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The Perfect Posture Myth- Physio Penrith

Why The Perfect Posture Doesn't Exist

Contrary to popular belief, there is no scientific evidence to suggest an upright sitting or standing position is the perfect posture

The idea that sitting up straight is best for our back and neck is more of a cultural belief than a scientific one, I'm sure all our mothers shouted at us to sit up with a straight back. But what we know is that when you sit up straight you often tense up your muscles and there is a real strain of trying to maintain that rigid, upright, apparently perfect posture. I often describe this type of stiffness and muscular tension like clenching a tight fist - try doing that for 8 hours and you'll be reporting that your hand and finger joints are stiff and sore and your forearm muscles are tight and weak.

The general gist of the current research is that posture variability is much more important, so to be changing postures throughout the day is better for you than remaining in one fixed static rigid posture.

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There is no link between a slouched posture and future back pain

There is some great research from a renowned professor that looked at the adolescent population to examine whether if you sit slumped it predicts your likelihood of getting back pain years later. They didn’t find any relationship with "poor posture" and future back pain, so there’s an absence of evidence to support the common beliefs around slumped sitting and back pain. 

So what are the risk factors for developing occupational back and neck pain?

The Stay@Work study reports that proven physical risk factors for the development of low back and neck pain include:

  • heavy physical workload

  • whole body vibration

  • frequent bending and twisting

  • heavy (manual) lifting for low back pain

  • Repeated neck flexion for neck pain

  • Lack of physical activity

  • Poor quality of sleep

  • Incorrect beliefs about neck and back pain

We do see increased mid back stiffness in those that sit for prolonged periods

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The thoracic spine, found between your neck and your low back, contributes around 33% of functional neck movement. Understanding the role the thoracic spine plays in neck pain can better guide our interventions.


Chances are of you sit for longer than 7 hours a day and exercise for less than 2.5 hours in the week that you'' have some restriction and stiffness in your mid back. This study in the UK found a correlation between a lack of thoracic mobility or range of motion (stiffness), sitting for > 7 hours and exercising for less than 2.5 hours in the week. This can then lead to the development of neck pain and neck-related headaches.

Thoracic stiffness is a significant feature of neck pain

Studies on normal individuals have noted that neck movement is dependent on thoracic posture and mobility. Nevertheless, only a few studies have investigated the impairment of thoracic mobility in neck pain individuals. Studies such as this one, this one and this one reported that reduced segmental mobility (restricted range of motion) in the upper thoracic spine could predict the onset of neck and shoulder pain.

Those individuals that sit for longer periods and that are less physically active are more likely to present with back stiffness and this is a significant feature of neck pain.

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Neck and shoulder blade strengthening helps neck pain

Strengthening of muscles will always lead to positive health outcomes and this certainly applies to those with musculoskeletal disorders associated with the workplace, such as back and neck pain. 

  • This study showed that people with chronic neck pain demonstrate a reduced ability to maintain an upright posture when distracted. Following intervention with an exercise program targeted at training the craniocervical flexor muscles, subjects with neck pain demonstrated an improved ability to maintain a neutral neck posture during prolonged sitting.

  • This study stated that positive changes were observed in patients with neck problems because of technology overuse, specifically using the computer, upon prescribing scapular exercises.

  • This study also showed positive benefits to the use of T, Y and I exercise to strengthening the back in the shoulder blade area. , The reported scapular strengthening exercise can be considered a more effective intervention method for patients with forward head posture in neck alignment and change in muscle activity.

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Recommendations from experts for reducing back and neck pain in the workplace:

  • Sit in comfortable postures with low levels of muscle activity around your spine and trunk i.e. don’ t tense your core during sitting.

  • Move often. This means changing postures while in your chair. Don’t be afraid to slouch for a while and relax those muscles if this feels good.

  • Be active in the workplace. Get out of the chair, move from sitting to standing to walking etc. The more movement, the better.

How do we help reduce or manage low back and neck pain associated with the workplace?

At Sydney Muscle & Joint Clinic our physiotherapy-led treatments of back and neck stiffness and pain associated with longer sitting hours is one that is high quality, consistent and one that focuses on symptom modification and then using specific exercises to build capacity to enable you to be more resilient in your workplace. We use the following interventions:

  • Thoracic manipulations and mobilisations to improve mid back mobility

  • Neck mobilisations to improve pain free neck movement and reduce neck pain and headaches

  • Soft tissue massage at the base of the skull to help reduce neck pain related to headaches

  • Thoracic mobility exercises

  • Specific craniocervical flexion strengthening exercises

  • Scapula (shoulder blade) strengthening exercises

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One specific posture doesn’t make sense - a variety of postures makes a whole lot of sense so creating variability of movement is actually more sensible than sitting upright

Sit in comfortable and relaxed positions

Move often, meaning change your position and posture regularly

Be physically active in and outside of the workplace

If you do seek professional help make sure you don't neglect the mid back and use strengthening exercises to help build resilience

Sitting upright does not help

Stretching and foam rolling does not help

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