Why 'good' posture might be bad
Posture
Anne Brennan: Williamstown South Physiotherapy
Many claim that ‘bad’ posture strains ligaments and injures joints and discs, or affects ‘alignment’creating pain. For decades, office workers and students have been told to ‘sit up straight’ in ergonomic chairs and ‘stretch’ every hour to prevent neck and shoulder injuries and damage.
This strategy isn’t working all that well.
A large international study found that solutions/ treatments/diagnoses based on this approach increased time taken off work for pain (Coggon, Ntani et al. 2013). There was no evidence that ergonomic interventions helps prevent or resolve pain. This is what is called an unexpected finding. AKA: awkward.
Professor Peter O’ Sullivan’s research group at Curtain University in Western Australia has been looking for evidence that ‘bad’ posture and psychosocial issues causes pain. Their study of over1000 young adults found no connection between slouching and neck or back pain. Their previous study found that girls who sit up straight have more pain than the ‘slumpers’ (Straker, Smith et al. 2011). Perhaps because they are trying, unsuccessfully, to do something about pain?
Yet experts cannot agree on what causes pain nor what exactly constitutes good posture.
As with so many current musculoskeletal /orthopedic /chiropractic/osteopathic pain theories, the ‘sitting up straight’ theory is only partially right.
Here is an alternative way to think about pain.
Undoubtedly muscles work best when neither fully stretched nor scrunched up, so maximum output =minimum effort. This is also good sports technique. Using muscles to their advantage minimizes the risk of fatigue, pain and injury. This should be a no-brainer. Sitting upright puts muscles iinto their advantaged position.
Muscles are meant to be dynamic: switching on and off, working hard in short bursts then resting/relaxing/softening. Rigid or prolonged stillness, even in good posture, encourages inflammation and protective pain when first moving after stillness.
Traditional ergonomic advice wrongly equates pain with joint and spine damage or mechanical faults, (bulging discs, impingement, worn out bones and pinched nerves etc). Equating pain with damage creates fear and encourages rest, bracing or splints, rigid core strengthening and stillness.
The evidence suggests that pain is likely to be neuro-muscular. That is: muscles detect risk and help create joint pain (not vice verse), inflammation and stiffness. This suggests that soothing movement,effective muscle relaxation/dynamic stability/flexibility not rigid postures helps settle pain
Ergonomic theory assumes that because sitting straight eases and minimises pain everyone should sit / stand ‘straight’ all the time. However, stillness/’good’ posture might ease pain the same way as wearing a brace eases back/ neck pain. It might feel good at first but this does not means it solves the problem.
Neck shoulder pain can last years and spread into shoulder/hips/ arms or legs . Then no amount of ‘sitting up straight’ will help. It can make it worse by locking in pain.