Pandemic Posture

Megan Cordes, PT, DPT, WCS, CLT, ATRIC

With the current pandemic raging and more and more people working from home with their laptops propped up in their recliners, what is happening to our backs and posture? How many of you out there reading this are sitting (because I assume you are) in “perfect” posture? What even is “perfect” posture anyway? So I did what every curious American does when contemplating a question and I turned to good ole Dr. Google. I searched “posture” and looked at the first 5 websites that popped up: Medline, Cleveland Clinic, WebMD, Healthline, and American Chiropractic Association - (seems legit right?); they all stated that “good posture” is essential for health and “poor posture” is bad for our bodies and wellbeing, but there is no clear cut consensus on what is “good”.

Why is posture even important, why should I care? According to Dr. Google, a neutral spine helps to decrease the wearing on joints, the stress on spinal and pelvic ligaments, nerve root impingement and disc degeneration. It also reduces low back pain, headaches, TMJ pain and tension in the shoulders all while increasing energy levels, lung capacity, circulation, and self-confidence. Man, if I can figure out what “good” posture is I’m never gonna move out of it.

“Poor spinal posture” is considered when the head and upper trunk are in a forward flexed position. However, I would argue that definition based on the picture. The first two guys' postures are just as “bad” as the next two.

Dr. Google Recommendations:

Here is a list I compiled from the top five Dr Google websites of what is defined as “good posture” -  which made things clear as mud. *Note - these are not all good recommendations and many contradict themselves.

Correct Sitting Posture:

  1. Weight distributed evenly on hips with both thighs and hips supported

  2. Bend your knees at a right angle and keep your knees even or slightly higher than the hips with your feet flat on the floor

  3. Knees should be at or below the level of the hips

  4. Keep your ankles in front of your knees (Not sure how you will do this if you keep the knees at a right angle as previously suggested).

  5. Avoid sitting in the same position for long periods of time (What is “long”? 30 min? 5 hours? What if I’m in a “perfect posture” though?)

  6. Rest your elbows and arms on your chair or desk with elbows between 90 and 120 degrees, keeping shoulders relaxed

  7. Forearms parallel to the ground

  8. Don’t twist at the waist while sitting, instead turn your whole body (Then why does my spine twist?)

  9. Keep your back supported fully

Correct Standing Posture:

  1. Stand straight and tall with shoulders back (How far?)

  2. Pull in your stomach (Does this want me to suck in all day? How will I breath?)

  3. Put the weight on the balls of your feet (I feel like I'm falling forward!)

  4. Keep your head level

  5. Let your arms hang naturally at your sides

  6. Feet shoulders width apart

  7. Keep knees slightly bent

  8. Stand with knees straight

  9. Earlobes in line with shoulders (What part of my shoulders?)

Correct Lying Posture:

  1. Maintain the curve in your back; do not sleep on your side or stomach

  2. Sleep on your side or back with a pillow under or between your knees if you are prone to back pain

  3. Select a firm mattress

  4. Use a back support - rolled up towel at under the waist

  5. If sleeping on your back, get rid of the pillow and place a roll under your neck

Correct Lifting Posture:

  1. Do not try to lift objects that are awkward or heavier than 30# (What if my child weighs 35#? How am I supposed to ever get stronger if I can’t lift weights?)

  2. Keep your back straight and bend at your knees and hips. Do not bend forward at the waist with straight knees

  3. Stand with a wide stance close to the object and keep your feet firm on the ground

  4. Stand completely upright without bending your back or twisting (Again, why does my back bend and twist if I’m NOT supposed to do it?)

  5. Hold packages close to the body

How on earth am I supposed to figure out what the perfect posture is if my five google doctors can't even decide?

The Reality is....

Our back is designed such that we have significantly more flexion (bending forward) than extension (leaning backwards). This is because of the shape of the vertebras; when we extend backwards, bony protrusions called facets come in contact with each other stopping the movement. There is much more mobility when the facets are gapping apart in flexion. Likewise, our face is located on the side of the body that favors neck and trunk flexion. Our arms and legs are designed to reach forward more easily than backwards. What does this mean? Our body is designed to live in a world in front of us. How many activities do you do in extension? That means our body is set up for us to bend, reach and look forward most of the time. Our body is also set up to promote ... dun dun dun ... “bad posture”.

