Are your kids going back to school, or starting college? Or are you reaching the end of a quarter at work, or have some important deadlines coming up? This is around the time when we (or our kids) tend to have increased sitting-related stresses on our body, and with that often comes neck or low back pain. We all know that posture is in some way related to pain, but many people struggle to find a solution. Sit up perfectly straight? Get a new chair? Wear a posture brace? Request a standing desk at work? Let’s explore this sometimes frustrating issue, figure out what we can do about it, and put some myths to rest.

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What is Good Posture?

At some level we have an idea of what “good” posture is: sitting or standing tall, the back of the neck long, head stacked on top of thorax, thorax stacked on top of pelvis, shoulders relaxed and slightly retracted back. This has been called Brügger relief position (after the neurologist who described it) and has been a mainstay of many “posture correcting” programs.

But answer me this: what is good posture for a cat?

Now you are probably trying to imagine all the positions you’ve seen your cat in (your cat who, to your knowledge, has never experienced back or neck pain): curled up in it’s little bed, sitting regally in sphinx position like he owns the place, sprawled over the arm of the couch face up, or stretched out impossibly long in a ray of sun coming through the window. Are any of these “good” postures?

What about snakes? What is good posture for a snake?

At this point you might be starting to realize that the question is actually kind of ridiculous. That’s because there’s no such thing as “good posture.” It’s something that was totally made up to try to explain why people get back pain when sitting for too long.

Many research papers show no relationship between posture and pain at all. Specifically, the research shows that back and neck pain are not caused by:

• Leg length inequalities
• How much curve is in your lower back
• How much curve is in (or lacking in) your neck
• Anterior pelvic tilt
• Forward head posture
• Spondylolisthesis (a condition where one vertebra is slipped forward on the one below it), or
• Text neck

If posture doesn’t cause pain, what does? And why does your back hurt after sitting all day?

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Spoiler Alert: Posture Still Matters

Let’s try an experiment. Grab your pinky finger with one hand and bend it backward until you feel a slight discomfort. Does that hurt? Probably not, but what if you held it in that position for 8 hours? I bet your pain would be pretty severe at the end of the day.

That’s because our body’s tissues don’t like to be put under strain for an extended period of time. But that very strain occurs in the muscles, ligaments, and discs of the lower back during prolonged sitting

So the TL;DR answer to the question is “Yes, posture does matter.” But not the way we are conditioned to think it matters.

Because we are not statues, after all. We are meant to move. Posture is not an arbitrary position
we have to be in all the time. The brain does have systems for controlling posture, but it is for
the purpose of finding efficient positions to move from. It helps us get our head into position to
efficiently move (you are less likely to experience strain repeatedly checking your blind spot if
you sit tall while doing so). Trunk alignment helps us move our arms and legs (try raising your
arms overhead while slumping forward–not so easy, is it?)

When you squat, your lower back has to flex forward ever-so-slightly to make room for your hips. When you reach with one arm, your back bends or rotates to assist. When you walk, your pelvis rotates back and forth to help maintain your center of gravity as you place one foot in front of the other. When you are preparing for an athletic movement, you’ll naturally adopt a quarter squat position. We are movement machines.

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The Best Posture is the Next Posture

If a prolonged sitting posture causes back pain because of tissue strain, then would you fare much better standing for a long time? Everyone responds to posture differently, but many people have also noticed their back starts to ache when having to stand in the same place for a long period of time. And yet, often the same people notice that beginning to walk makes their back feel better!

Ultimately it’s not the posture per se that causes pain, but the strain on tissues from sustaining a position (or repetitive movement) for too long. When you move, different parts of your body take turns bearing stress.

Brügger’s relief position is a great way to relieve sitting-related back pain throughout the day, but you don’t have to stay there!

Frequently adopting postures of relief, such as the Brügger position described above, can counteract any strain you would otherwise experience from prolonged slumping, because you are giving those tissues a break and not allowing the strain to occur. But so can getting up to move, if you have the opportunity to do so. In fact, frequent movement is beneficial because anything you do to improve your physical function will improve your brain’s control of posture.

And if you’re still having pain after that, you know who to call.