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Posture and pain

Local osteopath Alison Durant sent us an article about posture and pain... we've all been there (ouch!!) . Read on for some tips on how to avoid them.

As food for thought, I would like you to consider the fact that the head alone weighs between ten and eleven pounds (4.5-5.0kg). As soon as our head moves ahead of its balanced position, directly over our centre of gravity – somewhere between our belly button and our spine – as it does when we slouch, the muscles of the back, neck and shoulders have to work overtime to support it. Next time you’re slouching, think about the position of that ten pound weight, and the effect it is having on your back, neck and shoulders.

Tips for avoiding posture-related pain:

Use your abdominal muscles. You may work out regularly and have good abdominal tone. But this is of little help unless you use those muscles to support your posture throughout the day. The majority of my patients are confused about what constitutes good posture, and believe that changing their posture would be a very difficult thing to do – this is a myth! It’s actually easy when you know what to do; then you simply have to keep doing it until it becomes second nature – as second nature as it is for most people to slouch. The single most important factor, that will put the majority of people in a near optimal posture, is to engage (use) your abdominal muscles. What does that mean in practice? It means pulling your belly button in toward your spine, as if zipping yourself into tight jeans, and lifting up through the spine as if someone is pulling upwards on a piece of string attached to the top of your head. Notice how as you do so, your shoulders move back into their correct position, and your head moves back over your body. As a bonus, you should also grow an inch taller. The next question patients ask me is: “do I have to do this all the time?” to which the answer is “yes”. When sitting, standing or walking, you would do well to engage the abdominal muscles in this way. I do it all the time. Do I do it consciously? – No. In the majority of cases, where patients apply themselves to doing this, it should only take two weeks for the necessary neural channels to be forged between your brain and abdominal muscles so that using them becomes second nature.

Maintain a lumbar curve in your back. We all differ in the shape of our spines, but we all have a lumbar curve or lordosis; this is what we describe as the small of our back. It should appear when you pull your abdominals in – and it should be there! Many patients believe that they should flatten this curve by tucking their pelvis underneath them. I’m not quite sure where this idea comes from, though it seems to be taught in yoga classes. Some people have an exaggerated lordosis – but that will usually be normal for them.

Make sure you have an office chair if you’re working at a computer or desk. You can buy a decent chair for the cost of the treatment you’ll need after sitting on a chair with poor support. There are a wide variety of office chairs on the market, and it is difficult to know what one needs. It seems obvious, but I would suggest that you try a chair out before buying it. Most office chairs are on wheels to enable you to manoeuvre them easily, and tuck in close to your desk. Apart from that, the seat needs to be adjustable up and down, and the back of the chair adjustable both vertically and horizontally. If the chair has arms, then they need to be adjustable, so that you can pull yourself close in to your desk; you can then pin yourself between the back of the chair and the desk (alternatively you could choose a chair without arms).

Buy a lumbar support. These are great if a new office chair isn’t an option, and quite frankly, are great even if you do have a good office chair. A lumbar support consists of a cushion, ideally made of memory foam, which attaches to the back of your chair. When you sit back against it, it gives the spine support holding you in an upright position. Lumbar supports come in a variety of shapes and sizes. Some are cylindrical or a semi- cylinder. My preferred lumbar supports are shaped more like the back of an office chair, and will wrap around you ever so slightly. A good chair will not necessarily make you sit correctly – a lumbar support tends to force you to.

Plug in a keyboard if working mostly on a laptop. It is impossible to assume a good posture when working on a laptop. When sitting at a desktop computer (upright – abdominal muscles pulled in etc) the top of the screen of the computer should be at eyelevel. This is of course impossible when working on a laptop because the screen is connected to the keyboard. The way around this is to plug in a separate keyboard, and then raise the laptop up so that the top of the screen is at eyelevel. You can buy a special device to clip the laptop into, or you could just use a couple of box files.

Take regular breaks from prolonged sitting. Even if you have a perfect sitting posture it is not good for your back to sit for long periods of time. Humans are not well adapted for sitting, and yet it is what many of us spend most of our day doing. Try to take a break from sitting every fifteen to twenty minutes; at the very minimum stand up and move your hips around a little before sitting down again.

Breathe! And make that from your abdomen or diaphragm. Most of our shoulder, neck and back muscles have a secondary role in moving our ribs in order that we breathe, but the primary muscle of inspiration is the diaphragm - the huge dome shaped muscle beneath your lungs. The diaphragm does not need much assistance from the secondary muscles in the neck and shoulders, provided that we make use of it. Breathing shallowly – which we tend to do when under stress – overworks the muscles of the neck, shoulders and upper back causing them to fatigue and become painful. When we breathe from the diaphragm or abdomen, our bellies rise and fall with the breath. Incidentally, a slouched posture compresses the ribs together, making the diaphragm less efficient, and demanding the use of the muscles in our necks, upper backs and shoulders to assist with breathing. Sitting upright should allow you to breathe more easily: your blood will be better oxygenated with less muscular effort, and you should therefore feel more energised and awake!

Osteopathy. Can osteopathy help with posture? Well, as I stated above, only you can correct your posture, osteopathic treatment can’t do it for you. What osteopathic treatment can do is enable the adoption of a better posture. Years of sitting and standing in a poor position will mean that certain muscles and ligaments will have shortened considerably. At worst short muscles and ligaments hold you in a poor posture, at best; they prevent you from assuming a good posture. Osteopathic treatment will identify the joints, muscles and ligaments that need freeing up and stretching in order to help your body adapt to a new posture. Other muscles will be weak from not having been utilised and will need strengthening (that’s where pilates is useful – see below).

Join a pilates class. Pilates works on improving both core strength – i.e. strengthening the deep muscles that support the spine, including abdominal muscles – and flexibility. It works on the body at a very deep level and will develop the strength and engagement of the muscles that hold us in an upright position.


I strongly believe that posture has a large part to play in the development of problems in the back, neck, and shoulders. The text above offers simple and achievable tips for avoiding what I call “postural fatigue” of muscles and ligaments. If you would like to know more about how sitting and standing incorrectly give rise to strain and subsequent pain in joints, muscles, and ligaments, you can consult my article “why pain arises”, which you will find in the “about osteopathy” section of the website (www.alisondurant.co.uk). 

If you have any further questions about posture and pain, or a particular problem that you are suffering with, then please send me an email at the address below, and I will give you my thoughts on it.

Kind regards,

Alison Durant email: This email address is being protected from spambots. You need JavaScript enabled to view it. tel: 020 8968 7477


Alison qualified with a BSc(Ost) from the College of Osteopaths in 2001 and has since worked in a variety of osteopathic practices and gyms, before establishing her own osteopathic practice in Kensal Rise, West London. In addition to private practice, Alison teaches osteopathic technique to first and third year undergraduate students at the British School of Osteopathy.

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