
Posture for a Healthy Back - snake117
http://my.clevelandclinic.org/health/ns_overview/hic_Posture_for_a_Healthy_Back
======
vanderZwan
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.

~~~
hellbanner
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...](http://www.amazon.com/Pain-Free-Revolutionary-Stopping-
Chronic/dp/0553379887/)

~~~
toasterlovin
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.

~~~
beachstartup
yes - in my opinion, everyone should do barbell training, including
(especially) women. it fundamentally changes you for the better. physically
and mentally.

beware the person who warns against it - they have an agenda. it's
unquestionably good for you when done properly and within your limits of
capability.

i've heard less of the "but i don't want to get huge and bulky like a
bodybuilder" these days, probably because as resistance training increases in
popularity, people are realizing how incredibly, ridiculously, ludicrously,
unreasonably difficult it is to build and maintain muscle.

------
antognini
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...](http://lifestyle.beiruting.com/wp-
content/uploads/2011/02/superman-exercise.jpg)) 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...](https://liftingtechniques.files.wordpress.com/2012/12/golf.png?w=300))

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

~~~
antognini
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.

~~~
wishinghand
>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.

Face up or down?

~~~
antognini
Face down.

------
blueprint
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](https://www.youtube.com/watch?v=3MIZ6Fl2BTY)

~~~
jcfrei
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.

~~~
rsanheim
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.

------
mrpoptart
There's some conflicting data out there about this:
[http://www.npr.org/sections/goatsandsoda/2015/06/08/41231470...](http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-
posture-why-indigenous-cultures-dont-have-back-pain)

~~~
eevilspock
This one says sitting straight is bad, that a 35% lean back is ideal:
[http://mashable.com/2011/05/09/sitting-down-
infographic/](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
I work for a standing desk company
([http://www.focaluprightfurniture.com/](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.

~~~
wishinghand
I switch every hour between standing at my desk and leaning on the Mogo stool
you can buy from this company. Great alternative to standing all day
(tiresome, sometimes painful) to sitting all day (bad posture, induces weight
gain from being sedentary). And you can still wiggle around a bit with it. I
keep some blocks under my desk to help stretch my calves with while doing
either.

------
luck87
this should be our computer desk:
[https://kokyun.files.wordpress.com/2011/10/5531_130311939574...](https://kokyun.files.wordpress.com/2011/10/5531_130311939574_650844574_3354901_434869_n.jpg)

this is reality (if you are working with laptop or notebook or macbook):
[http://www.parkavenuespine.com/wp-
content/uploads/2013/09/iS...](http://www.parkavenuespine.com/wp-
content/uploads/2013/09/iStock_000024935989_Medium.jpg)

~~~
swah
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...](http://superuser.com/questions/231377/whats-the-correct-monitor-
height-for-large-monitors)

~~~
luck87
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...

------
megal0maniac
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
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/](http://ergodox.org/)

~~~
megal0maniac
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 :)

------
gcb0
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

------
abledon
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...](http://med.stanford.edu/news/all-news/2008/05/tai-chi-master-
studied-for-power-to-control-body.html)

------
chrisan
For those who have to sit, I'd recommend [http://www.amazon.com/Original-
McKenzie-Lumbar-Roll-Standard...](http://www.amazon.com/Original-McKenzie-
Lumbar-Roll-Standard/dp/B000H48WYA) (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

------
snake117
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...](http://www.bodybuilding.com/fun/posture-power-how-to-correct-your-
body-alignment.html)

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

------
mdesq
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
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
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.

------
somberi
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.

------
hellbanner
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.

~~~
jerf
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.

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

~~~
jerf
No, I lean back in my chair. There's also some evidence to suggest that the
"chaise longe" position is quite ergonomic, though I'm not quite that far
back. I'm fairly tall, so sitting pretty & straight as the pictures show is
generally not an option as even with chairs adjusted to full height I can't
sit with my knees at a right angle.

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

~~~
ljk
why not?

~~~
tertius
Because subluxation is not based in science.

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

------
ef4
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.

~~~
faehnrich
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.)

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

~~~
knodi123
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'? "

~~~
randomsearch
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.

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

