Posture for a Healthy Back

http://my.clevelandclinic.org/health/ns_overview/hic_Posture_for_a_Healthy_Back

by snake117 • 11 years ago

104 94 11 years ago

my.clevelandclinic.org

luck872• 11 years ago

this should be our computer desk: https://kokyun.files.wordpress.com/2011/10/5531_130311939574...

this is reality (if you are working with laptop or notebook or macbook): http://www.parkavenuespine.com/wp-content/uploads/2013/09/iS...

snake1172• 11 years ago

Very true. I use a MacBook Pro and I recently tried altering my workstation for that very reason. I bought a stand for the Pro, and a bluetooth keyboard and magic mouse. Sometimes I HDMI it to a larger screen and work farther away from the laptop itself. So far, it's been working very well for me and I'm probably going to change my other workstation to accommodate this as well. I don't feel as "slouchy" or tense when I'm done working.

melling3• 11 years ago

How about proper ergonomics for your hands on a keyboard?

https://h4labs.wordpress.com/2015/07/16/the-model-01-an-heir...

Mac keyboards, for example, use scissors switches or rubber dome, which aren't the best for your hands. Apple used to offer a mechanical switch with the Apple II: http://deskthority.net/wiki/Apple_Extended_Keyboard_II

swah• 11 years ago

I work on a desk without trays - the keyboard too high is a big problem for me. And trays (IIRC) aren't very sturdy/mouse friendly. So I'm thinking about having a low table when I move again.

Also, it seems to me that the old rule "top of monitor in the same height as your eyes" is actually a more personal "whatever works for you" thing. See discussion at http://superuser.com/questions/231377/whats-the-correct-moni...

luck872• 11 years ago

Yes, you have right! :-) I always put the monitor over the height of my eyes. To do that, I put an object under the monitore and I set the chair at the minimum height. So the chair is lower and in proportion the desk seems to be higher, and also the keyboard. This generates shoulder problems, too...

amelius• 11 years ago

What about a solution like this: [1]

[1] https://www.youtube.com/watch?v=XKrVByT6pq8&t=14

itsjustjoe• 11 years ago

The Varidesk is a very nice (and relatively cheap) solution. It's also surprisingly easy to adjust the height despite the weight. My only complaint is that you still need to put your monitors on a stand to get them high enough (for me at least).

neovive• 11 years ago

After experiencing wrist and back pain, I found it helpful to rotate my setup between desktop and laptop. At the office, I use a relatively ergonomic desktop setup with a keyboard draw and a 24" monitor at eye-level. If I need to work during the evening, I use a folding wood laptop table in bed (allows adjusting the laptop to proper angle) or I sit on a recliner that keeps my hands and eyes at the proper angle. I try to avoid using a laptop on a standard desk whenever possible.

megal0maniac2• 11 years ago

I work on a docked laptop with 2 screens (3 in total, I keep the laptop open) We all have USB keyboards for if we want to have the laptop closed, but lately I've been typing with both. My left hand on the USB keyboard and my right on the laptop. My hands are a natural distance apart from one another and my shoulders are more relaxed. It means that there's uneven wear on both keyboards, but I'm quite a bit more comfortable.

LesZedCB• 11 years ago

I have wanted an Ergodox* keyboard for a while. They would certainly solve that problem. I think your situation with the different key styles would really bother me, however.

* http://ergodox.org/

melling3• 11 years ago

It also has has mechanical switches and not cheap rubber domes:

http://superuser.com/a/366797

megal0maniac2• 11 years ago

They are different, but similar enough not to be annoying. The feel is different, but the curve is the same and so is the actuating force, so all in all not too bad. Both Dell keyboards. You could just as easily do this with 2 USB keyboards, it's the poor man's solution :)

mrpoptart• 11 years ago

There's some conflicting data out there about this: http://www.npr.org/sections/goatsandsoda/2015/06/08/41231470...

eevilspock• 11 years ago

This one says sitting straight is bad, that a 35% lean back is ideal: http://mashable.com/2011/05/09/sitting-down-infographic/

I have 2 blown lumbar disks, and for me at least, the 35% lean back, even if it means slouching on the couch, eliminates pain when I do have to sit for extended periods.

molladair• 11 years ago

I work for a standing desk company (http://www.focaluprightfurniture.com/) that also makes "leaning seats" to pair with standing desks. The seats keep your hips open at a 130-135° angle - like the "lean back" approach, but while standing. I've been using the setup since I started and I love it. Definitely the ideal.

vanderZwan3• 11 years ago

Something people underestimate (I think) is that having a correct posture requires having strong enough support muscles so that you can maintain said posture without getting tired, or even thinking about it.

