Good posture is important in many ways. It improves your appearance and helps you project self-confidence and self-assurance. It is worth achieving just for the aches and pains it may prevent. In particular, bad posture may contribute to back pain, and conversely, back pain can adversely affect your posture. Once your back starts hurting, it becomes a vicious cycle.
Unfortunately, for many of us, good posture does not come naturally. So long as people aren’t actually in pain, they tend to forget how delicately their backs are engineered. The three spinal curves—neck, upper back, and lower back—need to be kept in balanced alignment. Sitting and standing exert pressure on the lower back. Sitting is actually harder on the back than standing, and standing is five times as demanding on the spine and muscles as lying down.
Strong, flexible muscles are important in keeping the spinal curves aligned. Poor posture can strain both muscles and ligaments, making you more vulnerable to injury—as well as making everyday tasks, such as carrying groceries, more difficult. It can narrow the space between vertebrae, thereby increasing the risk of compressed nerves. Bad posture can also increase the wear on joint surfaces, and thus may also contribute to the development of osteoarthritis.
Posture is not simply what happens when you are sitting or standing still. It’s also dynamic—that is, how you hold yourself when you move.
Poor posture includes many telltale elements—rounded shoulders, protruding buttocks and abdomen, overly arched lower back, and head pushed forward in an exaggerated position. It may go along with previous injuries, certain medical conditions, poor muscle tone, and emotional stress. A sedentary lifestyle can reduce muscle strength and lead to bad posture.
Contrary to what some people may believe, “straightening up” now and then isn’t enough. Retraining postural habits takes time and effort.
Evaluating your posture
If you are having neck or back pain, your doctor may evaluate you and refer you to a physical therapist or other professional. But you can begin to evaluate your posture on your own. You can also work with a partner and inspect each other's posture.
From the side
Stand before a full-length mirror, naked or in tight clothing and flat shoes; use a hand mirror to see yourself in the long mirror. Assume your normal posture and do the following:
- Imagine dots at the front of your earlobe and shoulder, at the center of your hip, just behind your kneecap, and just in front of your ankle bone. Connect these dots—they should form a straight vertical line.
- Notice how your back curves. There should be a mild inward curve behind your neck and lower back. Your upper back should curve slightly outward.
- Check your chin. It should normally be parallel to the floor but not thrust forward.
- Sit in a straight armless chair. You should still be able to draw a straight vertical line from earlobe to hip, and the three natural curves of your back should be visible.
From the front
- When standing, your hips, shoulders, and knees should be level—one side should not be higher than the other. The spaces between your arms and waist should be the same on each side. Your kneecaps should face straight ahead, your ankles should be straight (not rolling inward), and your head should also be straight.
- When sitting, your shoulders should be at equal height, knees facing forward, and ankles straight.
Whether you seek professional evaluation or not, there’s a lot you can do on your own to improve poor posture and help maintain good posture, including the steps below. One important element: maintain a healthy weight. Being very overweight can cause or worsen poor posture. Regular exercise can help improve posture as well as weight control and overall health.
When you're standing or walking
- Think about your feet, and evaluate your footwear. Foot pain—and the posture changes it causes—may simply mean that you’re wearing the wrong shoes. It may also mean that you need evaluation by a podiatrist. Avoid high heels and worn-out shoes.
- Think tall. Imagine a wire attached to the top of your head, pulling it upward.
- Avoid standing or walking swayback—that is, with an extreme curve in the lower back. Instead, lift your chest up, pull in your abdomen, and tuck in your buttocks.
- Practice tightening your abdominal muscles and flattening your stomach. Hold the position for a few seconds, then relax. Repeat occasionally throughout the day.
- When standing for long periods, try to stand evenly balanced on both feet. If you get tired, shift your weight from one foot to another. Occasionally rest one foot on a small stool, if available.
When you're sitting
- For prolonged sitting, get an adjustable chair with good back support and armrests. Sit firmly back with your shoulders against the chair, your chest lifted, and upper back straight. Put a small lumbar roll against your lower back for additional support. Keep equal weight on your left and right buttocks. Your feet should be flat on the floor, and your thighs horizontal. If the chair is too high for this, use a fat book or small stool as a foot rest. Take frequent breaks.
- When working at a desk, lean forward at your hips, bringing your trunk forward, rather than bending at the waist or neck. Don’t look directly down at your work.
