There’s No Such Thing As Bad Posture
I remember an ad from years ago on the wall at McDonald’s that read. At Maccas, there’s no such thing as a good burger. And I remember thinking, der, they’re all pretty poor. But then it clicked, that for there to be good burgers, there must also be bad ones. So the ad was trying to convey that all Macca’s burgers are consistent.
I still think this slogan is dumb but it always comes to my mind whenever a patient tells me they have bad posture, or their pain must be from poor posture. I often see people with neck or back pain and I ask “what do you think is contributing to your pain?” and often the response is, “I know I have bad posture”. My response is, “you don’t have bad posture, there’s no such thing as bad posture, or good posture, just different postures”.
Posture commonly gets blamed as the cause of pain, particularly neck or back pain. But we don't have good evidence to back up this claim. It’s more to do with the time spent in one particular posture than the actual posture itself. It's an issue of lack of movement and lack of variability in our postures that are more likely contributing to any experience of pain.
If posture was a contributing factor to pain then we should see that people in pain (neck, shoulder, lower back) are more likely to sit in ‘poor’ postures, and that people without pain should on average have ‘better’ / straighter postures. Someone should study this…
Actually it is very well studied, and guess what most of them find? A lack of strong evidence than any specific posture is linked to better health outcomes. Again it’s more the lack of movement that is the issue, not the specific posture.
If you want to read more… start here:
Physiotherapist perceptions of optimal sitting and standing posture
Why Posture and Pain do not Simply Relate
No consensus on causality of spine postures or physical exposure and low back pain
Current Clinical Concepts of Posture
So we need to stop blaming just posture as the cause of pain.
Consider this scenario. A patient walks into a Health Professionals clinic for help with their neck pain. The patient explains that they think their bad posture is causing their pain. The professional agrees and confirms the patient's suspicions, and might say something like “Make sure you sit with good posture during the day, sit straight, shoulders back, tuck your chin in’’. The patient then proceeds to sit how they were advised, for all of 2 mins until they are too tired or sore to continue. So, they go back to sitting in their more comfortable posture feeling defeated and blaming themselves for being a failure and being too weak to even sit for 5 minutes in ‘good’ posture.
I'm being facetious, but this is not an uncommon scenario.
Try it yourself… See how long you can sit up straight, shoulders back and chin slightly tucked. It's hard work, and for most, it’s not comfortable or achievable for any real length of time. In fact, if your pain is perhaps linked to being stressed, tense, or like most, a lack of movement. Then adding extra stress and tension by holding a bolt upright posture likely won't help your pain. It may even make things worse.
The aim is to change postures often. Not blame the posture, but rather the time you stay in one posture for. Get up and move, change your posture often. And the next time your mum or grandma tells you to sit up straight. Just smile and nod…
Thanks for reading.