Sit up straight! Stop slouching! We’ve all heard it. We’ve all ignored it.
Most people recognize that good posture is important. Most people also want good posture. They want it so badly that they are constantly looking for ideas to make good posture easier. The problem? Good posture is HARD!
How hard it is? It’s the only activity that people hate doing so much that they look for exercises to do for it….but they refuse to actually do it. Strengthen my shoulders with some rows? You got it! Work that trap? Yes! Stretch and open up my chest? Oh it feels so good! Sit up straight? That’s a no from me.
Yet, I have many people who have successfully improved their posture and, as a result, have rapidly gotten rid of their back and referred pain, maintained their improvement, and returned to doing the things they love to do. How did they do it? Posture didn’t get easier, they just discovered that it was worth it!
Is it worth it for you? In this video I describe the exact step by step posture assessment that McKenzie Therapy clinicians are trained to use for discovering whether postural correction is an important part of their client’s treatment plan. If you prefer a written explanation to a video, keep reading below.
Step 1: Baseline symptoms in normal seated position
Don’t try to be a hero and sit up straight just yet. First, sit how you normally would and be honest. Then, in your normal seated position, write down or tell a trusted friend your baseline symptoms. WHERE do you feel your symptoms and and what INTENSITY do you feel your symptoms. Take note especially of whatever you feel which is farthest away from your back. This is because you want to discover whether posture brings your symptoms closer to your back or farther away from your back (farther down your hip or your leg). Examples of baseline symptoms:
- 5/10 pain across the entire low back.
- 6/10 burning down the front of my right thigh about 3/4th the distance to my knee.
- 3/10 numbness in my left foot.
For a more thorough explanation on the topic of figuring out the best baseline symptoms to keep track of, check out Self Treatment Series: Tracking Pain by Writing Down Baseline Symptoms.
Step 2: Find the “Good posture” position
To find an upright seated posture, first: arch your low back as far as you can, 100%, then ease off 10%. In other words, almost fully extend your low back.
Second: Slightly bring your head backwards so that it is in line with your shoulders. This often means bringing your head back 1-2 inches behind where you normally rest. Be careful not to tip your head up or down in this step. Use a friend, camera, or mirror to verify your head and neck are in the correct position.
Lastly, relax your shoulders since it’s common to tighten up while working on the first two steps. Once you follow these three steps, congratulations! You have found the upright posture. You might not feel like a congratulations since to maintain this position you should be able to tell it takes some work.
Step 3: Reassess your symptoms
While you are in this newfound position, what do you feel and where do you feel it? Write your symptoms down or tell a trusted friend and compare them to what you felt in your typical, relaxed sitting position. It’s important that you know the rules on interpreting changes in back symptoms in order to correctly determine if an upright posture is truly a good or bad change. If you don’t, then check out the article Baldi Movement Group wrote on the topic here: Back Self Treatment: Good vs. Bad Changes in Symptoms. Here are some examples of good changes:
- You used to have pain on the front of your thigh, now it is gone and you have pain on your hip instead.
- The discomfort that used to be across your entire back is now in a small spot in the middle of your back.
- Location of symptoms stayed the same but decreased from a 6/10 to a 4/10.
Here are some examples of bad changes:
- You no longer have pain in your back and instead have new pain on the front of your thigh.
- The sharp pain in the middle of your back has changed to a dull ache across your entire back.
- Location of symptoms stayed the same but increased from 4/10 to 6/10.
To be honest, however, after only one change in posture people rarely have a clear understanding of how much improvement or worsening of their symptoms occurs after changing to an upright posture. This leads us to:
Step 4: Repeat until you are sure.
In this step you are going back and forth between un upright and slouched seated posture. Hang out in each position for a minute or two and track how it effects your symptoms. Do you think an upright posture was good? Well then you better go back and forth between positions 4 or 5 times so that you are absolutely sure. Why? You are training yourself to avoid pain. You are reinforcing the idea that: sit up = good, slouch = bad. Let pain and symptoms be your teacher. They are a bigger motivation than your mother (depending on your mother) for improving posture.
If you have followed every step and read every article so that you understand for certain that sitting in an upright posture makes you worse. Don’t be shy: proudly sit slouched, skip the articles on here regarding posture, and continue following for when specific exercises are discussed for you to try.
For the majority of people: If a slouched posture makes your symptoms worse, you must stop in order to get better. There is no way around it. If your symptoms improve it means that your spine is in a better position. It means that, if you stay in this position, you will heal. If you get a cut on the back of your finger it can only heal if you keep your finger straight. If you keep bending the finger the cut will keep opening. The same thing is true for your back. Don’t open the cut. No exercise, manual treatment, or surgery can make your back better that poor posture cannot make worse again. But keep heart, it is also true that once the cut is healed you can bend your finger without a problem. Likewise, once your back heals you will be able to seat in a relaxed position again without any problem. Personally, I do my best to keep a good posture through most of the day, but at the end of the day I relax just like everyone else. You will be able to do this true, after you get better.
Did you go through the posture assessment described in this article? What were your results?
Dr. Charles Baldi
Ortho and spine specialist
Doctor of physical therapy
Baldi Movement Group LLC
www.baldimovementgroup.com
ContactUs@baldimovementgroup.com
(610) 484-4487