CTH Healthcare Articles

Chronic back pain? Forget posture.

Are you constantly trying to sit ‘well’? Sit ‘better’? Sit up straight? Stand tall? Pin your shoulders back?

Do you have chronic or on-going back pain?

Perhaps the most powerful strategy you can use is to relax about posture.

Slowly but surely people are becoming hyper-vigilant about how we should sit and move, including ‘rules’ and body dos and don’ts, and the things we must do in order to protect our backs and bodies from horrible injury.

This includes things like ‘engaging your core’, ‘activating your glutes’, putting parts of your body in specific or ‘safe’ positions in order to sit, stand, lift or walk… sound familiar?

For the most part these rules are pretty hard to maintain and are often not at all helpful – especially if you have pain. They also give the impression that our bodies are fragile, which isn’t the case. In reality we are extremely robust, even in the presence of pain.

The irony is that consciously holding yourself in a certain way or changing how you move, could actually be hindering not helping.

Is pain the result of bad posture?

Pain is often the result of de-conditioning, being unused to normal movement. Tension and stress are also often involved. And emotions like fear prime the nervous system to be on red alert for threat – which makes pain much more likely. There are plenty of people who don’t have ‘perfect posture’ who don’t have pain so it’s worth considering that something other than posture may be contributing.

De-conditioning occurs due to lack of movement in some way, resulting in decreased strength and mobility. Your nervous system, joints and muscles etc become less used to the things you don’t do. Sitting may contribute to that but it’s likely more to do with not moving for long periods of time on a daily basis or a various other contributing factors depending on the individual, rather than how you sit, or how much you protect yourself when you move.

Sitting bolt upright to avoid slouching, or engaging your core when you bend forward are just two examples of many ‘rules’ I see people applying to themselves, often as a result of well meaning but potentially misguided advice.

These strategies consciously tense muscles when actually your muscles should be relaxed and unconsciously engaged through movement (as children we learn to walk and run with no conscious awareness of any single structure, such as your core or glute; our body figures out the detail for us). They also contribute to sensitising the nervous system, which contributes to and perpetuates chronic pain.

Movement is the result of identifying a goal. For example, “I want to walk there, sit here or lift that”. In healthy movement, we generally aren’t aware of our body. But instructing individual bits, such as specific muscles, creates unnatural tension. It stops your joints from moving freely and unconsciously in the way they were designed to, which has a knock on effect on how your body can function.

The result of tense movement is decreased shock absorption, more tension and aggravated pain: not a particularly good strategy to relieve pain.

Try this quick exercise: clench your fist and try moving your hand back and forth. Does the movement feel easy and natural? How comfortable is it to keep your fist clenched? Now un-clench your fist and relax your hand, and try the same movement. Does this feel much easier and more comfortable?

Your wrist is similar to any other part of your body and works in the same way – muscles, joints, etc. work best together when they are relaxed, even in very active movements like running and jumping. The best athletes are very good at relaxing when they do their stuff, and they are stronger as a result.

So if posture is less relevant, what can you do?

Un-clench and move more. Work on being comfortable and relaxed in movement and at rest.

If you are terrified of slouching because you think it will damage your back, stop worrying. Slouching can’t hurt you, but your body doesn’t tolerate being static for long periods of time – whatever the position. If you sit bolt upright for hours, it’ll be uncomfortable, just like being slouched for hours. That doesn’t mean you can’t sit down for longer than five minutes, but like anything, it’s about finding moderation in a way that works for you.

Movement is the answer, and diverse movement is powerful medicine. The more movement the better – and make it fun. Your body is stronger than you think but if you’re scared of moving then seek help from a therapist who is pro-movement. Avoid ‘experts’ who tell you to stop moving and just rest. The aim of any treatment should be to find useful strategies that enable you to move well with confidence so you can enjoy life without pain – in a way that puts you in control.

carry triggs hodge osteopath image

Additional Support

CTH Healthcare is all about helping you get better, quicker, so that you can overcome pain and injury, and be independent of ongoing treatment. If you have any questions on this article or would like to find out how treatment might be able to help you get in touch using the form below.

Tags: back pain, chronic back pain, Chronic pain, posture

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