In my bodywork practice, the majority of my clients come to me because they are dealing with some level of pain and are seeking guidance for ways to eradicate it. Very often they have been to a doctor who prescribes pain medication that they are unwilling to take or have adverse reactions to, and are looking for an alternative treatment. One of the most common complaints these people are dealing with is back pain.
“Back pain” can encompass many things, as it refers to the rear section of your entire torso. Somebody with a back pain complaint could be speaking about pain around their shoulder, between their shoulders, under their armpits, anywhere along their spine, their side, the top area of their glutes, or the lower area of their spine right above their sacrum. More than half of the people I treat come in with lower back pain, and the biggest cause is that these folks sit in chairs all day. If you’ve ever had to sit in a chair for an extended period of time, you probably have a pretty good idea of why that might be.
It is not a new concept to say that sitting in chairs is bad for you. From internal health dealing with blood pressure/heart rate and respiration, to the external health of our neck, shoulders, hips and legs, sitting in a chair for more than a few minutes brings about many different adverse effects. As a movement therapist I am constantly reminding folks that our bodies are designed to locomote, and when we inhibit that ability, we run into dysfunction.
Think about yourself sitting down, or if you are currently sitting down, observe what happens after a bit. Most likely you’ll notice that the muscles of your lower back feel over-taxed, or begin to fatigue. When you relax them, allowing your spine to create a “C” shape, your chest slumps forward in a slouched posture. This doesn’t just result from one thing, and there are many contributing factors to the pressure that our lower backs take on from sitting.
Weak dynamic muscle:
Postural muscles make up important parts of what is often called the “core”, and are the muscles that work to keep us upright against gravity. The rest of our skeletal muscles are called phasic muscles, and those are the ones that we use for more dynamic movement. Our postural muscles are built to act in concert with our phasic muscles, helping us to accomplish complex physical tasks. Unfortunately for our bodies, sitting in a chair is not a complex task…exhausting, but not complex. For a person who sits or reclines for most of their day, phasic muscles will become weakened, leaving the postural muscles to do all the work when we’re sitting. When anything in the body has to work extra hard to make up for something else, it will quickly become overtaxed, and signal you to give it a rest.
When our overtaxed postural muscles take a rest and we create a “C” shape in a slouch, our pelvis is tilting back and decreasing the length of our hamstrings. Over time, they adapt to and operate at that length, so that even when we want to sit up, we’ve got a very important muscle group pulling back on our pelvis. Try sitting on the ground with your legs in front of you, and you’ll probably feel the pull I’m talking about.
Forward head posture:
Our eyes provide us with visual input, and when most of our attention is focused on visual input, we tend to get a bit “sucked in”. This is when your face gets closer and closer to a screen-be it your computer or smartphone. Our spine is a wonder of engineering, and made of about 33 interlocking vertebrae that are built to diffuse forces of load and gravity. When our head sits further forward in front of our center, something else has to move backward in space to balance that force, and that something is your lower back.
A little anatomy lesson
When we are developing in the womb, we are in a “C” shape, and so our thoracic(where your ribcage attaches) and our sacral(triangle shaped bottom of your spine) sections grow in that shape, and are known as primary spinal curvatures. The lumbar(lower back) and cervical(neck) sections of our spine are secondary curvatures, meaning they develop after birth. Our cervical curvature develops as we begin to lift our head, and our lumbar curvature develops as we begin walking. These secondary curvatures develop because there is force and gravity placed on them, requiring all of the structures around our spine to wake up, turn on, and adapt to new challenges of movement.
What is important to take away from this anatomy lesson is that it is the force and load that create a need for your lumbar curvature in the first place. This means patently that lumbar support is not the long-term fix, and is almost like using a crutch. Some higher-end desk chairs have been engineered pretty well and are definitely not all bad, but there are much more efficient things to help with lower back discomfort.
What can we do?
The first and most obvious answer is to avoid sitting in chairs as much. Standing desks have thankfully become very popular, and doing computer work outside of an office affords folks the freedom to move around and shift positions as they desire. Being sure to stand up and walk around intermittently throughout a day can make a world of a difference. Making sure to walk at least 30 minutes every day will also increase the strength in more of your phasic muscles, taking some of the burden off your postural muscles.
Secondly, try and set the screen you’re looking at to your eye level so you’re less likely to find your face sinking down and into whatever you’re looking at. A box under your computer or a cushion under your butt are some great examples. Using props to move your set-up around might seem silly, but anything that makes it easier for your body to function will make it easier for your mind to function.
Touch your toes! This is a generic cue that might not work for everybody, but the goal here is to lengthen your hamstring muscles a little bit, so try it out and listen to your body for how far you can go. You don’t want to stretch them out for too long at a time, so my favorite way to do this is to start standing with your legs mostly straight, roll your upper body over toward the ground as far as you can easily, stay for 30 seconds, and then roll back up to standing. Repeat this 4 or 5 times, and repeat it a couple of times a day. You’ll immediately notice a difference.
Lastly, change the way you’re sitting and what you’re sitting on. If you must be in a chair that has a back, support your back with a towel or sweatshirt rolled up and placed behind your lower rib cage, also referred to as the “bra-line”. This encourages your lower back to find it’s own natural curvature, taking the pressure off those postural muscles(it works in a car too!). A better option is to switch to sitting on a stool, as they allow freer movement of your legs underneath you and don’t have a back that you might unconsciously slump down against. It also leads to a greater likelihood of sitting with a more neutral(not tilted back) pelvis. Make sure your feet are firmly planted on the ground and that your knees are a little less than a 90 degree angle.
As with anything, each body is different. If you have lower back pain, it might not necessarily be just because you’re sitting in chairs a lot, but it most likely is a major contributing factor. Any of these adjustments I suggested are good for anybody to do, so give them a try. If after a couple of weeks you still have the same amount of discomfort, make an appointment with myself or another trusted bodyworker(and your doctor for another opinion) and explore your options.