By Brad Williamson BSc. (Physiotherapy) Distinction, APAM
Are you sitting TOO straight?
How many times have you been told ‘sit up straight!’? I can guarantee it is a lot
more than you have been told to slump! However, the current back pain and posture
research does not favour the social infatuation of maintaining a ruler-straight
spine in pursuit of a healthy back.
Whilst there are many unanswered questions pertaining to the cause and treatment
of back pain, there is a general consensus that posture is not a one-size-fitsall
scenario. So why is the myth of the straight back touted as healthy back behaviour?
It is a combination of factors; the first being that a straight back while sitting is
easier on the eye than a rounded back, an idea popularised in the 20th century.
This is why you probably received this piece of ‘wisdom’ regularly from one of your
Secondly, and most importantly, spinal mechanics are widely misunderstood.
As a result many people believe that postures in which the low back to bends predispose
the back to damage. This, however, is not supported by the scientific literature
Human bodies are well constructed pieces of kit, refined over millions of years
maintaining characteristics that benefit us and weeding out those that do not.
Keeping this is in mind, it is no coincidence that the low back (lumbar spine) is
highly mobile. This is because it is supposed to move! If it were supposed to be a
rigid pole, we would not have the freedom of movement that it offers. Not only is
the lumbar spine able to move, it needs to move. The vast majority of successful
low back pain rehabilitation programs assist recovery through the use of movement
and exercise. Motion is lotion ladies and gentlemen.
“Posture is not a one-size-fits-all scenario”
As aforementioned posture is not a one-stop-shop, the optimum posture varies
between individuals due to a whole host of factors. A sub-group of people with
back pain develop said pain as a result of maintaining a straight spine at all times,
this pattern is referred to as an active extensor pattern (1,2). Basically, by maintaining
a straight back all day, everyday the muscles of the low back are constantly
overactive. These muscles impart direct compression to the joints of the low back
during activities that high levels of muscle activity and joint loading are not required.
Having the low back musculature working constantly to keep the back
straight at all times is akin to red-lining your car, after a while it will fatigue!
“Having the low back musculature working constantly to keep the back
straight at all times is akin to red-lining your car, after a while it will fatigue!”
In summation, the purpose of this piece is to promote natural movement of the
spine, utilising the full range of motion available to us and dispelling misconceptions
about spinal mechanics. There are times however, when it is important to recruit
the musculature to maintain a strong, neutral spine and this is when the back
is being placed under external load. This does not mean that bending the back in
other situations is unhealthy, I think we have explored that it is in fact built to bend!
If you have back pain it is important to be professionally assessed in order to
identify the specific factors related to you and your pain. This allows for the development
of an individualised treatment program facilitating your return to being
pain free. So book in today to start your path back to being 100%!
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1. Dankaerts W, O’Sullivan PB, Burnett A, Straker L. Differences in Sitting
Postures are Associated With Nonspecific Chronic Low Back Pain Disorders
When Patients Are Subclassified. Spine (Phila Pa 1976). 2006 Mar
2. O’Sullivan PB. Diagnosis and classification of chronic low back pain disorders:
maladaptive movement. Man Ther. 2005 Nov;10(4):242-55.