Bad posture. It’s a crippling condition afflicting office workers around the world. A pandemic that seemingly can only be stopped by jamming our shoulder blades back and engaging a mega stable core… or so conventional wisdom would have us believe.
Despite a plethora of internet gurus telling us about the dangers of bad posture, the reality is that the importance of posture is significantly overstated. When looking into the research surrounding posture and actually having an understanding of what posture is, it becomes obvious that good posture is not the panacea it is perceived to be.
Pic from painscience.com
Defining posture is somewhat easy. It is simply a position or arrangement of body parts at any given point in time. A far more interesting question is “why do people have certain postures?”.
The adoption of any given posture is essentially the body adapting to a complete a particular task in the most energy efficient and biomechanically efficient way. This is why the typical office worker tends to lean their head forward and have their shoulder blades rounded. This allows them to complete their task – using their eyes, head and hands within a very small field directly in front of them.
This is not only true of desk workers. Overhead athletes (baseball pitchers, tennis players and volleyball players) with no pain generally have a different shoulder blade position of their dominant arm than their non-dominant arm1. Seemingly their asymmetry is a normal adaptation.
Consider the picture below. It makes sense that she is leaning forward towards her laptop as this allows her to complete her work with the most ease. Imagine if she were to sit completely upright with her shoulder blades back. If she had to use the keyboard, her arms would need to be outstretched likely creating a large amount of her strain and a quick fatigue of her shoulder muscles.
Posture is not about being lazy, it is not about falling into a position because your muscles are weak, and it is not about being pulled into a position by tight muscles. Muscle weakness and tightness may be the result of adapting to working at a desk, but they do not cause your posture at the desk.
When considering that posture is about adapting to tasks, it makes the idea of conforming to a perfect posture a ridiculous notion. We know there are variations in each individual’s skeletal make up, and we know that everyone has a great amount of variation in the tasks they need to complete, from work to home to leisure and recreational, none of us have exactly the same movement demands in our lives. So how can we say that there is a gold standard for posture? Why should everyone stand like the anatomy poster on my clinic room wall?
Perhaps the biggest fallacy of posture is that it is the cause of back and neck pain in desk workers. It doesn’t take long when looking into research that posture has very little to do with pain, especially when looking at asymptomatic populations (people with no pain). One study found that there was no difference in the spinal curves when comparing people with and without pain2. Another prospective study found that students with postural asymmetry, large thoracic kyphosis (hunched upper back) and/or lumbar lordosis (lower back curve) were no more likely to develop back pain in adulthood than peers with ‘better’ posture3.
In fact, there is potential that different postures are adopted as a result of pain, not necessarily causing pain4.
So why do people seem to develop pain from sitting at a desk? It is true that office workers are at a higher risk of developing neck pain than the general population5. Although any pain experience is likely to have structural as well as psychosocial elements, a major contributor seems to be the time spent sitting6. So perhaps any given posture is neither good nor bad, but holding that posture (whatever it is) may result in pain. Even if our postural adaptation is positive and energy saving, it may be too much of a good thing. After all, we may adapt too specifically to one task, spending too much time in one posture, and this may mean our ability to move out of that posture or adopt other postures may be diminished. What may be a reasonable posture for working at a desk may not be advantageous when playing tennis, or lifting weights (or kids) above your head.
The question that then needs to be asked then should be: ‘is this a posture problem or a movement problem?’.
It is worth pointing out here that posture is not irrelevant. If your posture is painful, it is worth changing.
Changing desk setup or posture may help your pain. But it is likely that the reduction in pain is simply because of a change of task, meaning stresses are placed on different parts of the body. But again, maintaining this new posture is just as likely to result in pain if it is the only one you have.
So what can we do to reduce the likelihood of experiencing pain from sitting a desk? MOVE! Incorporating more variation in movement during the day is a necessity. Rather than change your desk set up to be ergonomically perfect (whatever ‘perfect means), just change it regularly. Standing desks can be a great tool for reducing the risk of sitting related pain, but are most effective if you alternate between periods of sitting and standing.
Rather than passively stretching muscles that seem tight, move them actively, in ways you’re not used to moving. See the video below for an example.
Change the task, and let your posture adapt. But more importantly, give your body the resources to adapt to any posture.
If you are having trouble adapting to life sitting at a desk, come and see our team of Osteopaths, Physiotherapists, Exercise Physiologists and Performance Coaches at Absolute Health & Performance for an individualised assessment and movement program designed to give your body the resources to do what you need it to!
Written by Osteopath Matt Wallace-Smith | Absolute Health & Performance- Osteopathy Services Melbourne CBD.
References and Resources:
- Oyama et al. (2008) Asymmetric Resting Scapular Posture in Healthy Overhead Athletes. J Athl Train 43(6): 565-570
- Grob, Frauenfelder et al. (2007), The association between cervical spine curvature and neck pain. Eur Spine J. 2007 May; 16(5): 669–678
- Dieck, et al. (1985) An epidemiologic study of the relationship between postural asymmetry in the teen years and subsequent back and neck pain. Spine (Phila Pa 1976). 1985 Dec;10(10):872-7
- Hodges, Moseley (2003) Experimental muscle pain changes feedforward postural responses of the trunk muscles. Exp Brain Res 151:262–271
- Hush JM, Maher CG and Refshauge KM (2006). Risk factors for neck pain in office workers: a prospective study. BioMed Central Musculoskeletal Disorders. 7:81
- Ariens G et al (2001) Are neck flexion, neck rotation and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occupational and Environmental Medicine. 58(3) 200-207