Now I don’t really feel as though we worked our way to the top of the food chain being set up for failure. I do feel as though we are missing a key component to “posture” and how our body works though. MOVEMENT! We are made to move in a forward direction, we just aren’t meant to stay there for a long period of time. How are you supposed to get your baby in a crib with a “flat back”? You can’t do it. What about tying your tennis shoes? Painting a ceiling? Brushing your teeth without dropping toothpaste on your jammies? Getting on your undies? Activities that we do every day require us to move our head forward and bend forward from the waist, because that is how our body is made to move.

Upright Go Pro Results

Since I was concerned with slouching all day while sitting in the recliner writing blogs, I started wearing an Upright Go Pro, which is an electronic monitoring device worn on the back that connects to the phone for real time feedback. The website advertised them as “award winning” although I could not find any awards they had won on their site or anywhere for that matter. After completing a 10 min training session, the device will continue to monitor you throughout the day and vibrate when you have “slouched” too long. Basically the device vibrates if it is angled lower than where you have it set (between approximately 30 degrees and 80 degrees). The device allows you to define your own upright position; which can be good considering that everyone’s body is different, but can also be bad if you don’t have any clue what upright/good posture actually is.  So I did a little experiment of my own.

Different Things I Tried

What I’m doing

Screenshot of Device at the Time of Activity

Description of what I'm doing

Leaning over with back completely straight - hinging at my hips and no rounded back

Sitting up as tall as possible with no rounded back but jutting my chin forward

Slouched down in recliner

Set posture leaning backwards then stood up straight

My Impressions

So my overall impression of this is that it is not worth the almost $100 to purchase this device. It is a reminder to sit or stand up straight. It would be more beneficial if it vibrated when you were in one position for more than 10 min statically. That said, it does notify you if you have been “slouched” too long, but it has to be in the red zone. For instance, when I was mowing the grass, it did vibrate to remind me when I started letting the mower get too far away from me and slouching a bit - so that was helpful.  But it also annoyed me when I did maintain “good posture” (straight back) but had to lean over.

The Bottom Line:

As opposed to worrying about the “perfect posture”, we should be more concerned with moving and strength. Any posture is not good if you stay in it too long. Most REAL experts agree that staying in any one static position more than 30 minutes is just too long - even if it is a “good” one. We are made to move. I’m firing Dr. Google! According to some of the latest research (and real doctors), just moving for one minute every 30 minutes you are sitting still can actually increase your lifespan! The longer you stay still every day the higher your risk of obesity, diabetes, high blood pressure, high cholesterol, stroke, coronary artery disease and ultimately death. Yikes!

Did you know that sitting just 30 min reduces your metabolism by 90%. That will do nothing for those love handles. Even if you are working out at the gym for an hour a day, sitting for 10 hours negates all your gym efforts.

So how do we achieve the perfect posture? When someone comes in to see a therapist to work on their “posture”, what do we have them do? MOVE! Move to strengthen their postural muscles. So basically, movement fixes posture.

So I’m sure you are wondering what you can do to fix your posture now. Here are some ideas:

  1. Set your fancy watch or phone to vibrate every 30 minutes to remind you to move (Apple watches have a “breath” reminder that everyone turns off - turn it back on if you have one and MOVE while you breath)

  2. Get a standing desk

  3. Stand up to answer the phone

  4. Only get 1/2 a glass of water/tea at a time so you have to go back more frequently

  5. Get a stability ball to sit on - instead of the desk chair or even the recliner

  6. Find a you-tube chair yoga class like this one: Chair Yoga 2.0

  7. Stand up and sit down 10 times from the toilet after you “go”

  8. Perform a small chore around your house in between every episode of of your favorite Netflix show

Look - if you are quarantining yourself and staying socially distant during this time to prevent getting Coronavirus, don’t sit in your recliner for hours on end, worrying about your posture, or attributing any discomfort you may be having to poor posture. Get up! Get moving! Stay healthy!