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You Should’ve Listened To Your Mother!

December 12, 2012

Greater than 80% of the population will experience low back pain (LBP) at least once in their lives.  The number one predictor of LBP is a previous episode, meaning; once you experience LBP you are 4-5 times more likely to have a recurrence.  As back pain becomes more frequent, episodes can last longer and intensity of episodes can increase as well.  Taking a proactive approach to episodic LBP will help decrease your risk for injury and decrease the need for medical expenses such as medication, doctors’ visits, etc.

Proper sitting posture is typically a position that most of us don’t EVER attain.  One big reason is the type of surfaces in which we sit and the amount of sitting that we do.  For example, soft sofas, recliners, desk chairs, car seats, plane seats, etc. tend to encourage a slouched sitting posture.  Flexion activities or movements in which you bend forward at the waist increase pressure on the lumbar discs by 85%.  Slouched sitting IS a forward bending activity.  So if you are sitting at a computer all day in a slouched position, you are creating a significant amount of force on the discs of the spine.   Below are pictures that depict how forward bending/slouched sitting affect the biomechanics of the lumbar intervertebral discs.

On the left, properly aligned vertebrae evenly distribute the pressure on the intervertebral disc. On the right, slouching leads to squeezing of the front side of the disc and stretching of the back side, which could lead to tearing, rupture, or a herniated disc. Thanks to Donald Corenman, MD for this image.

Posture can be a large component of low back pain.  And as you may think, proper sitting posture is very difficult to maintain.   Poor posture over time may cause structures in the spine to be irritated or damaged.  Frequent standing and walking and can help mitigate these effects.  But if you are sitting, maintaining proper sitting posture is essential.  If you are reading this and have low back pain, sit up straight and arch your back a little so that you are sitting on the bones at the base of your pelvis.  50% or more of you will experience a reduction in pain.  You now have the power to effectively reduce your own pain!  You have control!

Poor Posture Proper Posture

Without a doubt, correcting posture is the most difficult activity for my patients to do.  With this in mind, I use the Level Belt to encourage correct sitting posture and also to remind my patients when their posture has deteriorated.  Because let’s face it, we lose focus on our posture when we are focusing our attention on something else and we go right back to that slouch, slumped posture that has become our “normal” sitting position.

Too much arch

Too much arch

Just right

Just right

Too much slouch

Too much slouch

I use the Level Belt with my patients to 1. Educate them on what neutral sitting posture is, and 2. Provide continual feedback to help them maintain neutral posture, thus ultimately reducing their pain.  And from the patient’s point of view, it’s something that they can do independently. This is the first step in starting to take control of your pain.  The Level Belt is a great tool to assist you in your pursuit of a pain-free status.   And most importantly, not having to rely on someone or something to “fix” your painful back is a very empowering experience.

Kristy High Pottkotter, PT, SCS, Cert MDT
Wexner Medical Center at The Ohio State University
Special thanks to Kristy Pottkotter for being this week’s guest columnist.

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2 Comments leave one →
  1. December 13, 2012 5:25 pm

    I like the Level Belt concept to practice what good posture feels like. Just as important is HOW you get there and how to maintain it in a dynamic way. Also I am wondering why the example does not have her feet on the ground. Don’t you consider the feet as part if the base of support?

  2. Perfect Practice permalink
    December 19, 2012 12:13 pm

    Michelle,

    Thank you for your comments and question regarding Kristy Pottkotter’s blog post. You’re right–it is just as important to figure out how to get to good sitting posture and how to maintain it dynamically, and the Level Belt really helps clients learn those concepts both in the clinic and when practicing at home.

    We do appreciate the contribution that the feet can make as part of the base of support in maintaining postural stability. However, we have found that taking those feet off the ground as an exercise adds an additional challenge to those stabilizing muscles of the core, helping to increase awareness, strength, endurance and balance.

    Thank you again for your comments and please let us know how if we can be of any further assistance.

    Best regards

    Chris McKenzie, PT, SCS, AT
    info@perfectpracticeusa.com

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