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Health & Exercise Forum

POSTURE: Part 1 of 3 of ACTIVITIES OF LIVING WITH LOWER BACK PAIN

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Mar 8, 2009

Dr. Paul MackareyGuest Columnist: Janet M. Caputo, PT, OCS

Research suggests that many spine problems can be prevented with good posture and proper body mechanics. Poor posture and improper body mechanics subject the spine to abnormal stresses that, over time, can lead to degeneration and pain. Good posture and proper body mechanics can minimize current spine pain and prevent recurrent episodes. The next three columns, written by my friend and associate, Janet Caputo, OCS, will be dedicated to the topic of proper body mechanics, good posture and ergonomics in the workplace and other daily activities

Posture is the position in which you hold your body upright against gravity. Good posture involves positions that place the least amount of stress on the spine. Good posture maintains the spine in a “neutral” position. In a neutral spine, the three normal curves are preserved (a small hollow at the base of the neck, a small roundness at the midback and a small hollow in the low back). When viewed from the side, the upper back appears straight with a small hollow in the lower back.

Good posture

  • Standing: Feet should be shoulder width apart. Distribute body weight evenly through feet. Do not lock knees. Maintain a small hollow in lower back with  “tailbone” slightly tucked down. Lift the breastbone by drawing shoulder blades back and down. Make chin level. Earlobes should be in line with the middle of shoulders. Relax jaw and neck muscles by resting tongue on the roof of mouth.
  • Sitting: Sit in a firm, high-back, straight-back chair. Buttocks should touch the back of chair while maintaining a small space between the back of knees and the seat of the chair. Distribute body weight evenly on both hips. Maintain an arch in the low back. A lumbar roll is recommended. It is a foam roll, 4” to 5” in diameter and 12” long, placed at belt level. Place feet flat on the floor with hips and knees bent at a right angle. Keep knees even with or slightly higher than hips. Use a footstool or footrest if necessary. Do not cross legs! Lift the breastbone by drawing shoulder blades back and down. Earlobes should be in line with the middle of shoulders. Position the armrests properly allowing elbows and forearms to rest with shoulders relaxed. If armrests are too high shoulders will shrug up and if too low will cause slouching.
  • Sleeping: Sleep on a firm (not hard) mattress. Lying on back with a pillow under knees or lying on side with a pillow between knees encourages the neutral spine position. Avoid sleeping on stomach on a sagging mattress. A cervical sleeping roll (a foam roll 3” in diameter and 18” long placed inside the pillow case along the lower border of a pillow) placed between the base of head and shoulders can help support the neck. A lumbar sleeping roll, 3” to 4” in diameter, tied around the waist at belt level can help support the lower back. These sleeping rolls, which can be purchased or can be made from a rolled up sheet or towel, helps maintain a neutral spine while lying on the back or on the side. Down or synthetic down pillows are recommended. The pillow allows your head to be aligned with the rest of the body. If the pillow is too thick, the head will be higher than the rest of the body. If the pillow is too thin, the head will be lower than the rest of the body.

Following these simple guidelines will assist in preventing or diminishing pain that originates from your spine. You can put good posture into action with next week’s article: “Good Body Mechanics”!