Neck Pain: Postural Correction Strategies

Retraining neutral sitting posture is an important factor in the recovery from of an episode of neck pain and also for preventing future episodes of neck pain. Sitting postural correction becomes especially important for those of us who spend a great deal of our time working at a computer or seated at a workstation of any kind. Most present day occupations and many leisure activities (involving the internet or a mobile device) place the neck and upper back in vulnerable positions stressing many anatomical structures of the cervical spine.

Frequent correction of neutral sitting posture serves two primary functions. First, it allows for regular reduction of adverse loads placed on the joints of the spine due to poor neck and upper back posture. Second it provides a training effect to the deep cervical stabilizing muscles during their functional postural supporting role. The aim of postural correction strategies is to change postural habits, not to strengthen weak muscles. Ultimately this should result in a comfortable low effort strategy which is easily assumed and maintained during prolonged sitting activities. Rigid high-effort correction of sitting posture should always be discouraged as this often results in increased muscle activity and pain.

Key Aspects of the Seating Surface

  • The feet should be flat on the floor
  • The thighs should be slightly inclined downward from horizontal (hips slightly higher than knees)
  • The buttocks should be completely supported by the seating surface
  • Go here for more tips on computer ergonomics

Sequence of Correcting Sitting Posture

  1. Gently roll the pelvis back and forth until sitting on the bony prominences deep within the buttock (ischial tuberosity). This will restore the natural curve (lordosis) in the small of the low back. This first step is the most important.
  2. Without arching or extending the spine, slightly lift the breast bone (sternum). Minimal correction should be needed here.
  3. Finally, slightly lift the back of the head towards the ceiling in order to achieve a neutral position of the eyes relative to the horizon. If steps one and two are performed correctly, minimal to no correction will be needed at the head and neck.

The neutral position should be comfortably maintained for ten seconds and repeated every 10 to 20 minutes during sitting. A timer is recommended to ensure adherence to the schedule. In between repetitions of the postural correction exercise a relaxed non-rigid posture should be assumed. We should not attempt to maintain “the perfect posture” during prolonged sitting. This is not recommended or realistic. Over the course of several days or a few weeks of practice, the neutral sitting posture will be more easily attained without conscious thought. Through self-awareness the body will learn this new strategy just like any other practiced skill ultimately leading to a healthy postural habit requiring little effort or conscious thought.

Now go ahead and try it….then re-read this blog post for reinforcement.

References

  1. Falla, D., O’Leary, S., Fagan, A., & Jull, G. (2007). Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Manual Therapy, 12(2), 139–43.
  2. Wegner, S., Jull, G., O’Leary, S., & Johnston, V. (2010). The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Manual Therapy, 15(6), 562–6.