By far the biggest benefit of going to the gym has been that my core muscles got stronger, which in turn has cured all back pains I had.

michaelmachine• 11 years ago

Same for me! My back pain was gone almost immediately after I started working out again.

hellbanner4• 11 years ago

Thanks for saying this - another reminder to do more core (got down and planked).

What exercises did you find most beneficial for strengthening?

On a related note -- I periodically do stretches where I stand on one leg and roll my hip & waist out to the side extending it behind me -- that helps alleviate tension in the side.

Similar - hanging on my forearms from chairs or those ab machines at the gym.

Pain Free (a method for stopping chronic pain) has 4.5 stars over 800 reviews @ http://www.amazon.com/Pain-Free-Revolutionary-Stopping-Chron...

serg_chernata• 11 years ago

I started using row machines at the gym for this exact reason. It's a really low impact workout but provides great cardio and involves your entire body.

vanderZwan3• 11 years ago

I can't really say, since I'm not really "into" fitness at all, and everybody is different. Just let a good personal trainer look into it; the whole added value of a personal trainer is that they know what they're doing, so you don't have to know.

Mine let me do a number of test exercises and then created a program to work on the weak points she noticed (while explaining everything clearly), and it worked really effectively.

For example, in my case I needed to work a bit extra on shoulder support muscles because I'm somewhat hypermobile. This helped with all kinds of other exercises, because the shoulder muscles were the weakest link "holding back" the other muscles.

richmt2• 11 years ago

I hear lots of discussion that deadlifting with proper form strengthens the core. Also, being a compound lift, you'll hit tons of other muscle groups as well.

Mark rippetoe's book on starting strength is a great read on how to execute compound barbell exercises like the deadlift, and also has some great information on things like progressive overload. I'd recommend it even if you don't plan on following the starting strength program.

j_s• 11 years ago

For a very simple, basic routine that is probably only useful to someone (like me) who has done nothing for a long time, try something like in this video: https://www.youtube.com/watch?v=bCMNMHBY1Dk

I did the exercises facing the wall rather than crushing myself on the floor; the primary benefit was in awakening a few back muscles enough so that I would feel the soreness if I was sitting incorrectly.

toasterlovin3• 11 years ago

The deadlift will get you the most results for the amount of time you put in. It directly strengthens all the muscles involved in keeping you upright and in a normal anatomical position. A barbell and plates will put you back about $250-$300. Then, if you spend 20 minutes every Monday, Wednesday, & Friday deadlifting and just increase the weight on the bar by 5-10 pounds each workout, you'll be a totally different (better, stronger) person in about 2 months.

theseatoms• 11 years ago

I recommend yoga, and I'm surprised that no one else has done so yet ITT.

roymurdock• 11 years ago

Agreed. I've felt an extreme difference in comfort and posture within a month after I started doing squats and deadlifts every other day. I felt more powerful and less lethargic in all my activities, walking and sitting included. These are crucial exercises that I can't recommend highly enough.

gww• 11 years ago

I had the same issue with shoulder slouching. The muscles that pulled my shoulders back were incredibly weak while my pectoralis minor was very tight. I ended up with rotator cuff impediments and thoracic outlet syndrome in both my shoulders. After four months of PT and consistent weight lifting my shoulders have felt the best they have been since I as a teenager.

farslan• 11 years ago

Agree. I've started 8 months ago for http://stronglifts.com/ and it was the best decision I gave.

CPLX• 11 years ago

Yes this is (in my opinion) the best simple and comprehensive program for a beginner.

For the tech-minded reading here, this is doubly so, as the app is really top notch, you can basically install it on your phone and just do exactly what it tells you to do and be in better shape quickly if you have the discipline to stick to it.

makmanalp2• 11 years ago

Not only back pains - I was very surprised when what I thought was RSI in my wrists was actually because of posture - somehow some nerves were getting pinched. I discovered this when I was doing some weird neck / shoulder stretches and the pain very suddenly receded. Then I started fixing my monitor to be higher and taking care of my posture, and I've had minimal issues since then. I'm guessing I had some early form of something like Thoracic Outlet Syndrome.

vanderZwan3• 11 years ago

Yeah, tensed up muscles are weird in how they can cause pain elsewhere, no?

