Top 3 posture types leading to back pain by Physiotherapist Sylvia Ho

You’ve tried pilates and yoga, ergonomic back supports, and back braces, but your chronic back pain persists. So what is the true cause of that nagging pain in your lower back? The answer is: posture.

While there are numerous remedies for back pain, they are not one-size-fits-all. Learn first to identify your posture and its stress points in order to find the right solution, instead of potentially worsening your condition with the wrong one.

Understanding posture

Posture is how your body is positioned while you’re sitting or standing. The concept seems simple, but a neutral posture doesn’t come naturally to most of us, and thus requires deeper understanding. But in order to know what’s good, we need to identify the bad.

There are three “faulty” postures commonly seen in the modern setting. They are:

Here, we’ll be exploring the first posture – the arched back.

Arched back posture

Scientifically known as the kyphotic-lordotic posture, it is often mistaken for the ideal posture as a result of erroneous media representation: numerous ads depict models posing in this posture, which features an upright back.

Why does it happen?

It is identified by an arched spine, a facedown pelvis, and pushed-back chest, and has two main causes: a weak abdomen, and forward centre of gravity. A weak rectus abdominus, specifically in the lower region, draws the pelvis down and rolls the belly forward, thus facilitating the arched back. This is then compensated by pushing back the chest, further compressing the lower back muscles and resulting in lower back pain.

Who has this posture?

Pregnant women and those with a large belly that weighs them down; thinner people with a weak lower rectus abdominus are susceptible too.

What makes it worse?

Stress points that aggravate the arched back posture can include extended walking and standing, running, and lying flat on a hard bed.

Don’t

Sit on the edge of your chair with an upright back.
Swim breaststroke, and practise yoga poses like Cobra, Upward Facing Dog, and Superman.
Use back support accessories with an arched shape.

Sit deep in your chair, with your back fully on the backrest. Your lower back “switches off” as there’s no pressure on it.
Squat, cycle, and practise yoga poses like Cat Stretch and knees-to-chest to open up the lower back.
Reverse crunches. They’re double duty, strengthening weak abs, and rounding the back.

Further treatment

Physiotherapists first treat an arched back with special exercises for the tightened back and hip flexors. A stiff pelvis, which is like a door hinge, will also need loosening.

The next step is motor control: here, physiotherapists train you to adopt the neutral posture. Because it would be completely foreign to you, physio will help retrain your brain to communicate with your nerves and muscles to practise lumbo pelvic dissociation: separating the lumbar from the pelvis. Think of it as developing a new muscle memory: getting your muscles acquainted to an entirely new way of walking, standing, and sitting with this new posture – and ultimately, helping you straighten out your back pain issues.

References

_{May S, Lomas D. 2010. Posture, the lumbar spine and back pain. In: JH Stone, M Blouin, editors. International Encyclopedia of Rehabilitation.}
_{O’Sullivan PB, Mitchell T, Bulich P, Waller R, Holte J (2006) The relationship between posture and back}
_{muscle endurance in industrial workers with flexion-related low back pain.}
_{Tüzün, C., Yorulmaz, I., Cindaş, A., & Vatan, S. (1999). Low back pain and posture. Clinical rheumatology, 18(4), 308-312.}
_{Malik, A. N., Rasul, H. N. u. & Siddiqi, F. A. (2013) Cross sectional survey of prevalence of low back pain in forward bend sitting posture. Rawal Medical Journal, 38 (3), 253-255.}
_{Widhe, T. (2001). Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence. European Spine Journal, 10(2), 118-123.}