Dr. Dan Michael
Dr. Dan Michael
Telling someone to “sit up straight, shoulders back and head up” might have been good enough for the Victorian era, but it has not done much for the likes of the modern 21st century desk worker who suffers from epidemic levels of lower back and neck pain.
As it turns out, neck and back pain is a difficult problem to solve, and, ironically, some people even give themselves a back injury by trying to work on their posture too hard, doing too much of the right thing and not enough of another. While antiquated posture advice might have gotten us this far, posture, like many things in nature, responds best to a balanced approach.
Good posture is truly a balancing act that thrives best when the right pieces get put in the right places, and here is how to do that.
Last month, I wrote about the importance of your core and the connection to your breathing. This month, you will get the opportunity to practice your newfound skill in the sitting position, and with good posture. Historically, posture advice from experts has focused almost entirely on what the back, neck and shoulder muscles are doing, and rightfully so. After all, it only makes sense that you would want to control these back muscles, but what about the front muscles?
When you sit or stand, your brain naturally activates your back muscles to put you in the upright position, often without any conscious effort, and thankfully we do not have to think about these muscles, otherwise it would be impossible to walk and carry on a conversation at the same time. But by focusing on your core and your breathing, you will be able to help your spine balance the tension from front to back, easing some of the stress that your back muscles place on the joints and discs of the spine.
This is why, in some cases, people who try too hard to “sit up straight” and have “good posture,” without balancing the front-to-back equation with core and breathing tension, end up injuring themselves, causing even more back pain, and often leaving them wondering if they need space age technology to simply sit at their desk without experiencing pain.
Unfortunately, many of these cases never learn to breathe and brace effectively with their posture and relegate their condition to increasingly more and more aggressive forms of medical management to ease their suffering.
While it is important to pay attention to where the muscles in your body should have tension, it is equally important to observe where there should not be tension.
Generally, having excessive tension where your natural spinal curves change direction is problematic. These include where your pelvis meets your lower back, where your lower back meets your lower ribs, where your upper back meets your neck, and where your neck meets the back of the head. In spinal anatomy, we call these “transitional junctions” because it is where the spine begins to curve the opposite direction (and the vertebra change shape, too). These junctions help form our natural spinal curves, but forming these curves to excess with strong spinal muscle tension can cause injury.
Secondly, the muscles of our limbs (hips and shoulders) should never carry chronic tension on the front side of our body. For example, think about what happens when adults go into the “fetal position” as a self-protective mechanism from imminent threat; the hips become flexed to protect vital organs, and the shoulders cave in and elevate to protect the chest and neck. Carrying chronic tension like this leads to preventable chronic pain, muscle tension and fatigue.
Generally speaking, we can now see a trend begin to emerge as it becomes clear that our trunk area suffers from a lack of front-sided core tension, which ultimately makes our back muscles work harder. Conversely, our limbs suffer from a lack of back-sided, glute and shoulder blade tension that ultimately make our hips and shoulders work too hard. These two concepts tend to become more and more challenging as we age, as gravity takes its toll, and as our weaknesses give rise to the aches and pains that we encounter throughout our lives because of our poor posture.
Now you can have a 21st century approach to posture right now in your own home.
Start by sitting upright, with your head on top of your shoulders, eyes looking forward.
Your ear opening should fall at the level of the hip bone, not in front or behind a plumb line that would be seen from someone looking at you standing from the side.
The ends of your collar bones should also pass through that line as well, as a guide for where your shoulder blades should be positioned.
Your shoulders should feel like they are being lightly “shrugged down” away from your ears, but without any tension in your arms or forearms.
Your head should feel as if you are making a very slight “double chin” motion, not too hard, to help guide your neck into an elongated position.
There should be some, but not too much, tension in your core, and you should be noticing how the tension in your stomach increases with breathing in, and how your core muscles follow the air out as you breathe out. Generally, there should be enough tension to balance a glass of wine on your belly if you were laying down.
Your hips should be relaxed in the front, with your core doing all the balancing work needed to stay upright.
Set a timer to go off every 30 minutes to remind you to take a moment to be conscious of your body, where there may be tension, where there is lack of tension, and that you may need to breathe.
For older spines, some of these directives may be anatomically impossible to achieve due to the natural course of spinal aging, so do take precautions when doing these exercises, and, as always, for all readers, if you have any health concerns about any of these practices, do ask your doctor before performing them.

— Dr. Dan Michael is a chiropractic physician at NW Sports Rehab, 1929 43rd Ave. E., Madison Park. Call 206-328-5466 for more information.