When you take a seat do you automatically slouch? If you do, why does it even matter? Slouching is bad for you, not simply because of the appearance, but because it causes neck pain, back pain, and even insufficient intake of oxygen. Yes you read it correctly. This blog is going to discuss: which sitting posture is correct, what sitting posture says about you, is sitting posture important, how sitting posture affects you, how to improve sitting posture, will sitting up straight improve posture, and posture when sitting at a desk.

What sitting posture says about you?

Looking at a random person sitting in a restaurant, I can tell if they have lower back pain, neck pain, mid back pain, knee problems, and even if they are breathing efficiently. Yes, posture affects your breathing! Your posture says a lot about you, especially if I’m the one evaluating it! When I see someone slouching, I see exhausted muscles, tight muscles, weak muscles, and a lack of oxygen. When a patient walks into my office, I can almost immediately tell if they work behind a desk. If your head is too far in front of your body, I see someone who uses handheld devices the wrong way. Take a look at your posture. Have someone take a picture of you when you are not expecting it and use the guidelines below to determine what your posture says about you. 

Which sitting posture is correct?

Many people and different websites have their opinion about what correct posture is. Well, I’m here to tell you that there’s only one right answer. If you want to know what correct posture is you have to understand a little about how your spine works! Barring any kind of birth defects or scoliosis, the spine is straight vertically speaking. From a side view, as seen in the photo on the right, you can see that the spine has 3 natural curvatures. The curvature in the cervical (neck) and lumbar (lower back) spine are the same kind of curve referred to as lordotic. The curvature in the thoracic spine (mid-back) and sacrum (pelvic region) is the exact opposite and referred to as kyphotic. 

These are natural curvatures that we have but the problem is when these curves get increased or decreased. When excessive curvature, you  can can see one to all of the following presentations:

• Forward Head 
• Excessive arch in the lower back or sitting your butt out (lordosis)
• Hunch Back (kyphosis)

By the time all three are present, your posture has sufficiently declined. That means you have lost the efficient movement patterns that we are born with (except for those genetic disorders or injuries of course). When you are sitting, your shoulders should be on top on your hips. This ensures your body is not in front of or behind your pelvis. Your knees should NOT be squeezed together or crossed! The twisting of the pelvis and the rotation of the hip joint inside the socket carries its damage in every single step you take and the decline in proper movement pattern happens there. The muscles on the inside of your thighs become too tight and your hip joint becomes restricted which can lead to knee and lower back problems for instance. If you think of the spine as a piano, each key has its own sound and plays a role in the beautiful music you hear. With restrictions in movement, with the wrong patterns of movement developed as a result of the sitting life style for instance, you disable the segmental movements (the movement of each vertebra) and the way the body is moved around. This is the slow but sure way to get on the wrong track of health.

 Is sitting posture important?

If you notice your posture is starting to decline, don’t postpone taking the necessary action until you have neck pain, lower back pain, shoulder and knee pain, or whatever the case may be. The longer the problem is present the longer it will take to correct. Damage may be so bad in some cases that we can only prevent further damage from occurring and the hope to reverse the process is gone.

Posture is important for many reasons with the most unrealized one being oxygen intake! From the postural perspective you have three diaphragms: cervical (vocal), abdominal, and pelvic diaphragms. In order for you to breathe properly, all three of these diaphragms need to be parallel to each other. When you slouch, this is not the case! When you stick your chest out (military posture) and arching your lower back you no longer sustain the very basic and foundational piece necessary for maximal breathing. Your body now has to work harder to get oxygen into your body; so it starts using auxiliary muscles in the neck to elevate the rib cage and initiate the expansion of the lungs. The muscles in your neck are not designed to do this extra task long term, and the end result becomes tight neck muscles and tension of the area. The most common type of headache, cervicogenic headache or Tension headache is a commonly seen issue I see at the clinic as a result of that.

Since the whole body is connected, a failure in one area does not stay isolated. In the example I just gave, the exhausted muscles in the back of the neck can no longer do their main job efficiently and the end result becomes the forward neck movement. Forward head move brings the center of gravity even more forward so to avoid falling forward, the brain, being in charge of everything in the body, shifts the center of gravity to avoid loss of balance. I hope you have begun to see the process of postural decline and its impact on health.

