By Beth Hall, Clinic Manager at ApexNetwork Physical Therapy Paris, IL
After working all day, there is nothing more you look forward to than being able to sit back and relax. You get home, and kick back in your recliner to read the paper or take a nap. However, when you get up to make your way to the dinner table after having sat for an hour or two, you notice your back feels more stiff and sore than when you left work. Most people attribute these symptoms to the labors of their job earlier that day. It couldn’t be related to poor posture, could it?
Poor posture creates undo stress on muscles, ligaments, tendons and discs that support the spine. When these postures are sustained, these stresses cause the tissues to become overstretched. Often times, pain that is related to poor posture does not occur immediately. However, repeated assumption of poor postures slowly damages the soft tissues over time thereby resulting in pain that appears to have developed for no apparent reason.

Two of the seven ergonomic risk factors are sustained posture and awkward posture. Sustained posture can be easily corrected with frequent position changes. It is recommended that positions be changed every 30 minutes. This can be as simple as standing up from your chair to stretch, or walking to the cooler to get a drink of water. Awkward posture, or postures that move your joints out of neutral positions, can also be fixed but this frequently requires adopting new habits.
When we sleep, our bodies tell us when to change positions. Frequently, we wake to a sore shoulder or hip, or even numbness/tingling in our hands that indicates to us that we need to move. Changing your sleeping posture usually eliminates the symptom that caused you to wake. Other things to consider when sleeping in order to improve alignment of your spine include placing a pillow between your knees when lying on your side, or under your knees when lying on your back. It is also important to avoid flexing your wrists and elbows under your body, as this can compromise circulation and create pressure on your nerves. Avoiding prolonged sleeping on your stomach also can reduce neck pain, as this position requires you to turn your head to near end range of motion. Another awkward posture to be avoided is sleeping with multiple pillows under your head. This can cause extreme neck flexion, which can lead to overstretched soft tissues and pain. One pillow is ideal for providing optimal support of the head and neck.
How often should pillows and mattresses be changed? It is suggested that you change pillows every two years. Firm mattresses facilitate more neutral spine positions, and it is recommended that you flip or turn your mattress every two months. The average life of a mattress is 5-7 years.
When we are awake, we tend to pay less attention to the signals our bodies send us, as we are often multi-tasking. As we sit at our desks for hours responding to e-mails, answering the phone and reading memos, the aches in our backs and necks go unnoticed, at least until they become pronounced. By this time, the pain does not easily remit. Simple changes to work stations and postural habits can prevent/eliminate this pain.
The first item to be addressed when considering office positions is your chair. It should be adjusted so that your feet rest flat on the floor, and your hips, knees and elbows are at 90 degree angles, or slightly less. If you are vertically challenged, then a foot rest may be used to allow for better adjustment of your chair in relation to your desk. After your chair is adjusted, then you can address your computer position. The keyboard and monitor should be directly in front of you (not at the corner of the desk) to eliminate the need to twist your trunk or neck. Monitors should be positioned so that the middle of the screen is at eye level. Often, the monitor is too low. Raising it can be accomplished by something as simple as placing a ream of paper under its base. Screens should also be within 22 inches of your eyes to eliminate unnecessary strain. Other items to consider are headsets for individuals who frequently use the phone. Wrist supports at the keyboard are also beneficial for maintaining a neutral position at the wrist, especially if repetitive typing is required.
In all positions, the goal is to maintain neutral alignment of the spine. This means keeping the natural curve at the neck and low back. Use of a lumbar roll can help achieve this posture. Lumbar rolls should measure 1 ½ to 2 inches in diameter when pressure is applied to them. They do not need to be expensive. Lumbar rolls can be as simple as a rolled up hand towel or a small section of a pool noodle. These are best used with firm seating. It is important to remember to first scoot all the way back in your seat before placing the roll at the “small” of your back. This ensures the most support for the curve of your back. Overstuffed furniture and recliners allow the low back to sag into flexion causing stress on the surrounding soft tissues. These furniture styles also often have pillows at the head that push the head and neck forward creating the same problem as found at the low back. The same ergonomic principles as discussed with office seating apply to seating at home or in your vehicle. Since we all come in different shapes and sizes, the standard lumbar support found in your vehicle may not actually “fit” you. In this event, it is best to deflate the lumbar area of your seat and use a separate lumbar roll as suggested above.
If you are currently experiencing pain, hopefully you will find the suggestions in this article helpful with reducing or eliminating your discomfort. However, even if you are pain free at this moment, these recommendations may be helpful in preventing you from developing painful conditions related to poor posture. So, the next time you find yourself plopping into that big recliner, or shopping for furniture for home or work, keep these tips in mind.