Ive said it before and I will say it again…….The problem with mis-leading information

I totally understand this and can see why they feel this way.  Society is swamped with information about posture and how we should sit and lift things. Whilst I am not saying that there is NEVER a time for this advice, I am confident in saying that it only applies to about 1-2% of the population.  This is a bold statement I know but it is the truth unfortunately.

Where do I get this belief from you may ask? Well from reading multiple research papers I have started to see a trend in how back pain develops and how it is best managed.  It is this level of in depth studying that I believe enables me to fully justify my reasoning and would welcome the opportunity for others to challenge this belief and conduct a healthy debate :).

I want to begin by sharing a paper below by P. Kent, R. Laird, T. Haines, 2015, which looked at two groups of patients all with back pain and applied two different approaches.

In this study they categorised groups into three areas to determine their intervention.  Group 1 were based on those who have extreme end of range positions such as excessive slumping into full spinal flexion, Group 2 who showed weak muscular endurance after completing repetitive movements, such as multiple lifting within work and then Group 3 who were categorised for having over active muscular at the back usually created through fear of movement.

Each group then had a specific and individualised programme set for them which looked at different ways of moving and were compared to the control group who had standard care and advice (which incidentally is usually generic).  The outcomes were not surprising in the sense that those who were part of the individualised care programme made around x2.6 (times) better progress at 3 months and x3.3 (times) better progress at 12 month follow up compared to the standard care group.

What this shows is that generic advice such as ‘sit up straight’ is not the solution in every lower back pain case.  I have in fact seen the complete opposite where the advice was ‘allow yourself to slump a little more to reduce your pain’ and the results were remarkable.  The patient at the time had just purchased a new core gym ball 6 months ago and started to sit on it every day to ‘straighten her back’ and in the process had created a huge amount of tension in her back area due to the new ‘mechanical load’ she was placing on it daily.  I often compare things like this to running a marathon – if you decide to run 26 miles from day one of your training then you are going to have a problem at some point very soon as tissue capacity will be exceeded, however, most of us can run smaller distances comfortably and it not cause issues in our knees of hips.

On this same topic, all of us can run varying distances when we run.  If we all followed the same training programme then some of us would do well and others would not (the likelihood is that more would do worse than good due to the lack of specificity).  So how can we possibly say then that there is one ‘perfect’ posture when there is nothing else in the human world which says there is one thing that we should all do every day (not scientifically or evidence based anyway!).

The best advice I can give on this topic of posture and back pain is that our spines were designed to move.  They were not designed to stay in one position at all times, and that includes that of being straight.  Motion is lotion is a great saying and could not be more true of the spine and posture.