How to improve sitting posture?

Don’t fall for the posture brace ads! They work as good as your mom telling you to sit up straight!! How long did THAT last?! Making a conscious effort to have a good posture last until you get distracted, Now if the BRAIN tells your body how to be, you are set for life. Imagine, if you had to make a conscious effort to blink!!

To understand how the map of your brain when it comes to movement and sensation is, a postural neurology exam needs to be performed. This is when through a series of tests, the actual weak parts of this map are tagged and then exercised. We are not talking about cognitive testing or Soduku here. Brain Based Neurology and Posture is the very test that unfortunately gets missed when it comes to all muscle-skeletal issues. Here is a video of one of these simple postural neurology exercises.

The Postural Neurology exercises are the only tools to activate the portions of the brain that tell your body to be upright against gravity, and provide what is referred to as positive neurolplasticity. (good ‘in’, good ‘out’, garbage ‘in’, garbage ‘out’ ). Postural neurology is the first step in the right direction. What comes next to bring it all together is Functional Movement. Dynamic Neuromuscular Stabilization (DNS) was developed based on the fact that all babies regardless of their differences all go through the same developmental patterns. Just as you can erase everything on your phone but there will be certain apps that you cannot delete, these developmental patterns of movement are a part of all us and are not erasable. So why reinvent the wheels if we can re-walk the tracks we once walked?!! Understanding the proper patterns of movement, we can identify where you deviate from this design and correct it with specific DNS exercises like the one below. 

Instead of buying a posture brace or zapping device to “fix” your problem, take a look at how nature intended for you to move and re-walk the neural tracks and movement patterns that you once did without innately and without any lessons. Good posture assures a healthier life and fewer if any injuries.

Why isn’t Postural Neurology and DNS not a common?

I can only voice my suspicion and that is, common treatments are not necessarily based on what is effective but what makes more sense financially!!!

You as a patient want to seek care when there is insurance coverage, insurance companies want to collect your premium and hopefully not authorize treatment ( a term called medical necessity becomes their way of getting out of it), or negotiate rates with the providers that is financially appealing to them. The provider gets paid less so tries to see more patients to make up for it; as a result, can’t spend as much time with the patient. 30-45 minutes of one on one with a patient simply does not make a financial sense. So the options are to not do the effective treatment that takes time or do them but be out of network so it’s not work for free!

Being a common practice vs effective treatment do not necessarily go hand in hand! Of course, if you think about it, when you are desperate enough, time and money don’t matter as much. I, as a doctor with a private practice, have a choice to abide by the rules that are imposed by insurance company to get a better bottom line for them or say no. I opted for the latter so I can do what I KNOW works.

Posture When Sitting at a Desk

If you are a desk worker, a student or simply sit for many hours, you may think you have no choice but to sit behind a desk all day. The least you can do is to make the changes necessary to minimize the damage done. Check out my blog on Ergonomics from some great do’s and don’ts when it comes to your office set-up. 

If you want to make sure you are practicing good posture at the office a fun tool is an air disk. You pump it up and place it on your chair at work. This works by activating the portion of your midbrain that has to do with the upright posture. If you plan to use an air disk, make sure you do not over pump it or fill it up too much. It should have some give to it without being completely flat.

One of the best things you can do for your posture when your sitting behind a desk all day is to take micro-breaks! Get up often (every 40-45 min) go drink some water, go to the bathroom, and then come back to sit on your air disc. Before sitting back on your Air disc, do what the video below shows! Praise the Sun is a simple way to activate the part of your brain called PMRF, that tells your body to go upright against gravity.

Sit on the floor with every chance you get and if it is uncomfortable, sit on enough cushions to make it easier. Over time, you can start using fewer cushions to sit on. My most favorite way to sit on the floor is in the video below. It not only helps your lower back but the mid back and neck as well. Pay close attention to the details given in the video.

I hope reading this blog has helped you understand why posture is important and what you can do to address bad posture. If you want to learn more about posture or want some more exercises you can do, visit the Website and Youtube Channel for some great information. Remember knowledge is power. 

Dr. Shakib