I had something similar where neck- and shoulder tension was the cause of headaches. And a friend of mine suffered from what felt like a tooth-ache for weeks, which turned out to be caused by a cramped up jaw muscle (which nobody thought of at first, since they were focussing on where she felt the pain).

manifestsilence• 11 years ago

I've struggled with a minor case (once major) of TOS for years, particularly with clarinet playing. I totally agree with the importance of strength for this.

I recently switched to a standing desk at work, with a tall chair for the option to sit, and it has helped some, but I think what helped most was rowing and weight lifting.

The other thing I've been finding is how much emotions affect posture. When I'm feeling open and unafraid, my whole front side opens up and relaxes, and when feeling insecure, it all curls forward.

ljk2• 11 years ago

what's a good exercise for targeting the back muscle group?

gadders3• 11 years ago

Deadlifts, as mentioned elsewhere in the thread.

sgk284• 11 years ago

Deadlifts and squats are great workouts for targeting a wide array of muscle groups, including back.

scroy• 11 years ago

Squats and deadlifts (and similar compound exercises) are best for building back and core strength. Stretches, especially yoga, can help expand tight chest muscles.

Swimming is good for building endurance and working the whole body.

lkiernan2• 11 years ago

Note: Don't only work your back if you're asking as a beginner.

Deadlifts will work your entire core better than most other exercises. make sure you research correct form beforehand.

mdesq• 11 years ago

I've always driven with the most (comfortable) distance between me and the steering wheel. My reasoning has been that maybe I'm safer when there's more space between me and the windshield, steering wheel, etc. and that there's a tiny bit more time for that airbag to inflate should the need arise.

a-priori• 11 years ago

In general more space between you and the airbag is safer. You want it to be fully inflated before you hit it. But they're designed to inflate in the time it takes a typical person to impact the airbag. Basically all you need to do is sit back in your seat and in a comfortable position and you should be okay.

Every now and then you see nervous drivers sitting forwards in their seat with their face near the wheel. It's scary to think what would happen if the airbag were to deploy. Just don't be that person.

Also, be careful sitting too far away that you're not locking your elbows. You might cause serious injury to your arms in even a minor crash.

gambiting• 11 years ago

Well, I do know what happens in that situation. My friend used to be one of those drivers, with the steering wheel literally on her chest, holding the steering wheel as if she was hugging it. She always said that's what was comfortable for her. Until she had an accident - and obviously the airbag had nowhere to go and pushed pieces of plastic from the steering wheel directly in her chest, avoiding the heart by millimeters, and also cracked nearly every rib in her chest. She had to have multiple operations to remove the little bits of plastic form multiple points in her body. Suffice to say, she drives like a normal person now.

ef4• 11 years ago

I remember seeing an electronic gizmo that would supposedly remind you to correct your posture throughout the day. Has anybody tried something like that? I feel like the gentle constant feedback might actually work.

makmanalp2• 11 years ago

It's the Lumo Lift (http://www.lumobodytech.com/). I've heard mixed things.

faehnrich2• 11 years ago

One place I worked, they installed a program that reminded people every few minutes to take breaks and have good posture.

The longer you worked, it showed a different color for how fatigued you were. Taking regular breaks kept you at green, constantly typing made it go toward red.

I found that the program displayed the colors by just displaying different picture files of just that color. I changed those files to pictures of your character from Doom as he takes more damage. The longer I typed without a break, the bloodier the guys face got.

Oh, as for your question, no it didn't work. I just saw it as a distraction so removed the program (which I wasn't supposed to be able to do.)

hellbanner4• 11 years ago

Rolling up t-shirts or a jacket under my wrists while I type has been tremendous for avoiding wrist pain in the day.

For my back, I practice rolling my hips forward (roll your groin towards the chair), which changes which muscles are use and can alleviate low back pain.

axx• 11 years ago

This will only work, if your desk is low. If your desk is too high, you will increase the stress on your wrists.

jerf2• 11 years ago

After a lot of screwing around with desks and trays and other things, I finally just gave up and started typing with my keyboard in my lap. This has worked quite well now for a long time; everything seems to be in the correct ergonomic position, with a basic ergonomic split keyboard (though even the non-split keyboard on my laptop isn't too bad). For mouse usage, I just use it infrequently enough for this to be practical, by having a keyboard-heavy setup.

hellbanner4• 11 years ago

Are you hunched over? I use a kinesis freestyle 2 keyboard to avoid hunching over (arms spread out)

blueprint• 11 years ago

This is a very insufficient article. Almost useless. It doesn't mention anything about hip and sacral alignment, which is absolutely critical to having correct posture. Unfortunately, sitting in a chair, as well as various other modern activities, completely messes up not only the alignment of the hip and sacrum, but conditions the soft tissue in those areas to hold a bad position. That's why it's so hard to have good posture for modern people - our bodies are molded into the wrong shape and are holding it.

