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Correct sitting posture – it’s all about balance


A debate has arisen lately between physios. Should we advise our patients, who suffer from back or neck pain, to sit with a straight back or NOT? Until lately, there was a common belief that sitting with a straight back was the proper way. Indeed, sitting up straight is the most efficient way for the spine to sustain the small, but continuous load of the sitting position.

However, lately there is a notion that this advise creates more problems than it actually solves. It is believed that limiting our patients or preventing them from sitting and moving freely, creates musculoskeletal dysfunctions. Tryly, some of our clients who have received the incomplete information that bending their back will cause damage, tend to adopt a hyper-protective behavior that creates even more pain and dysfunction.
Thoughts Become Things card with beach background

Holding a rigid back posture and avoid bending, usually leads the spine to lose its inherent elasticity, and therefore its capacity to absorb and release load is limited. Movements become monotonous, almost “robotic” and gradually even the slightest vibration or perturbation causes pain. Additionally, fear avoidance increases the sensitivity of the Nervous System.




We must be aware that the pain perception is not solely related to the degree of physical trauma or dysfunction, but also to the meaning and importance that carries to the brain. Thus, if the brain perceives a threat in a particular area of the body, for example the neck or the back, it can increase the sensitivity to pain, in order to self-protect. Practically, the nervous system, as a control unit, magnifies the perception of pain to minimise the risk for further dammage.





So the problem with keeping a straight back, is not in the mechanics, but to the qualitive features behind it. How can we combine the 2 views and what are the recommendations we should give to our patients?

  1. The problem with the sitting position is mostly lying on how long we stay in it. Even if we sit with a straight back, we must stand up regularly and walk or do some simple stretches to boost the blood circulation and relieve the muscles (for more information press here).
  2. The alignment of the body during sitting or movement is important. You should avoid monotonous, assymetrical positions, such as
  • crossing legs
  • leaning on the armchair and especially always at the same side
  • slouch and leave your waist unsupported
  • not keeping the ergonomic sitting posture doesn’t mean you are going to have a problem; however these poor postures put more strain on the joints, and create malalignment when you stand up and move, predisposing you to tissue trauma.



3. Nowadays, children spend a lot of time in front of screens. Telling them off and constantly nagging about their sitting posture is not effective. Encourage them to adopt a a more active lifestyle and motivate them to   participate in sports activities of their preference. Physical activity balances the negative effects of the sitting lifestyle, and the conditioned muscles help them sit up straight, without so much effort.






Alex Karagiannidis, MSc., Dip.MDT., BSc(Hons) Physiotherapy