Posture: The Good, The Bad and The…Evidence

If I said to you what would you consider “bad” posture, I imagine you might tell me sitting or standing in a slouched position. If I then asked you what would you consider “good” posture, I’m guessing you might tell me sitting or standing up straight. But is there such thing as good or bad posture? Is posture a cause of back pain? Is our posture important when we are lifting? Let’s take a look at the evidence and explore this further!

Lifting Techniques

A common belief is that there are good and bad postures and correct and incorrect lifting techniques, and these bad postures and incorrect lifting techniques are often blamed as a cause for back pain. The current guidance for manual handling from the Health and Safety Executive, states a good lifting technique is with a straight or a slight bend of the back when lifting, and that good manual handling can reduce risk of injury.

Now there are some links between lifting and injury, and yes, at times awkward postures and heavy lifting can prompt some episodes of acute low back pain, but that’s not always the case. In truth, there is no strong evidence that “incorrect” manual handling techniques such as bending, twisting or awkward postures are a cause of low back pain, or that they are unsafe to do. The best lifting technique is the one that feels most comfortable for your body, and for all of us that might look slightly different. So be reassured that it is safe to lift however feels best for you!

Well, that’s great news to hear that a lifting technique that is comfortable is safe to do, and it is also safe to bend our back when we lift, but…what about posture in general, do we need to worry or think about it?

“Good” vs “Bad” Posture

Common advice you may have heard is that we need to maintain a “good” posture, so standing or sitting up straight, in order to protect our spine, and that it is “bad” or harmful to slouch. This can be unhelpful as it can lead to certain postures or movements being avoided or can be understandably fear-inducing to someone if they find themselves in a “bad” posture. Thankfully evidence shows that our spines are robust, strong and adaptable structures and are capable of adopting different postures. Well, this is brilliant news!

But wait, what about when certain postures are painful? There is evidence that some postures might provoke symptoms for someone who is experiencing low back pain but it cannot be concluded that the postures are the cause of pain. So whilst certain postures aren’t the cause of pain and all postures are safe to do, if certain positions are painful we might work on modifying our movements in the short term to allow us to keep moving whilst our pain settles.

And what about this “good” or upright posture I’ve heard about for years, surely there’s got to be some benefits to it mustn’t there? What makes it so, well…“good”?

So, there are some benefits to sitting or standing up straight. There is evidence that shows that sitting in an upright posture during times of stress can help maintain and improve our self-esteem, reduce a negative mood, and increase a positive mood compared to a more slouched posture. Sitting upright during these times can be one helpful way to achieve this, but another, arguably more beneficial, way is with physical activity. (For more information on physical activity and how much to aim for, check out our blog on this topic by clicking here).

Ok so now we understand I can get some benefits to sitting upright, which I can also achieve by being physically active, but overall, there is no “good” or “bad” posture.

So, should I just maintain one posture all the time?

Not quite. Our body was designed to move in all directions and if we maintain any one posture, whether that is sitting up straight or slouching, after a period of time that may become uncomfortable. So, the best thing to do is keep yourself moving in as many directions throughout the day as possible. Ask yourself, are you able to sit up straight? Are you also able to slouch? Can you also twist and bend? If the answer is yes to all of those questions, then keep yourself moving! If the answer is no to any of those questions then you might find it helpful to come and see one of our specialist Physiotherapists who will be able to help you.

References

Dankaerts, W., O’Sullivan, P., Burnett, A., Straker, L., Davey, P. and Gupta, R. (2009). Discriminating Healthy Controls and Two Clinical Subgroups of Nonspecific Chronic Low Back Pain Patients Using Trunk Muscle Activation and Lumbosacral Kinematics of Postures and Movements. Spine, 34(15), pp.1610–1618. doi: https://doi.org/10.1097/brs.0b013e3181aa6175

Department of Health and Social Care (2019). Physical Activity guidelines: UK Chief Medical Officers’ Report. [online] Gov.uk. Available at: https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report

HSE (2023). Manual handling at work: Good handling technique – HSE. [online] www.hse.gov.uk. Available at: https://www.hse.gov.uk/msd/manual-handling/good-handling-technique.htm

Kwon, B.K., Roffey, D.M., Bishop, P.B., Dagenais, S. and Wai, E.K. (2011). Systematic review: occupational physical activity and low back pain. Occupational Medicine, 61(8), pp.541–548. doi: https://doi.org/10.1093/occmed/kqr092

Nair, S., Sagar, M., Sollers, J., Consedine, N. and Broadbent, E. (2015). Do slumped and upright postures affect stress responses? A randomized trial. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, [online] 34(6), pp.632–41. doi: https://doi.org/10.1037/hea0000146

Slater, D., Korakakis, V., O’Sullivan, P., Nolan, D. and O’Sullivan, K. (2019). ‘Sit Up Straight’: Time to Re-evaluate. Journal of Orthopaedic & Sports Physical Therapy, 49(8), pp.562–564. doi: https://doi.org/10.2519/jospt.2019.0610