Suppose an arch's keystone is pushed out of the place? The arch collapses, and can't support anything on top of it. The sacrum is that keystone.

For real progress towards fixing posture, have a look at the explanation presented by the Olympic athlete in this video.

https://www.youtube.com/watch?v=3MIZ6Fl2BTY

jcfrei• 11 years ago

What really confused me was the following tip: Try to avoid sitting in the same position for more than 30 minutes. So is there a correct sitting position? Or is the correct sitting position "sitting differently" every 30 minutes? Those are two mutually exclusive things.

brational• 11 years ago

Or is the correct sitting position "sitting differently" every 30 minutes?

Actually, yes. No sitting posture is one the body should be holding for extended time. We are supposed to move.

rsanheim• 11 years ago

Kelly Starret has a great quote about this: "your best position is your next position".

Which is really another way of staying that you should be moving and changing positions frequently. Sitting to standing, on a stool, one foot up, then the other, etc.

You can really run in to problems when you are sitting in the same horrible posture for hours on end. One side benefit of a standing desk is that it makes it a lot harder to stay in one position for hours because you can't slump back against a char. So you actively have to find ways to support your own weight, or at least you realize you are slumping forward in an awkward way onto the standing desk and you change position.

gcb0• 11 years ago

everywhere in the past, those list of hints without references said to sleep on your site with the legs pulled close to the chest with a a pillow between three knees. this one says to explicitly avoid that and provide no explanation

randomsearch2• 11 years ago

Went to the physio with RSI and she recommended I take up swimming. Totally worked.

knodi123• 11 years ago

Effectiveness aside, how skeptical were you when you heard that? It's easy to hear these explanations in hindsight, but I bet at the time you'd be, like, "What kind of advice is that? Are you just using a medical-grade magic 8 ball? 'Swim more'? "

melling3• 11 years ago

No one knows what causes RSI. There are lots of anecdotal stories for different cures.

http://thespanishsite.com/public_html/org/ergo/rsi.html

randomsearch2• 11 years ago

Sorry, my original answer was cut short by an interruption!

She was a great physio -- afterwards I asked her to come back about another complaint (running injury) and she was the only physio (of 3) to improve that too. So it wasn't just "go swim more" but "do a bunch of things".

First she explained why I was getting RSI, which was due to overreaching caused by bad posture, laptop usage, etc. Gave me advice on how to stop it getting worse, which worked. I bought an ergonomic mouse, avoid some keyboard shortcuts, changed my chair.

Then she advised me to swim and walk (!) more. I had no expectations, just followed her instructions. I was particularly surprised to find that walking helped so much, but without doubt swimming was key. Swimming is so good because it works out so many muscle groups and stretches and expands your body. A colleague later told me that he'd had RSI and took up swimming to cure it.

My RSI is pretty much gone now, even working very long hours, but I've continued to swim every day. I'd recommend it, as it's much better than running for your joints and also avoids lifting weights, which I've never been keen on due to the competitive (slightly obsessive!) attitudes of those who attend crossfit, etc. Being able to swim well is a really useful skill.

faehnrich2• 11 years ago

That is an incorrect lifting position because that guy's huge chin makes him top-heavy, he'll just fall over the box.

merpnderp• 11 years ago

I've been wanting a harder mattress for a while. Now I have a great excuse.

somberi• 11 years ago

A physical therapist once told me that you need to to sit and stand as if a string is connected to the middle of your sternum and being pulled skywards. Apparently this is what they teach in Ballet schools. For me it worked well and my back pain, over a 4 week period vanished.

chrisan• 11 years ago

For those who have to sit, I'd recommend http://www.amazon.com/Original-McKenzie-Lumbar-Roll-Standard... (which was recommended by my Dr. and physical therapist after I bulged a disc trying to He-Man a kids playground up onto a truck bed)

I carry mine between my desk and car. Makes a big difference in how long I can drive

abledon• 11 years ago

If you really want to go further than just healing basic ailments, check out eastern forms of energy cultivation.

