Sit Up Straight! Does Posture Matter?

by Sami Sivén, PT, DPT, OCS, CSCS, COMT

“Sit up straight!” Was my Mom right to yell at me about my posture?

Posture is a topic that everyone seems to have an opinion or feelings about. Most people I meet feel pretty guilty about their “bad” posture.

The real question is, does posture matter?

Being a physical therapist, I will keep this focused on health and injury. Mood and how other people perceive you are an entirely different discussion where posture is concerned, and I am less familiar with the evidence related to these topics.

There is no evidence that indicates that posture is related to risk for pain, injury, nor dysfunction.

If you sit slouched, it doesn’t mean you are more likely to develop back pain, a rounded spine when you are older, shoulder pain, neck pain, et cetera, at least according to the research.

“But I hurt when I sit slouched for a long time.” Ok, if that happens to you, then you should consider not slouching for so long, or perhaps engage in regular exercise.

Pain is your body’s way of getting you to move. That is why we don’t sit still for hours naturally. If you have too much pressure on one area of your skin, you skin can go numb and even lose blood flow for so long that you can get an ulcer! A healthy person will move before this happens, because developing an ulcer is painful unless you have no feeling to that part of your body. Your nervous system protects you and keeps you from hurting yourself by making you hurt. When you sit slouched, you put your ligaments and or joints in an end range position, a stretch or compression, and eventually that leads to pain. If you change position, the pain should go away. This is normal. If you ignore this pain because you are too busy meeting a work deadline, et cetera, then it may hurt for longer. You ignored your early warning system and now allowed some damage to occur, and so now you are sore. Keep doing this over and over again and you can see why pain and injury can develop.

But does this mean slouching is “bad” or a “bad posture?” No, slouching is just slouching. There is not really an “ideal” posture. Every posture, when held too long, will eventually become uncomfortable and you will need to change position. Trying to live your life in some ideal posture is a fruitless endeavor, because your body needs to relax sometimes.

What I teach people is “what you don’t use, you lose.” If you never extend your spine, then over time you lose some flexibility in extending your spine. Just like if you never reach behind your back or overhead, you lose flexibility in doing that. If you sit slouched all the time and never stretch back, you can have a hard time laying flat eventually. The key is to regularly engage in exercise that requires you to move your body into lots of different positions, if you want to keep the ability to move into those positions. Since this allows you to have more movement options, it’s probably a good idea. Think yoga class or something similar. Hate yoga? That’s ok, find something you like that challenges you physically and do that more than once per week, that’s a fantastic start.

Pay attention to your body, if it hurts, move. Change position, be your body’s friend. Some people find posture breaks helpful: once per hour, stretch your body back, stand up and stretch in all directions, twist, roll your shoulders, roll your neck, et cetera.

If you have pain, sometimes certain postures can aggravate your pain. In physical therapy, we modify your activities and postures to help you have less pain, then we work on things to help you keep the pain at bay. You can eventually probably go back to all the different postures you could do before, without having to worry about them being “bad”. Sometimes bodies have become very stiff and wont tolerate certain positions anymore. Best to avoid this if you can, but if you are there, its ok. Exercise is your best way to try to help.

How about posture when you are doing certain activities? That can matter. When you are lifting something overhead, its a lot harder to do if you are slouched. If you pick up your chest, you will find that it is much easier and you will feel stronger throughout the lift. When you pick up something from the floor, lead with your chest as you come up and look straight ahead. Most people will find that this helps the lift. If you carry something heavy, standing up straight is usually a stronger posture to carry form than rounded over. I think postures during activities are much more important than postures when you are still. However, in the end, if you can accomplish the task and you don’t excessively strain yourself doing it, its probably fine. Your body will let you know if it isn’t. As long as the activity isn’t too foreign to you in recent history, you will most likely be ok.

Feel free to tell your Mom she’s wrong, if you think that is wise…