Standing Posture

Stand with your feet shoulder width apart as this gives you a larger base of support.

Allow the weight to be transmitted though your heels, then find a balance point in the centre of the foot.

Your bottom should be tucked under so that there is not a large curve in the back. There should still be a small curve in the back. The stomach muscles should be drawing in.

Your chin should be tucked in (not up in the air). This is a rotational movement, so as the chin goes in, the back of the head goes up. Think of a balloon attached to the back of the head lifting it up. If you pull the chin straight back, you will get the double chin look (not so good!).

Your shoulders should be relaxed and down, with the bottom of the shoulder blades drawing slightly together. You should feel a lengthening through the front of the body.

From side on, your ear, shoulder, hip and ankle should all be in alignment.

If you are standing in the one place for long periods, like when ironing, place one foot on a raised box or stool in front of you. Alternate the feet to help decrease the strain on the back.

When bending forward over an object (e.g. when bending over the sink to shave, or wash dishes) where possible try to stand with one foot in front of the other. This widens your base of support and helps reduce the strain on the back.

Sleeping Positions

  • It is generally best to sleep on your side. A pillow under your head should keep your neck and spine in line. If the pillow is too high or too low, you will be bending your neck to one side and straining it.
  • When sleeping on the side, bending the knees will help to stabilise the body. A pillow between the knees may be comfortable.
  • Alternatively, you may like to have the top knee bent with the bottom leg straight. A pillow under the top knee in this position can reduce twisting on the low back and may be more comfortable for you.
  • If you wish to sleep on your back, a pillow under the head will help stop you from extending your neck (bending it backwards). You should also have a pillow under your knees to help take the strain off your low back.
  • Sleeping on your stomach requires full rotation of your head and neck, and is thus very stressful on your neck. If you do lie on your stomach for any reason, NEVER have a pillow under your head. Extension and rotation is extremely bad for your neck if maintained for a period of time.
  • Remember that you should be comfortable. Your body will tell you what it likes. so listen to it.

BEDS

  • Your bed should be firm enough to keep your spine straight and give even support.
  • It should have enough cushioning so that there is not excessive pressure on your shoulder and hips (if side sleeping).
  • Most of all it should be comfortable for you.

PILLOWS

  • The aim of the pillow is to keep your head in line with the spine.
  • We recommend Dentons Pillows.
  • Contoured pillows are good, but there is not one perfect pillow for everyone.
  • Remember if you are changing your pillow, give yourself several days for your body to adjust before you decide if you like it or not.

Sitting Posture

CORRECT SITTING POSTURE

  • Sit as far back in the chair as possible, do not sit on the edge.
  • Your feet should be flat on the floor. This can be done by either lowering your chair (if possible) or “raising the ground” by using a foot rest or even old telephone books. This helps you transfer the body weight to the ground.
  • Your knees should be at hip height or slightly lower. A small wedge cushion may be used, which helps tilt the pelvis forward maintaining the lumbar lordosis (the natural curve of the lower back).
  • Adjust the back of the chair to a 100°-110° reclined angle, if possible.
  • Adjust any back support in the chair to support your upper and lower back. If the chair does not have good back support, then a separate back support or small pillow can be used to help support the back.
  • Some chairs have an active back mechanism that allows you to change the angle of your back. If your chair has this, use it to make frequent position changes.
  • Your chin should be tucked in (not up in the air). This is a rotational movement, so as the chin goes in, the back of the head goes up. If you pull the chin straight back, you will get the double chin look.
  • Gently draw your shoulder blades together and down. Adjust the armrests (if fitted) so that your shoulders remain relaxed and down. If your armrests are in the way, remove them.
  • If writing or drawing at a desk, a slanted work surface prevents you slouching over the desk and helps maintain good posture.