The evidence is finally starting to accumulate in the west for why this cultural phenomenon has somehow stuck around for thousands of years, exciting!: http://med.stanford.edu/news/all-news/2008/05/tai-chi-master...

antognini3• 11 years ago

I recently hurt my back and got interested in the anatomy of the lumbar spine and ended up reading the textbook Low Back Disorders by Stuart McGill. McGill is a professor of kinesiology at the University of Waterloo and has spent his ~30 yr research career studying the lower back. It was an informative and surprisingly interesting read!

He made the point throughout the book that a lot of "common sense" clinical wisdom regarding the low back has little basis in the scientific literature. Among these was that there really is no "correct" sitting posture. All sitting postures are damaging to the low back over long periods of time. Instead he recommends varying the sitting posture at least every ~10 minutes or so, and standing up for a few minutes at least once an hour. Acceptable sitting postures could be anything from sitting up straight as in the illustration in the article, leaning back, sitting cross-legged in the chair, or putting your feet up on the desk. All are fine as long as you change it up every now and again.

There were a few other bits of wisdom in the book. A few I remember off the top of my head:

- Don't do sit-ups under any circumstances. They are among the worst exercises you can do for your back. The traditional back extension exercise (e.g., http://lifestyle.beiruting.com/wp-content/uploads/2011/02/su...) also puts the lower back under a huge amount of stress.

- Muscle strength is not well correlated with having a healthy back. Muscle endurance is much better correlated with back health.

- Don't do anything to exert your back within an hour or two after waking up (including stretching the back to extreme flexion by, for instance, trying to touch your toes). The hydrostatic pressure in the discs after rising from bed is much greater, which increases the risk of herniation. (This is why one is ~1/2 an inch taller in the morning than in the evening.)

- If the spine is flexed for a long period of time (e.g., one is sitting slouched over for twenty minutes), the ligaments become lax and remain lax for some time afterwards. Only 50% of the intervertebral joint stiffness remains two minutes later, and even 30 minutes later some residual laxity remained. So if you've been sitting slouched over, don't immediately go and exert your back by lifting a heavy object. Stand up for a few minutes before exertion.

- Squatting is not necessarily better than stooping when picking up an object. It's most important to keep the spine in a neutral posture.

- When picking up a light object, it's best to use the golfer's lift if possible (e.g., https://liftingtechniques.files.wordpress.com/2012/12/golf.p...)

wishinghand3• 11 years ago

Is there an appropriate exercise for extending the muscle endurance of the back?

antognini3• 11 years ago

There were a few that were recommended:

1. Side bridge. Laying on your side, raise the hips up with your weight on your feet and elbow. Hold until failure. This improves the endurance of the lateral musculature.

2. This requires a box with an incline of ~55 degrees. Get in a sit-up position with the back against the incline and with the feet secured to the ground. Have someone pull the box back a few inches. Support yourself as long as possible until any part of your back touches the box. This improves endurance of the flexors.

3. The upper body is cantilevered over the end of a bench or table with the feet secured. The arms are held across the chest with the hands on the opposite shoulders. Failure occurs when the body drops below horizontal.

4. Bird-dog exercise. Starting on your hands and knees, raise one leg and the opposite arm out to horizontal and hold for ~10 seconds at a time.

5. Curl-up. NOT a sit-up. Lie on your back with one leg at 90 degrees and the other flat on the floor. With NO cervical or lumbar flexion, lift your head an inch or two off the floor and hold.

chestnut-tree• 11 years ago

This short 3 min video from the New York Times features four core exercises that protect the spine. It's narrated by the same Stuart McGill mentioned in antognini's post

https://www.youtube.com/watch?v=kukmaW9CmSU

toasterlovin3• 11 years ago

All other thing being equal, a stronger muscle will have more endurance than a weaker muscle. The reason is quite intuitive: the same load is a smaller percentage of total strength for the stronger muscle, and thus less fatiguing, than it is for the weaker muscle.

tertius2• 11 years ago

Not liking the first reference here from the "American Chiropractic Association."

ljk2• 11 years ago

why not?

tertius2• 11 years ago

Because subluxation is not based in science.

snake1172• 11 years ago

Hey guys I'm posting a follow-up article here and I submitted the link through HN: http://www.bodybuilding.com/fun/posture-power-how-to-correct...

This was the first article that led me to the Cleveland Clinic website. I hope you find it worthwhile.

Posture for a Healthy Back

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