- When driving, position your seat so you can easily reach the wheel, as well as the accelerator and brake. Change the seat position occasionally, tilting slightly forward or back, if possible. Try a lumbar roll for your lower back. During a long trip, stop every couple of hours to rest and stretch. Practice good sitting posture while driving—don’t slump. Remember the imaginary wire at the top of your head, pulling it upward.
When you're lying down
- Make sure your mattress is comfortable—it need not be hard, but it shouldn’t sag. Back pain in the morning may be a sign that your bed or sleeping position is bad. Avoid pillows that are too thin or too fat.
When you're lifting, carrying
- Beware of repetitive lifting or carrying objects that are too heavy for you. Long-term use of a heavy backpack or shoulder bag can cause posture problems.
Can you sit your way to good posture?
Desk chairs have been blamed for many backaches. There are a number of alternative types of chairs currently available that claim to help your posture. These include the saddle seat (shaped like a saddle, usually backless, which you straddle while sitting) and the kneeling chair (on which you perch with legs bent at about 60°, with your knees and shins resting on supports). There is even a chair made of slings which you strap around your back and knees while sitting. All of these chairs have potential problems—sometimes relieving one ache only to create another—and can be quite expensive (up to $1,500 for some models). According to Dr. Gregory Thielman, assistant professor of physical therapy at the University of the Sciences in Philadelphia, they are of no value in improving posture.
On the other hand, Dr. Thielman is cautiously optimistic about using an exercise ball as a desk chair. These large inflatable balls (also called physioballs or fitness balls) require “active sitting,” and are often used by physical therapists to help strengthen core muscles and improve posture. One sure thing: it’s hard to slump while sitting on the ball.
Still, there’s no solid evidence that sitting on an exercise ball for deskwork is beneficial, and it may be problematic. For instance, the space under your desk may be too small for a ball that’s the right size for you, in which case you’ll have to lean forward and may fall off the ball. Also, there are no armrests. Sitting on the ball may create problems with the position of the rest of your work station. And in one study, back discomfort initially increased after one hour of use in some subjects, probably because they were not used to sitting on a ball.
Best advice: For work, choose a chair with a good “ergonomic” design—that is, it should have an adjustable back, seat, and armrests. Wheels help, too. However, if you find an alternative chair appealing, don’t mind the expense, and are willing to modify your workstation to make the chair fit in, you may want to give one a try. If you work long hours at a desk or drawing board, you might even like to have more than one chair or else an adjustable desk (sit/stand workstation). And don’t forget to vary your position during the day: lean back frequently; stand up and move around.
20 minutes to better posture
These simple stretching and strengthening exercises target muscles (such as the hamstrings and abdominals) essential for good posture. Try to do them in the morning and again in the evening.
Lower back and abdominal workout: Lie on your back with arms out to your sides. Bend your knees and raise them toward your chest. Slowly lower both knees to the floor on one side. Hold for 15 seconds. Bring knees back to starting position, keeping arms and shoulder blades on floor, then lower to other side. Repeat five times on each side.
Thigh stretch: Lying flat on your stomach, grasp your left ankle with your left hand. Press the bent leg back against your hand’s resistance. Hold for 20 to 30 seconds. Then pull that leg upward to your buttocks. Hold for 20 seconds, then lower your leg part way. Repeat five times with each leg.
Hamstring stretch: Working with a partner, sit on the floor with legs straight and hands behind you for balance. Put one leg on your partner’s shoulder and press down 20 to 30 seconds. Then ask your partner to press down just above your knee while he rises slightly to create a passive stretch. Hold for 30 seconds. Repeat five times with each leg.
Neck stretch: Sitting on a stool or chair, and holding the seat with your right hand, put your left hand on the rear right side of your head. Gently pull your head down while rotating your chin to the right. Change hands and repeat on the opposite side. Repeat five times on each side. You can also stretch your neck by gently pulling your head down toward your shoulder. Hold for 20 to 30 seconds.
Shoulder and upper back workout: Sit on a straight chair, but without touching the back. (1) With your hands clasped behind your head, raise your shoulders toward your ears, then press down. (2) Press the back of your head into your hands, so the muscles along your upper spine tighten; hold for five seconds. (3) Press your elbows back 10 times, so you feel the movement in your shoulder blades.
Back stretch: Hold the rim of a sink, with your arms straight but not locked. Place your feet hip-width apart, right under your shoulders, knees slightly bent. With neck muscles relaxed, let your hips sink back as if you were about to sit down. Feel the stretch down the length of your spine. Hold position for 10 seconds. Gradually stand up. Repeat five times.