The global “posture correction” market is a multi-billion-dollar industry ranging from ergonomic chairs and desks, to workshops for manual labourers on best posture for lifting, to devices like Upright™ which attach to the wearer’s lumbar spine and vibrate when their back starts to curve! This has also crept into the yoga sphere in a big way. How many times have you heard “This pose improves your posture” in a yoga class?
There is such a widespread belief in the concepts of “good” and “bad” posture that we can easily assume that there is a strong evidence basis for these. *Spoiler alert – there really isn’t!*
The idea of “good” posture is merely a social construct and its history is explored in detail in this article by Tom Jesson. The historian Gillman (2014) reported that the order to stand up straight has its roots in the development of the military drill formation in the sixteenth century and by the end of the eighteenth century this posture had taken on a broader meaning as the way to mould a man into a soldier. Posture became a way to transform a person into someone different, and a way to enforce discipline. The concept of good posture began to be taught to the wealthy and fashionable in London and by the nineteenth century, posture became closely associated with notions of health and illness. The middle classes in particular spent their money on self-care books, which sold in their millions, teaching them how to stand up straight. By the end of the 1800s, posture, having broken out of the military into civilian life, had become infused with meaning about not only discipline, but also health and illness, and morality and decay. It had also become medicalised. Still to this day, this concept is tightly engrained in our culture.
Does Poor Posture Cause Back Pain?
However, systematic reviews (considered the “gold standard”) by Driessen et al (2010) and Clemes, Haslam and Haslam (2010) have found ergonomic interventions for workers, and advice for manual workers on the best posture for lifting, respectively, have not reduced work-related back pain.
If you have no choice but to sit or stand all day, then stacking your joints will certainly help you to conserve muscular energy, but we also have to recognize that being in one fixed position for prolonged periods is not good for our body. Li et al (2022) reported that high amounts of sitting time were associated with increased risk of all-cause mortality and cardiovascular disease (CVD). A systematic review and meta-analysis by Bailey et al (2019) reported that higher levels of total daily sitting time are associated with an increased risk of CVD and diabetes, independent of physical activity. They suggested that reductions in total daily sitting may be recommended in public health guidelines.
No single sitting or standing posture protects a person from back pain. People with both slumped and upright postures can experience back pain. Rather than how we sit or stand being the problem, I believe that it is the fact that as long as we are sitting, we are not moving our bodies.
I’m not trying to suggest that our posture has no impact on how we feel or that we should suddenly adopt a completely carefree attitude towards it, but it might be time to move away from the idea of an ideal posture and invest our time and energy on moving our bodies more throughout each day.
Join one of my upcoming live workshops:
References:
Bailey, D., Hewson, D., Champion, R., and Sayegh, S. (2019) ‘Sitting Time and Risk of Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.’ American Journal of Preventive Medicine 57(3): 408-416.
Clemes, S., Haslam, C., and Haslam, R. 2010. “What constitutes effective manual handling training? A systematic review.” Occupational medicine 60(2): 101–107.
Driessen, M., Proper, K.., van Tulder, M., Anema, J., Bongers, P., and van der Beek, A. 2010. “The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review.” Occupational and environmental medicine 67(4): 277–285.
Gilman, S. 2014. “Stand Up Straight: Notes Toward a History of Posture.” J Med Humanities 35: 57–83.
Li, S., Lear, S., Rangarajan, S., et al. (2022) ‘Association of Sitting Time With Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries.’ JAMA Cardiol 7(8): 796–807.