October 2019 – Should we re-evaluate how we look at Posture?

By Joel Wallace

We are surrounded by talk around posture.

This includes how we should stand, how we should sit, how posture is the cause of our pain and the amazing new devices we should get to instantly fix it. At work we often told about the correct ergonomic set up to prevent posture pain, we are told about how we should or shouldn’t move and lift to prevent injury.

It’s very easy to take this information as fact, with OH&S reinforcing this, and many health professionals feeding into it with treatment plans about correcting posture and switching on and off different muscles.

Interestingly, looking at the evidence available, very little of what we hear is well supported by research and is often contrary to evidence based advice.

A great journal article, ‘Sit up Straight’ – Time to Re-evaluate’, has recently been produced looking at the research and what it actually says when it comes to posture.

Below are 7 key points that that the authors concluded.

There is NO single ‘correct’ posture

Despite common posture beliefs, there is no strong evidence that one optimal posture exists or that avoiding ‘incorrect’ postures will prevent back pain.

Differences in postures are a fact of life

There are natural variations in spinal curvatures and there is no single spinal curvature strongly associated with pain. Pain should not be attributed to relatively ‘normal’ variations.

Posture reflects beliefs and mood

Posture can offer insights into a person’s emotions, thoughts and body image. Some postures are adopted as a protective strategy and may reflect concerns regarding body vulnerability. Understanding the reasons behind preferred postures can be useful.

It is safe to adopt more comfortable postures

Comfortable postures vary between individuals. Exploring different postures, including those frequently avoided, and changing habitual postures may provide symptomatic relief.

The spine is robust and can be trusted

The spine is a robust, adaptable structure, capable of safely moving and loading in a variety of postures. The common warning to protect the spine is not evidence-informed and can lead to fear.

Sitting is not dangerous

Sitting down for more than 30 minutes in one position is NOT dangerous. However, moving and changing positions can be helpful, and being physically active is important for your health.

One size does not fit all

Postural and movement screening does not prevent pain in the workplace. Preferred lifting styles are influenced by the naturally varying spinal curvatures and advice to adopt a specific posture or to brace the core is not evidence-based.

 

The full article can be found in full at: Journal of Orthopaedic & Sports Physical Therapy, 2019 Volume:49 Issue:Pages:562–564 DOI:10.2519/jospt.2019.0610.

 

 

 

 

 

 

April 2019 – Lower Back Pain and Exercise

Motion Health Pilates

Lower Back Pain? Keep Moving
By Joel Wallace

Almost everyone at some point experiences back pain, and for some this might be a regular occurrence.

It is very easy to fear back pain and treat it differently to how we would other pains and aches. This may be for many different reasons but is often due to uncertainty, past experience or belief we will make it worse.

Surprisingly to a lot of people is that in most cases we don’t need to rush for ‘treatment’ and it quite safe to continue normal activities and exercise. Most episodes of lower back pain resolve themselves in around 6-8 days.

Some things to keep in mind about back pain are:

• Pain does not equate to damage

• The rate of spontaneous re-absorption of lumbar disc herniation’s is about 67%.

• Exercise has been linked with positive effects on the discs such as promoting regeneration and strengthening the inter-vertebral discs

• Isolated exercise such as ‘core’, transverse abdominal and glute exercises are not more effective than any other type of exercise for lower back pain

• Posture has not been shown by research to play a major role in the development of lower back pain

• Bending, and twisting has not been shown to be an independent cause of lower back pain or associated with pain intensity.

• On the other hand – Avoiding or being fearful of certain movements have been associated with ongoing lower back pain

For a helpful approach around exercise and lower back pain, see the below simple advice by Cor-Kinetic:

Don’t over complicate exercise & activity for back pain, use the following guidelines for your symptoms:

• Low levels of activity = increase activity a bit

• High levels of activity = reduce activity a bit

• Stiff movement = focus on relaxed movements

• Need higher levels of loading for sport/work = load them up

• Specific feared movements = grade the exposure to specific feared positions/movements

• Positions/activities that are painful beyond a tolerable level = its ok to back off for a bit (make sure to reintroduce them)

• Negative associations around exercise/activity = Make it fun, engaging & meaningful

• Bit of pain doing stuff = it’s ok

If you have any questions or want to know more speak to your Exercise Physiologist or Physiotherapist at Motion Health.

Remember that you don’t always need to rush for ‘treatment’ and that movement and exercise is good for you.