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Positions and Postures

Updated: May 16, 2021

There is no denying that some postures are better than others. However, are we able to maintain “optimal” posture continually all day? Definitely not. That being said, understanding the best postures to strive to achieve will go a long way to keeping you feeling well.

I try to leave rationalizations aside, as they distract us from what we really need to see.

The feeling of urgency moves me, and I let it guide me.


Sitting – First off – Sitting as the new smoking is not far from truth, but as many of us are forced to sitting mind a few tips. Starting off, keep your hips above your knees. Too much time spent sinking into couches, or with malpositioned office chairs will cause issues in the hips and lower back. Second -- lumbar support! Your lower back is designed to maintain a slight curve. When we sit in positions where this is not maintained the passive structures (discs, ligaments and joints) are under stress. Finally -- sit upright! Try to aim to line up your ear, shoulder and hips. Slouching is an epidemic which causes a domino effect of symptoms; headaches, neck pain, upper back and shoulder stiffness to lower back pain. As society becomes more sedentary optimized sitting positions will be more important in the constant battle of fending off sitting related injuries (which are surprisingly common).

Standing – As with sitting it is important to try and maintain an upright position. Mind the slouching. Keep your shoulders slightly engaged backwards with a slight tuck in the chin. Standing is easier on the body than sitting but maintaining one static position for excessive periods can come with consequences.

Sleeping – As we sleep for 1/3 of our life (give or take) ensuring positions that keep our spine in a neutral, stress free state is important. First off – get off your stomach! Stomach sleeping is horrible. There is no way to keep the neck in a neutral position, causing cranked facet joints for long periods of time (queue that notorious morning neck ache). Not to mention the joint compression in your middle and lower back throughout the night.

The side lying position can be adequate if properly measured pillow height and a pencil straight position (or nearly) can be maintained. The optimal sleeping position is on your back, with the proper pillows arranged. The stress to the back is minimized in this position and always recommended.

Start thinking a bit about these positions and postures you find yourself in throughout the day, especially the ones that are held for prolonged spans. Many patients suffer unnecessarily when small modifications would make a world of difference.

Dr. Greg Tollefson

Expert in the diagnosis and treatment of musculoskeletal disorders



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