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. Below are a few different seated and standing postures. There are also some different exercises to target postural muscles. Subscribe to our YouTube Channel, Dynamic Physical Therapy Chicago, and Follow us on Instagram for more exercise videos for posture.
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.
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.
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.
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.
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Please reach us at info@dynamic-pt.com for questions about posture or the below exercises.
The first set of exercises are for strengthening the scapular and core muscles. These muscles help keep you upright. The stronger these muscles are the longer and less fatigued you will be maintaining proper posture.
The second set of exercises starting with the door pec stretch help decrease the tightness in the neck, shoulders and pectoral muscles, which can become tight when working at a computer. We recommend working on the stretches throughout the work day to maintain flexibility.
Keeping your scapular and core muscles strong, and your neck and chest muscles flexible can reduce the amount of pain and tightness with sitting and standing for prolonged periods of times. These exercises should be performed daily for optimal results. Please reach out to us at info@dynamic-pt.com or call us at 312-643-1555 with any questions.
1. Anchor the resistance band in the middle (so both ends hang down) at about stomach height
2. Begin in a standing upright position, holding a resistance band handle in each hand, palms facing inward
3. Pull your arms back against the resistance band by squeezing your shoulder blades together and bending at your elbows, then return to the starting position
4. Make sure to keep your back straight by engaging your core muscles and do not shrug or hike your shoulders up
5. 2-3 Sets of 10
1. Anchor the resistance band overhead
2. Begin in a standing position holding the handles on both ends of the resistance band anchored in front of you
3. Keeping your elbows straight, pull your hands down toward your hips. You should feel your shoulder blades go down (as if you are tucking them into your back pockets). Slowly return to the start and repeat.
4. Make sure to maintain good posture during the exercise and do not shrug or hike your shoulders up
5. 2-3 Sets of 10
1. Anchor one end of the resistance band overhead.
2. Position yourself so that you are in a half-kneeling position to the side of the resistance band. The leg closest to the band should be kneeling or down; the other leg is in the ‘forward position’. Hold the end of the resistance band with both hands
3. Slowly pull the band down and across your body in a diagonal ‘chopping’ motion, using core & gluteal muscles to stabilize, then return to starting position and repeat.
5. 2-3 sets of 10
1. Anchor one end of the resistance band near the floor
2. Position yourself so that you are in a half-kneeling position to the side of the resistance band. The leg closest to the band should be kneeling or down; the other leg is in the ‘forward position’. Hold the end of the resistance band with both hands
3. Pull your arms diagonally up to your other side in a lifting motion, using core and gluteal muscles to stabilize, slowly return to the starting position and repeat.
5. 2-3 sets of 10
1. Lay face down with a towel roll under the forehead
2. Slowly raise your arms up along side you, palm up, by engaging your shoulder blades to lift the arms.
3. Keep your shoulders down and do not engage the upper trapezius or neck muscles.
4. 2-3 sets of 10
1. Begin in a standing upright position in the center of a doorway.
2. With your elbows bent, place your forearms on the sides of the doorway at a 90 degree angle from your sides, then take a small step forward until your feel a stretch in the front of your shoulders.
3. Hold this position for 30 seconds, 3 sets.
1. Begin sitting upright in a chair, grasping the edge with one hand.
2. Rotate your head to the side opposite your anchored arm, then tuck your chin towards your chest. With your free hand, grasp the back of your head and gently pull it downward until you feel a stretch and hold.
3. Hold this position for 30 seconds, 3 sets
1. Begin sitting in an upright position.
2. Use one hand to tilt your head sideways, pulling your ear toward one shoulder until you feel a stretch in the opposite side of your neck, and hold.
3. Hold this position for 30 seconds, 3 sets