Correct Sitting and Standing Postures
May 7, 2020|Back Pain, Hip Pain, Neck Pain, Posture
We have addressed different topics in the past few weeks regarding proper posture, but we thought we would be specific in this blog post for correct and incorrect sitting and standing postures. We have had multiple people reach out to us and have performed many telehealth sessions focusing on patients’ work station set ups at home. Poor sitting or standing posture can cause neck, mid back and low back pain, hip pain, headaches, sciatic nerve pain and/or arm/hand numbness or tingling. It is also important to get up frequently, every 20-30 minutes, to help reset posture and get the body moving. There is no one perfect posture. The key is to change up your position. I will be discussing a few different seated and standing postures. I have also provided some exercises to perform seated on the ball. You can access other postural exercises on our video pages located on our website, dynamic-pt.com.
Incorrect Seated Postures
Does this look like you? Legs crossed promoting increased pressue on one hip, causing the pelvis to be asymmetrical and shifting your upper body towards the opposite side. Notice the mouse and keyboard are further away from the body, which causes increased strain to the shoulders (upper trapezius muscle). This posture can lead to sciatica, hip, low back, neck, mid-back, and shoulder pain. This posture could also cause numbness/tingling in the arms and headaches.
This posture is what I would call a slouched posture, notice there is no low back support, the arms are unsupported and stretch out to reach the keyboard and mouse. Mary also has some forward head posture to help compensate for her slouched position in an attempt to get more midline. This can lead to neck and low back pain, headaches, and numbness and tingling in the arms.
Mary is attempting to have good posture sitting at the edge of the chair, but the mouse is too far away, causing her to hike up her right shoulder. This can result in neck and shoulder (upper trapezius) tightness. That tightness can lead to trigger points in her right upper trapeizus and numbness and tingling in her right arm. She will also shift more weight onto her right hip, which may lead to hip tightness, low back pain and sciatica. She is also reaching for her keyboard, which results in a forward lean through her spine, which could cause increased mid-back and neck pain and headaches.
Correct Seated Postures
In this photo, Mary is sitting with a book underneath her feet to allow her hips and knees to be at 90 degrees. This helps to prevent crossing the legs and shifting in the chair to one side, which can cause low back, hip and sciatic pain. The pillow behind her back gives her back upright support, and the pillow under her arms supports her upper extremities, allowing her neck, mid-back and shoulders to relax. The other thing to notice in this image is that both the keyboard and mouse are close to her so she doesn’t have to stretch her arm out to reach them. The last thing to look at are her eyes. Notice how the monitor is set up so she is able to look straight ahead and not down or up. This will help decrease neck pain and headaches. If you have a laptop, think about turning it into a desktop so you are using an external keyboard, mouse and monitor if possible. If not, prop the laptop up a stack of books to make it the correct eye level. If you are using dual monitors, try and have one main monitor or situate them so they are next to each other. If you need to turn to look at the other monitor, turn your body, not your neck, and adjust the keyboard so it is also sitting in front of that monitor. I frequently see people with neck issues that use dual monitors. Turning your head just a couple degrees frequently throughout the day can cause cervical muscle imbalances and joint stiffness on one side.
This photo is very similar to the last photo with the only variation of a pillow under each arm. This can be helpful if you have a chair without armrests, in which case, you may need to use a couple pillows. The goal of the pillows is to keep the shoulders relaxed, the elbows at 90 degrees, and allow you to comfortably reach the keyboard and mouse without having to strain your shoulders and neck.
In this image, Mary is sitting on the edge of the chair, which helps to promote core, scapular and cervical strength. In this position it is very difficult to cross your legs, shift to one side or put your head in the forward head position. It also helps your shoulders to remain relaxed and makes it more difficult to reach forward for your keyboard or mouse. Depending on how long your legs are, you may still require a book under your feet to maintain the 90 degree hip and knee position. This position is also harder to sustain for prolonged periods of time due to the increased muscle enagement.
If you happen to have an exercise ball at home, preferred size being 65 cm, this can be another great option to mix into your various sitting postures. Just like the other seated postures, this one should be used intermittently and not all the time. You are unsupported on the ball, which is great for core, midback and neck engagement, but it also means that you will fatigue more quickly than supported sitting. It is very difficult to slouch on the ball, and just like the other postures, you want the keyboard and mouse close to the edge of the desk. I am also adding a few videos of some exercises that you could perform at your desk while sitting on the ball. The exercises are helpful for low back mobility and core stability. Plus, they add some fun and variety while you are sitting at your desk.
Incorrect Standing Posture
In this standing posture, Mary is shifting to her left side, which causes her pelvis to be asymmetrical and tightens up the structures of her left outer leg, including her IT band. This position also causes her to lock her left knee, which can cause knee and hip problems. This posture also affects the upper body as it has to compensate to accomodate the positioning of the lower body.
This posture may look correct to you, but take a look at Mary’s knees and notice how they are locked putting all the weight into her heels and forcing her pelvis forward. This postion can lead to low back pain and muscle tightness. The core and gluteal muscles don’t have to do much of anything in this position so structures like the low back, hamstrings and calf musculature tighten up to keep her upright.
Correct Standing Posture
In this photo, Mary’s knees are soft so her weight is in her midfoot and not her heels. This position promotes her shoulders stacked over her ribs, her ribs stacked over her hips, her hips over her knees and her knees over her ankles. Her abdominal and gluteal muscles are engaged so her low back, hamstring and calf muscles don’t have to tighten up to keep her upright. This position also promotes her shoulders to be relaxed and keeps her head in the correct position. I tend to cue patients to squeeze their gluteal muscles. If it is easy to enage them, you are probably in the correct position. If you have difficulty engaging them and have to change your body position to get them to engage, you are probably in an incorrect posture.
If you start feeling fatigued with standing adding a book to take some weight off one leg can help prolong your standing time. This is the same posture as the one that I just discussed, except Mary is propping one leg up on a book to give some weight-bearing relief. This posture would be in lieu of the first incorrect standing posture of shifting to one side. By using a book, Mary’s pelvis is able to maintain a symmetrical position so she is not compensating with her upper body.
Questions or comments about the sitting and standing postures discussed in this blog or looking to have your posture evaluated? Please reach out to Meredith@dynamic-pt.com or Mary@dynamic-pt.com or call us at 312-643-1555.
