Should you 'fix' your posture? Why experts say always sitting up straight won't help your back pain.
Did your parent or a grandparent ever poke your back so you would pull your shoulders back? Or perhaps a teacher reminding you to sit up straight and at attention? Or maybe you (like me) have gotten those targeted Instagram ads trying to sell you Taylor Swift’s posture trainer?
Good posture has long been touted as part of the picture of health (and respectability) and a way to prevent back pain. But what if it isn’t? Recent research is questioning decades of advice about how we should sit, stand and lift. There’s a good chance everything you think about posture is flawed.
Read on for the myths experts want to dispel, and the habits that can prevent back pain.
What is good posture?
In the U.S. and much of the Western world, we’ve long been fixated on standing and sitting up straight. When standing, that means keeping feet a little more than shoulder-width apart and facing forward, your hips tucked, back straight, core engaged, shoulders back and pulled down away from the chin, neutral neck and the chin slightly tucked. It’s similar for sitting: straight back, shoulders back, weight distributed evenly on each hip, knees at a right angle and feet flat on the floor.
The theory is that standing or sitting straight reduces the amount of stress on your muscles, joints, ligaments and each intervertebral disc — the rubbery, shock-absorbing spacers between your vertebrae — to prevent this padding from degrading which, in turn, causes pain.
But in practice, it’s not that simple, experts say.
What’s wrong with 'good' posture?
The jury is still out on whether straight posture is better for your spine and overall well-being than bent posture. In fact, there really isn’t a great deal of research on the topic. One team of Australian researchers compiled all the studies they could locate about posture and lower back pain and injuries, hoping in vain to get closer to a conclusive answer to the best spinal alignments for preventing problems. Another Australian study tried to establish whether neck posture (think the “tech neck” position you're probably in while reading this) correlated to pain in teenagers. It didn’t.
“Posture — sitting, standing, bending, lifting— is highly variable in people with and without pain,” Peter O’Sullivan, one of the Australian researchers and a professor of physiotherapy and exercise science at Curtin University, tells Yahoo Life. “The systematic reviews don’t show a difference in basic posture between pain and no pain [and] there is little evidence that ‘poor posture’ is a cause of back pain.” In fact, in their study of lifting posture, O’Sullivan and his colleagues found that those without low back pain lift with a more curved or “flexed” back on average.
Instead, bent, slouching or otherwise “poor” posture might be a reaction to pain rather than a cause. “People with pain tend to over-protect their backs, [moving] slower and stiffer — with more muscle tension,” observes O’Sullivan.
The link between posture and health
Historically, posture has been a fairly loaded topic, Beth Linker, a medical historian and author of Slouch, tells Yahoo Life. Linker found that our fixation with being upright can be traced back to Charles Darwin’s theory of evolution, which suggested that it was humankind’s ability to stand up straight that separated humans from other primates, rather than our larger and more complex brains.
Then, during World War I, military officials started doing physical examinations to determine the fitness of servicemen. These included posture exams, and doctors began “thinking that a physical value had predictive value,” when in fact, they didn’t, at least not when it came to posture, says Linker.
Around the 1940s, scientists started to consider a causal link between posture and back pain. “Pain is really hard to pinpoint and we have all these different pain theories,” says Linker. “There often aren’t biomarkers of pain, so [looking at posture has been] an attempt to find the biomarker.”
What you can do about back pain — and when posture matters
O’Sullivan says that being inactive, sedentary, stressed, sleeping poorly, suffering from mental health issues, smoking and being overweight can all lead to back pain. And, of course, you can injure your back by trying to lift or carry things that are too heavy.
Linker, who was a physical therapist before she became a historian, emphasizes that while posture may neither cause nor prevent back pain in otherwise healthy people, “postural therapies to alleviate pain” in someone already hurting are valid. She suggests seeing a doctor if you have chronic back pain, and, ideally, a physical therapist who can tell you precisely which muscles to strengthen and stretch.
O’Sullivan and Linker agree that sitting or standing in any one position — however straight or slouched — for too long can leave you achy. “There is some evidence that holding tense upright postures can be painful for some people, and relaxing the posture in these cases eases pain,” says O’Sullivan. “For others [who may be] sitting slumped for long periods, if that is painful, they can benefit from being more upright. ... The key is variability of posture.”
O’Sullivan says that rather than trying to wrench yourself upright to prevent back pain, being less sedentary and exercising are the best defenses, since too much sitting is a major risk factor for back pain. “Movement is important for the spine, so varying your posture and taking care of all aspects of your health is key,” including sleeping well and getting regular exercise," O’Sullivan says. Conversely, “if you sit all day and don’t engage in physical activity, that’s unhealthy for all aspects of health.”
