The Best Thing You Can Do With Your Posture For Back Pain Relief
You may be familiar with the thought or belief that you have either “good” or “bad” posture. If you have “bad” posture, you will have back pain. If you have “good” posture, then you are well-mannered and shouldn’t have pain. Does posture for back pain relief really matter as much as we have historically been taught? 
Spoiler alert: the BEST thing you can do with your posture for your back pain relief IS NOT to always have “good” posture.
Physical therapists have been preaching posture for back pain relief far too long. If you would like to learn a little about the history of the concept of posture, check out this article here. 
Posture has gotten a lot of attention over the past few decades, especially in the relationship of posture to pain problems or injury. It used to be taught that posture can cause injury or a problem. However, the research has shown that’s not the case. We can’t seem to find a direct causal relationship of posture and an injury/pain problem.
We can confidently say that posture has not been found to cause pain, but we can also say that IF pain is present, it may influence someone’s pain or injury.

Let’s Ditch The “Good” or “Bad” Posture Labels

I think my point is that we can all relax a little about posture. Yes, I do think the posture we default towards may impact one’s pain experience, but we can also quit labeling posture as “good” or posture as “bad.”
This is extremely important with people who experience persistent pain. When they hear a lot of negative language around their habits, body, etc., they take on the weight of “something is wrong with me” or “I’m damaged.” The person with persistent pain may then AVOID movements because it is bad and take on the belief that their body is fragile…the fear avoidance behaviors start.

We Need Posture Options, Not Perfect Posture

Posture is dynamic. It’s not good or bad. We all should have many options for our posture. 
Your body is resilient, not fragile. So you can assume the posture you like and it won’t “break your back.” I say that while also holding the truth that you should move in and out of postures frequently to give your body a movement break. If we maintain any posture for a really long time, we may find areas tight, stiff, sore, lax, etc. In a nutshell, we all need a lot of “posture options.”
For example, the person with a spinal cord injury with a loss of movement and sensation below a certain level does not have the “posture options” that I do. I can move as much as I want when I sit to get comfortable. The person with paralysis may have to use their wheelchair to tilt and recline and offload tissues that need a break. If they don’t, they may have tissue breakdown. They need options, too, for their skin and joint health.

The Purpose Of Posture

Posture serves a purpose. Your posture can set you up for functional success. Your posture DOES matter when it comes to creating an environment for you to perform your best. If I am completely slumped forward and do repeated overhead movements, this does not set up my shoulder joint for success. 
The three natural curves of the spine were designed to help absorb shock, allow for ease of movement, and distribute forces evenly throughout the spinal column. Dr. M. Panjabi (an international researcher in spine biomechanics) defines “neutral spine” as [t]he posture of the spine in which the overall internal stresses in the spinal column and the muscular effort to hold the posture are minimal.”
He says that “when we maintain postures that are “out of alignment” for an extended period of time, other structures have to kick in that otherwise should be “quiet.” These tissues can become unduly stretched or unduly shortened,” which may play a role in one’s experience of pain or injury but it cannot be said that it causes the problem.
Posture definitely matters when helping a post-partum runner hit the trails again. Posture and technique do matter for an Olympic lifter who does the movement over and over and over again. 

Posture And Breath

Time for an experiment. Compare your breathing when you are completely slumped forward in a chair, versus standing up. 
Do you breathe better slumped forward or standing (or sitting) upright? 
We breathe more efficiently when our ribcage is positioned over our pelvis and our diaphragm can descend and allow for more oxygen intake. We breathe around 22,000 times per day, so why not make this as efficient as possible? 

Posture And Beliefs

Posture affects how you feel. Our thoughts, beliefs, and sensory (bodily) experiences are all processed in our brain. Your posture DOES matter when it comes to how you feel about yourself. In my training as a trauma-informed yoga therapist, this concept is huge.
Imagine you are in front of a huge crowd giving a presentation. You are nervous and sweating bullets, but you really want to do this well. You decide to stand tall, present yourself as confident, and look people in the eye when you talk.
Do you think this would have any effect on how you do in your presentation? What if you assumed a slumped over position, only looking down at your notes and talking quietly? I am a firm believer that your posture affects how you feel, and how you feel can affect your posture. Just a fun thought.

What’s The Best Thing You Can Do With Your Posture For Back Pain Relief?

Give yourself a break–no need to label yourself as someone with bad posture or good posture. JUST MOVE, AND MOVE OFTEN–this is the most important thing. Your body needs movement, space, and blood flow. Your tissues need to be stressed and loaded IN A VARIETY OF WAYS. 
Assume different postures, become curious about the relationship you have with a certain posture. What posture would set you up for functional success at your desk, or running, or lifting overhead?
I do not think that most of us will have “ideal alignment” all of the time. What I think is important is aiming for balance and to keep moving. Use your yoga practice or movement routine to target lengthening and/or strengthening the tissues that need it.
Your posture does matter, but what matters most is that you keep moving and keep moving often in a way that brings you joy and relief. So cut yourself some slack.
Emily Warren

Dr. Emily Warren

Hi! I am Emily. I am a Doctor of Physical Therapy and integrative spine care specialist. I am a runner, gardener, wanna-be bread baker, wife, and mom of 2 cute humans and 1 furry pup. I understand the joy that comes from living an active life, and want to provide resources for you to beat back pain so you can live your best life.