatically states that "The best chair is the one you get out of". According to O'Sullivan: "…if you are pain-free and sitting comfortably, you don't need a new chair. If you have persistent pain, you could try different chairs and find the one that's right for you."
Enter the sit/stand desk. Fantastic improvement! Of course, now we are seeing health issues like back pain and leg circulation problems from too much standing without movement.
Solution? Alter the time between sitting to standing. Some clinicians and ergonomists recommend a 30-minute sit to 10-minute stand interval. O'Sullivan comments: "Prolonged periods of inactivity have been shown to raise the risk of heart disease, diabetes and other conditions, but we need to be careful. In recent times, there's been a trend to tell people to get up and move around every 30 minutes or so, but this can make those with chronic pain even more aware of their frailty. Instead of forcing people to move at prescribed intervals, I think we should be telling people just to move more." Personally, I would take this just a step farther- try to move BEFORE you become uncomfortable. People often find that they get uncomfortable after a certain period of time. If you change position before discomfort occurs, you may find you are doing better at the end of the day. You can find your personal comfort interval using a timer function and set your interval accordingly. Getting away from your desk and walking a few times a day is also a helpful change.
I recently worked with a patient who is very fit but had significant sciatica, mostly related to sitting and driving. In talking about the set up in her car, it became clear she was under the impression that she needed to sit as erect as possible while driving. I asked her to recline her seat back 5-10 degrees. She looked at me as if I had recommended spine surgery, "no way, I have always been taught to sit straight and not slouch driving". She agreed to humor me and try my suggestion. No more sciatica!
The adjustable car seat is your friend. There is no perfect adjustment. Feel free to fiddle with it whenever you take a longer drive. You might be surprised how much better you feel at the end of your trip!
If you are having trouble with neck pain, headaches or back pain, our experienced doctors can guide you to a solution that is right for you.