Top 3 posture types leading to back pain

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 is good posture, we need to identify the bad.

3 most common poor postures types in Singapore

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

1. Arched-back
2. Flat-back
3. Swayed-back

1) 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 the Arched-Back Posture 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.

Do

• 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.

Physiotherapy treatment for Arched Back Posture

The physiotherapist first treats 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.

2) Flat-back Posture

The Flatback Posture, also known as the C-shape, slump, or slouch posture, is characterized by a rounded spine without a natural curve. This posture can lead to back pain because it puts continuous strain on the spinal structures, causing stretching and discomfort. People who are tall, tend to slouch while working, or have weak lower back muscles are more prone to this posture. Activities that further round the back, such as rowing, cycling, squatting, or sitting on the floor, can aggravate the pain. On the other hand, activities that encourage arching and extension, like yoga, Superman exercises, walking, or swimming breaststroke, can help alleviate the discomfort. Strengthening the back and buttock muscles through specific exercises can also be beneficial in improving posture and reducing pain associated with the Flatback Posture.

3) Swayback Posture

The Sway Back Posture, commonly referred to as the Lazy Posture or the cerebral posture, is characterized by a forward pelvis, a backward-hanging thorax, and a protruding head. This posture is called “lazy” because individuals adopting it tend to switch off their muscles, including the buttock, abdominal, and leg muscles.

The lower back pain associated with this posture is caused by the spine relying heavily on the lower back structures for support. Activities that compress the spine, such as certain yoga positions, swimming breaststroke, running, and standing or walking for extended periods, can worsen the pain. Additionally, activities that involve looking down, like using smartphones or reading with the head hanging forward, can exacerbate neck pain.

Correcting the posture involves bringing the pelvis back over the ankle and extending the thorax upward. Strengthening the buttock and quadriceps muscles through specific exercises can help improve muscle activation and reduce pain associated with the Lazy Posture.

Another Posture Type That Could be Causing you Pain – The S-back Posture

Apart from the 3 previously mentioned poor posture types, there is another posture that is becoming increasingly common in Singapore.

S-Back Posture

The Lordotic posture, also known as the S-shaped posture, is characterized by a pronounced arch in the lower back. This posture can lead to lower back pain due to increased compression in the back. Factors that contribute to this posture include pregnancy, weak abdominal muscles, and poor muscle control. Activities that further increase arching, such as certain swimming strokes, standing or walking for prolonged periods, and performing yoga’s cobra position, can aggravate the pain. To alleviate the discomfort, exercises targeting the Lordotic posture can be beneficial. These include the Child’s Pose, which stretches and opens up the lower back, and the backward pelvic rock, which strengthens the abdominal muscles and retrains muscle activation. Additionally, stretching the hip flexors through a half-kneeling position can help counter the forward tilt of the pelvis. By incorporating these exercises, individuals with a Lordotic posture can work towards improving their posture and reducing associated pain.

Experiencing back pain? Click here to find out more about physiotherapy for back pain relief and how Core Concepts can help you resolve pain.

References

1. May S, Lomas D. 2010. Posture, the lumbar spine and back pain. In: JH Stone, M Blouin, editors. International Encyclopedia of Rehabilitation. 
2. 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. 
3. Tüzün, C., Yorulmaz, I., Cindaş, A., & Vatan, S. (1999). Low back pain and posture. Clinical rheumatology, 18(4), 308-312. 
4. 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.
5. Widhe, T. (2001). Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence. European Spine Journal, 10(2), 118-123.