Slouch when you sit, it’s good for you!

Yes, you read this title correctly. Yes, a Masters Qualified musculoskeletal physiotherapist is telling you its ok to slouch whilst sitting. Whilst many physiotherapists still hold to our traditional thoughts, but are we really giving the right advice? Stay with me for the rest of this piece and I’ll explain why this statement may not be as crazy as some of you are thinking right now.

I don’t know about you, but I always remember my amazing mother hounding me about sitting up straight and keeping my shoulders back. There were days I confess where it felt like I joined the military early. I’ve had countless patients in my clinic saying, “I know I have terrible posture and slouch”. The perception is widespread in many countries, but there is very limited research linking the way we sit with injury.

Let’s give you a quick history lesson so we can learn where this belief may have stemmed from. More than 10 years before Martin Luther King Jr gave his “I have a dream” speech, orthopaedic surgeons were giving definitions for healthy spinal posture. These were based on perceptions of the natural spinal curve and postures where the spinal muscles seemed to be most relaxed. Due to these early perceptions, we today are still giving the same advice. The apple never does fall far from the tree..

What do physiotherapists’ say?

I confess, physiotherapists have traditionally held the view that sitting with a straight back is better than slouching. This is the advice we have been giving our patients for many years. The good news is that as evidence changes, so can our views.

Let’s get to the problem with sitting straight..

The problem with maintaining a neutral posture is that you simply can’t stay sitting straight all your life. The reason why we’re all terrible at sitting straight is because it’s not natural to hold this position all the time. Even with ergonomic supports and chairs with backrests we naturally change the position of our spine. In fact, if we attempted to just sit tall for a long period of time, we would be in jeopardy and could potentially cause injury.

If you think about your body for a second, let me ask you a question. Do you ever hold one position for more than a couple of minutes? (Don’t catch me on a technicality like meditation – I’m talking generally) The reason for this is that your body needs movement. Movement performs more functions than we think. It helps our lymphatic system (the bodies waste disposal system) drain fluid, it helps to supply muscles with oxygen and it prevents shortening of our muscles, just to name a few. We know in running that people who are less stiff will absorb force better and reduce their risk of injury but that’s a topic for another time.

So, is slouching the solution?

I wouldn’t write this blog just to tell you all to maintain another static posture. Whilst it is completely fine to slouch, if we just maintain this position whilst sitting then we are still not moving.

The key to posture, is to change it frequently

The question I propose to you all today is, what if there wasn’t a “perfect” posture. What if the key was to change position regularly. One study looked at people with and without low back pain during standing. They found the one thing separating people with pain from the ones without, was the ones without moved more frequently!

I want to caveat the above by saying that sitting upright is good. Sitting upright for short periods has been shown to activate our spinal stabilising muscles which we know can help prevent injury. The risk is taking that too far and saying you need to sit upright all the time. Considering this, I want to show the readers some tips on changing position.

Here are some tips to help you change position more..

My number one tip to patients is take a rolled towel with you to work. They are great for putting behind your low back, and remember you don’t need it in the same place all the time! Move that towel a little higher and a little lower to change the way your spine is sitting. You can have it at work, in the car or at home on your favourite rocking chair – they are coming back!

Set an alarm on your phone for every 30 minutes to remind you to do some quick postural changes. One exercise that Click Physiotherapy would recommend is some simple pelvic rocks. For these you want to feel your low back move and hold your upper back relatively still. Whilst sitting, rock you pelvic back as far as it will go, so your low back is slumped, then tip your pelvis forwards so it arches your low back. You can help the motor drive to some of your postural muscles through periodically sitting up nice and tall, so this exercise will help keep some tone through those still important muscles that run section by section along your spine. For a video of this exercise please check out Click Physiotherapy’s YouTube channel.

Some final thoughts

To sum this all up.. Sitting slouched may not be as bad as we once thought. What is bad, is any sustained position over a long period of time – including sitting bolt upright, like we were once taught. So vary that back position in sitting and standing and see the difference it makes!

K.M. Gallagher, J.P. Callaghan (2015) Early static standing is associated with prolonged standing induced low back pain. Hum. Mov. Sci., 44 (2015), pp. 111-121

V.Korakakis, K.O’Sullivan, P.Sullivan, et al (2018) Physiotherapist perceptions of optimal sitting and standing posture. Msk Science & Practice v39, pp. 24-31