Struggling to find a comfortable sitting position? Suffering from neck, mid or lower back pain after sitting for long periods? You are not alone….

We all know about the slumped position which we ALL adopt from time to time. However simply saying “sit up” is not specific enough to promote correct positioning. It is important to note that we do not expect or recommend anyone to stay in the same position for long periods as this will lead to problems of its own. What we do recommend is that whilst you are in a sitting position that you try to maintain a neutral position for the shoulders, spine and pelvis.

There are a few potential scenarios which we see regularly in clinic, the two main positions are the slumped (C shaped position) and the “sitting up too tall” presentation (See pictures below). The slumped position is adopted if we are being a bit lazy and resting back on the chair. Unfortunately if we continue to adopt this position, over time the back muscles become weak through lack of use. This can lead to difficulty with normal day to day activities and we generally have “a bad back”.

Equally if we sit up too much because we are conscious of our posture we will cause a similar presentation of symptoms to the slumped position. This is due to muscle over activity and the muscle fatigue due to constant use. We then start to feel the well known dull achy sensation which alleviates when we get up and move around for 5 or 10 minutes. Movement allows the muscles to relax a little and when the pain reduces we sit back down and “carry on”..

The main focus for both these scenarios is posture education and advice. Providing manual treatments such as massage, acupuncture and stretching will help to control the symptoms but will not resolve the underlying problem. If posture changes are not implemented it will only be a matter of time before the symptoms return….

The slumped sitting position causes the head to be forward of the body (Poking chin), shoulders which are held forwards and sometimes down, with a rounded mid and lower back (Thoracic and Lumbar spine).

The “Too tall” position” causes the pelvis to be tilted forwards, increases the curve of the lower back and places excess stress on lid and upper back musculature. See pictures below…

Slumped posture                                                                                                       Too tall

It depends on you and your body as an individual as to how your back copes with this stress and where or when you start to feel discomfort. Potentially these positions will cause hip pain, lower, mid and upper spinal / back pain, shoulder and neck pain potentially leading to headaches.

The movements required to achieve a neutral sitting position or “good posture” are simple sounding but not so simple to perform. Over time I have developed some simple cues which I have found most effective and have described these simply below.

Sit on a dining chair to practice, now let yourself slump, then sit up as tall as you can. Now relax and try to “find” the middle of the two movements. You should feel the bony bits in your bum, this is what we call the seat bones (Ischial tuberosity). This aligns the pelvis.

The lumbar spine sits on top of the pelvis so if the pelvis is in a neutral position, the lumbar spine is in a neutral position.

Next is to think about the shoulders, push your shoulders as far forwards as you can, then brace the shoulders as far back as your can. Now let the shoulders relax a little and this should set you  into the correct position.

Finally, we do the funky chicken! poke you chin forwards then tuck your chin in as much as you can, relax a little. Here is a picture of good sitting posture…

You can have a friend or partner take a picture of you (Side on!) Try a before and after and see if you can match the movements and positions in the pictures….