Posture is a topic that often arises in conversations about pain and body mechanics, with a common assumption that “poor posture” is the primary cause of many musculoskeletal issues. At Rise NW10 Physiotherapy, some of the most frequent questions we hear from patients are:
"What is the best sitting or standing posture?"
"How can I improve my posture?"
"Do you think I have this pain because of my posture?"
These are valid concerns, but the truth is, there’s a lot of misinformation about posture, particularly online and on social media platforms like YouTube. Many of my patients come into sessions with preconceived notions, only to leave with a completely different understanding of how posture truly affects their bodies. Surprisingly, some people even experience pain from over-correcting their posture, trying too hard to maintain a "perfect" stance.
So, what do we actually know about posture? When should you worry about it, and when is it time to let go of myths and focus on a more holistic approach?
The Historical View of Posture and Pain
For years, poor posture has been blamed for various musculoskeletal problems. The typical advice was to sit up straight, keep your shoulders back, and avoid slouching at all costs. However, the science behind posture and pain is evolving, and it turns out that maintaining perfect posture isn't necessarily the solution to preventing pain. In fact, some people develop pain by constantly trying to correct their posture.
The Relationship Between Posture and Pain: What the Evidence Says
Posture and Back Pain
Low back pain is one of the most common issues in healthcare, and while posture plays a role, it’s not the only factor. For example, a systematic review published in Pain (2012) found no definitive link between sitting posture and low back pain across large populations. What we know is that movement—changing positions frequently—is more important than maintaining a single “ideal” posture. Trying too hard to sit perfectly upright for long hours might strain the muscles and joints, leading to discomfort. Encouraging a more relaxed, dynamic approach to posture, where people change positions throughout the day, can often be more effective than rigidly maintaining a certain stance.
Posture and Neck Pain
Forward head posture, a common complaint among office workers and those using smartphones, has been linked to neck pain. However, while correcting it can help, strengthening exercises and improving overall ergonomics are just as important. A 2019 meta-analysis published in the Journal of Physical Therapy Science found that while forward head posture is associated with neck pain, it is only one of many contributing factors. People who focus too much on holding their head in perfect alignment often become more tense, which may exacerbate neck pain. The solution? A combination of movement, relaxation, and strengthening.
Posture and Shoulder Pain
Similar to neck pain, shoulder pain is often linked to poor posture, particularly rounded shoulders. This can compress the structures in the shoulder joint, leading to impingement and rotator cuff injuries. Evidence suggests that correcting shoulder posture—combined with targeted exercises to strengthen the scapular muscles—can reduce pain and improve shoulder function. But remember, it’s not about maintaining an overly stiff posture; instead, it's about functional movement and muscle balance.
Posture and Psychological Impact
Research suggests that body posture not only influences how others perceive you but also affects how you feel about yourself. An upright posture—characterized by standing tall, shoulders back, and head held high—is linked to higher self-esteem, improved mood, and a greater sense of confidence. In contrast, slouching or adopting a closed posture—such as rounded shoulders, a forward head, and a slumped back—is associated with feelings of low energy, reduced self-esteem, and increased stress or anxiety. The concept of "power poses," popularized by social psychologist Amy Cuddy, highlights this relationship; her studies indicated that adopting open, expansive postures for a few minutes can enhance feelings of power and confidence. Although some claims about physiological changes have been debated, research continues to support that maintaining an upright and expansive posture positively impacts self-confidence and reduces stress. If you resonate with the challenges of maintaining good posture, it's essential to know that there is no passive way to correct it. Engaging in activities such as ballet, dynamic yoga classes, or Pilates can effectively strengthen the muscles that influence your posture, fostering long-term improvements in both physical alignment and psychological well-being.
Do You Need to Worry About Your Posture?
The short answer is: it depends. The focus shouldn't be on achieving "perfect" posture but rather on how comfortable and functional your body feels in different positions. If you're experiencing pain, the issue might not be your posture itself but other contributing factors.
Here’s what we know:
Dynamic Posture: Rather than obsessing over maintaining a specific alignment, it’s more beneficial to vary your posture throughout the day. Change positions frequently, stand up, stretch, and move around.
Comfort Over Perfection: Trying to force yourself into a "perfect" sitting or standing position for extended periods can contribute to muscle tension and pain. Comfort, ease of movement, and a relaxed approach are key.
Strength and Flexibility Matter: Posture correction without addressing muscle strength and flexibility is incomplete. Strengthening the right muscles in the right positions is essential to support better posture.
Practical Tips for Improving Posture and Reducing Pain
Move Frequently: Avoid sitting or standing still for too long. Set a reminder to move or stretch every 30 to 60 minutes.
Ergonomics: Adjust your workstation to fit your body, rather than trying to adjust your body to fit the workstation. More information can be found here.
Strengthen the Right Muscles: Focus on the muscles affecting your body.
Stretch Tight Areas
Practice Mindful Posture: Throughout the day, remind yourself to sit or stand comfortably, rather than rigidly. Small adjustments can help reduce tension and improve your overall alignment.
Breathing Techniques: Practicing diaphragmatic breathing can reduce muscle tension and stress, which can indirectly improve posture.
Conclusion
There’s no one-size-fits-all approach to posture. While poor posture can contribute to musculoskeletal pain, it's often not the sole cause. Rather than striving for a "perfect" posture, focus on maintaining a dynamic, comfortable posture and incorporating movement, strengthening, and relaxation techniques into your daily routine. With the right combination of these strategies, you’ll be well on your way to managing pain and improving overall function.
At Rise NW10 Physiotherapy, we take a holistic approach, helping you understand the true relationship between posture, pain, and movement.
To read more about desk work ergonomics:
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