AT THE COMPUTER

  • If working on a computer, the keyboard height should be set so that the elbows are slightly open (100°-110°) and wrists relaxed and straight.
  • The keyboard and monitor should be situated directly in front of you, with items used frequently (e.g. the telephone) should be close at hand.
  • The monitor should be positioned so that your eyes are level with the top one third of the screen. The monitor should be at least an arms length away.
  • Position the monitor to reduce glare.

TAKING BREAKS

  • If you are sitting at your desk or computer for an extended period of time, it is important that you take regular breaks. Your body is not designed to sit still for long periods, no matter how good your workstation and posture are.
  • Every 20 to 30 minutes you should stop and rest for 1 to 2 minutes. Stretch your neck and shoulders and allow them to relax again. Cover your eyes for 15 seconds to avoid eye strain. Check your seated posture.
  • Every hour you should take a 5 to 10 minute break from your desk. Get up and move around, why not grab a glass of water?

Managing Back Pain

AN ACUTE EPISODE

If you hurt your back lifting, or you develop acute pain after sneezing or suffer another form of trauma, then it is likely that you have injured the tissues and thus will have some degree of inflammation. (This is like spraining your ankle) Therefore, for the first 24 to 48 hours you should not put straight heat on the area. If you put heat on an inflamed area, you will increase the inflammation and hence the pain. Icing or contrast bathing (alternating heat and cold) is best.

If the pain is severe, you may need to rest for a day or two. However it is best to try to modify your activities and stay active. Resting in a position of ease is good. Try to lie in a position which eases the pain the most. You can try lying on your back on the floor with your legs up and knees resting on a chair, sofa or low table. This helps to take the strain off the low back. Make sure you have a small pillow under your head.

Try to move within your pain-free range of motion as much as possible. Not moving at all for fear of pain will make the problem worse. Gentle stretching is also helpful as long as it does not aggravate the pain.

If you wish to take painkillers, it is always best to check with your doctor or pharmacist first.

It can be a good idea to see an osteopath for a diagnosis and treatment. Although the pain may slowly resolve, it can leave restrictions or weaknesses that may predispose to future problems. It is common to see patients who have had mild to moderate back problems which have mostly resolved themselves, until it has lead to a more major injury, such as disc protrusion, which then takes a lot longer to improve.

CHRONIC PAIN

Developing a good back routine is best for managing a chronic back problem. An osteopath will be able to assess your body and address any restrictions found. They will be able to advise you on improving your posture as well as a good stretching and strengthening routine.

REMEMBER THAT PREVENTION IS BETTER THAN A CURE. GOOD BACK HABITS DEVELOPED NOW WILL HELP PREVENT FUTURE BACK PROBLEMS.

Lifting Correctly

  • Before lifting an object, stand back and assess it.
  • Don’t be too proud to ask for help.
  • Then get close to the object, place your feet shoulder width apart.
  • Bend down using your knees, not your back. The back should remain straight.
  • Consciously pull the stomach muscles in.
  • Take a firm grasp of the object, holding it close to your body.
  • Lift by straightening the legs, allowing the big muscles in your legs to do the work.
  • DO NOT use your back. Your back should remain straight and your stomach muscles should still be working. When carrying the object, turn by moving your feet, not your waist.
  • Put the object down by bending the knees.

ALTERNATIVE

  • An alternative to bending both knees in a squat to lift is to bend down and have one knee on the ground with the other bent. The body is still directly facing the object.
  • As you lift using your leg muscles, one leg will be behind the other.
  • Remember to still use your abdominals to help support the back.
  • This is a good option for people with knee problems or other issues which limit their ability to lift from a squat.

OTHER NOTES FOR LIFTING

When lifting out of a car or other difficult area where you have to reach forward to reach the object, it is important to hold the stomach in and bring the object as close to your body as possible. Try to keep your feet wide to give you a good base of support and thus help with balance.

If you have to bend or twist for unusual locations, you must be very careful. It is important to know that you should never twist and straighten your spine at the same time. Your spine has different mechanics for twisting when it is bent and when it is straight. If you twist your back, always untwist before bending or straightening your back.