For individuals who sit at work for long hours, can years of practicing unhealthy posture be corrected through a step-by-step approach to ensure optimal body position while sitting?

Sitting Posture

Sitting up straight with a healthy posture requires the conscious alignment of the hips, pelvis, lower back, upper back, shoulders, neck, and head. Learning or retraining oneself to maintain correct sitting posture can relieve lower back pain, improve respiration and digestion, and reduce tension in the neck and shoulders. (Albarrati, A. et al., 2018) It starts by paying attention to posture throughout the day and correcting it whenever forward head posture, leaning, or slouching develops. Targeted exercises can also help build upper-body strength, and stretching can stabilize and strengthen the core muscles, lower back, and pelvic joints. (Albarrati, A. et al., 2018)

Sit Up Straight Guide

Sitting up straight can be uncomfortable because it is not a natural position for the body to be in for an extended time. Nowadays, work, school, appointments, and other activities require us to sit much longer than intended. The muscles also have to work against gravity, leading to muscle exhaustion, slouching, and slumping, which can cause chronic back, leg, neck, and/or shoulder pain. (Jung, K. S. et al., 2020)

Sitting up straight may seem simple, but the focus tends to be on straightening just the lower/lumbar spine. This posture is unsustainable and exhausts and stresses the upper and lower back. (Jung, K. S. et al., 2020) The whole body needs to be considered when protecting the stability and balance of the spine. Learning and maintaining the ability to sit up straight is a process that requires practice.  Find a comfortable chair to sit in, and follow these steps to achieve the optimal postural alignment (Canadian Centre for Occupational Health and Safety, 2022)

Knee Spacing

• The hips should be at a roughly 90-degree angle.

Knee Position

• The knees should be at a 90-degree angle level with the hips.
• Use a pillow to achieve the right knee position if the seat is too low.

Keep the Feet Flat on the Floor

• If feet don’t reach the floor, place a footstool, box, book, or other flat object underneath them.

Sitting Bones

• Also known as the ischial tuberosities, these are two knobby bones on the underside of the pelvis.
• Feel around to find them.

Pelvis Adjustment

• Shift the body so that the sitting bones are directly under the pelvis rather than situated too far back, stressing the lower back or too far forward, leading to slumping.

Spine Check

• There should be a slight spinal curve, and one should be able to slip a hand between the lower back and the back of the chair.

Shoulder Check

• The shoulders should be level and vertically aligned with the hips.
• If the shoulder blades are pulled back or the shoulders are lifted or curled forward, relax them into a neutral position.

Head Positioning

• The head tends to tilt too far forward while sitting as work and the day progresses.
• Adjust the head position to align the neck with the upper spine.
• The head should be slightly tilted forward, with the ears aligned with the shoulders.

Check for Pain and Discomfort

• Pain may be due to structural imbalances of the spine, pelvis, or hips.
• Use a lumbar chair support or place a rolled-up towel or cushion at the lower back to keep the back straight.

Added Tips

Tools and tricks to help prevent and avoid back, hip, and neck pain.

Chairs

• All the bells and whistles for an ergonomic desk chair are unnecessary.
• Focus on features like adjustable seat height and lumbar support. The correct seat depth recommendations are deeper if tall and shallower if short. (van Niekerk, S. M. et al., 2012)

Cushions

• If sitting on a cushion or using one to bolster the back or hips, recommendations are not to go too soft.
• Cushions that are too soft allow the ability to shift from one hip to the next, often without realizing it.
• They usually eventually flatten and lose support.

Monitor Position

• There is no point in sitting straight if the monitor is too high or too low.
• The monitor should be at eye level to maintain the proper head and shoulder alignment.
• If the monitor is too low, place a box or book underneath it.
• If it is too high, raise the chair’s height and place a footrest under the feet to keep them flat.

Avoid Crossing Legs or Feet

• Crossing the legs or feet places stress on the opposite hip, thigh, and knee and wears the body out faster.
• If the hips or legs are tiring prematurely, the individual is not sitting correctly or in the wrong chair.

Use Comfortable Footwear

• Maintaining flat feet on the floor while sitting is imperative.
• This is not possible in high heels or platform shoes.
• Change into a comfortable pair of flat shoes while sitting.

Take Regular breaks

• Even with an ergonomic desk chair, the body is not meant to be sitting for hours and hours.
• Get up at least every hour, walking and stretching to reactivate the muscles and circulation.

Try a Sitting-Standing Desk

• Sitting-standing desks have become more popular.
• A standing desk can ensure better body posture and reduce stress on the lower back when placed at the right height and position. (Canadian Centre for Occupational Health and Safety, 2022)

Sitting up straight requires body alignment awareness, stable core muscles, and balanced pelvis, hips, spine, shoulders, neck, and head positioning. It may take some time before these steps become normal, but they will become second nature with perseverance and practice. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

---

Posture and Mobility

---

References

Albarrati, A., Zafar, H., Alghadir, A. H., & Anwer, S. (2018). Effect of Upright and Slouched Sitting Postures on the Respiratory Muscle Strength in Healthy Young Males. BioMed research international, 2018, 3058970. doi.org/10.1155/2018/3058970

Jung, K. S., Jung, J. H., In, T. S., & Cho, H. Y. (2020). Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain. Medicina (Kaunas, Lithuania), 57(1), 3. doi.org/10.3390/medicina57010003

Canadian Centre for Occupational Health and Safety. (2022). Working in a sitting position – good body position. Retrieved from www.ccohs.ca/oshanswers/ergonomics/sitting/sitting_position.html

van Niekerk, S. M., Louw, Q. A., & Hillier, S. (2012). The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review. BMC musculoskeletal disorders, 13, 145. doi.org/10.1186/1471-2474-13-145