Everywhere you look there is information about how poor posture is causing your neck and back pain. There are all kinds of products that are trying to be sold to us like posture shirts, braces, and even a device that beeps when you slump. These products may have helped some people be more aware of their posture, but for the most part I think these are just companies trying to make a dollar based on misinformation and the misconception about posture. In our society and the medical community, posture seems to be a common scapegoat for neck and back pain. If you look at the research, there is evidence to support poor posture causing pain, but there is also a lot of research that says there is no direct relationship between posture and pain. There are many people with what we consider to be poor posture but have no back or neck pain whatsoever. My belief about posture and the way I address it with my patients is that posture can be a contributing factor to pain, but it is not the only factor or even the main cause of symptoms. I like to think of poor posture as more of a symptom of dysfunctional joints and muscles rather than poor posture being the cause of pain, stiffness, and weakness. If you stop moving your joints and using your muscles, then it only makes sense that you will struggle with sitting and standing up straight rather than slouching.
Another thing to consider is our idea of bad and good posture. There technically isn’t a specific posture that is right for everyone. Everybody has anatomical variations, and someone with what you might think of as bad posture is actually perfectly fine for them. The issue isn’t necessarily posture but prolonged positions. Our body is made to move and likes movement. It does not like being in one position for long periods of time. This over works some muscles while under working others and puts increased stress on certain joints and structures. Over time this causes problems. Sitting in any prolonged position, even if it is with perfect sitting posture, is not good for us. Sitting with what we think of as bad posture for a short amount of time causes no harm. It is about how often and how long we are in a particular position, not necessarily the exact position we are in. This is something I teach my patients. Unless a certain position increases pain, then I am not too concerned about their posture. I am more worried about making sure that their joints and muscles are functioning well, that they are moving well throughout the day, and that they avoid prolonged positions as much as possible. Even if you have a job that requires you to sit all day, you can still change up your sitting position, do quick exercises at the desk to keep you moving, or just take a quick break and stand up.
With all that being said, there is nothing wrong with doing “postural exercises” or wanting to work on improving your posture. The idea of strengthening your muscles to better hold a position and to prevent issues down the road is always a great idea, and we should all be doing it. Just don’t focus too much on the exact posture itself. Focus on how well you can move into different positions, and make sure you are never still for too long.
Mason Porter, PT, DPT