Posture is often tied to spinal health, with a prevailing belief that incorrect sitting, standing or bending leads to spinal pain. That perspective is not strongly supported by the evidence, yet an entire industry thrives on products and interventions aimed at correcting posture.
Common beliefs and the evidence
Health professionals often advise maintaining a neutral posture while sitting, bending or lifting. The Australian manual handling guidelines also promote a straight or slightly bent back during lifting tasks.
No conclusive evidence exists that specific spinal curvatures correlate with pain prevention.
What we are told, and what the research shows
The advice
- Hold a neutral back while sitting, bending or lifting.
- A straight back is the safe back.
- Correct posture prevents pain.
The evidence
- No single spinal curvature is proven to prevent pain.
- Bending is not shown to be dangerous in itself.
- The link between posture and pain is not well supported.
The fitness industry and the core
The fitness industry often emphasises activating core muscles to maintain correct posture. Again, there is no solid proof that such practices prevent or reduce pain and disability.
Strength work is worth doing. Doing it because your spine is fragile without it is a different claim, and it is not one the research backs.
The influence of media and culture
Media and cultural stereotypes contribute a great deal to our posture beliefs. Fear inducing messages in mainstream media, and long standing views linking posture to personal attributes, reinforce unhelpful ideals.
Where the beliefs come from
Mainstream media
Fear inducing messages about what sitting is doing to you.
Cultural stereotype
Posture read as a signal of character and confidence.
Product marketing
Equipment sold on the promise of correcting you.
What we see in the room
Practitioners observe that people with low back pain often show more trunk muscle activity and avoid certain postures out of fear. That guarded movement can be counterproductive.
The job is to help people adopt relaxed postures, and to make clear that those postures are safe and can relieve symptoms.
Changing the posture narrative
The key is to shift away from a single correct posture and recognise the spine as robust and adaptable. Sitting for extended periods is not inherently dangerous, and variety of movement is useful.
One posture, or many
One posture
Health professionals often advise maintaining a neutral posture while sitting, bending or lifting.
Guarding
People with low back pain often show more trunk muscle activity and avoid certain postures out of fear.
Many positions
The key is to shift away from a single correct posture and recognise the spine as robust and adaptable.
Changed often
Sitting for extended periods is not inherently dangerous, and variety of movement is useful.
Pain is rarely explained by normal posture variation.
The myth, and the better approach
The myth
- There is one correct posture.
- Sitting for long is inherently dangerous.
- Pain means you sat badly.
The better approach
- Many comfortable positions, changed often.
- Variety of movement through the day.
- Pain is rarely explained by normal posture variation.
Beyond the studio
Reframing the posture narrative means overcoming entrenched beliefs in the health and ergonomic fields. Like the shift away from recommending bed rest for low back pain, it is time to update how we think about spinal health and posture.
Redefining our approach to posture means recognising the lack of evidence linking specific postures to pain prevention, understanding the resilience of the spine, and promoting adaptability and comfort in how we move.
Worried about your posture
If posture is the thing you keep being told to fix, we will assess how you actually move and tell you what we find.
Read about postureSources
- Caneiro, J. P., O'Sullivan, P., Lipp, O. V., Mitchinson, L., Oeveraas, N., Bhalvani, P., Abrugiato, R., Thorkildsen, S., and Smith, A. (2018). Evaluation of implicit associations between back posture and safety of bending and lifting in people without pain. Scandinavian Journal of Pain, 18(4), 719 to 728.
- Caneiro, J. P., O'Sullivan, P., Smith, A., Ovrebekk, I. R., Tozer, L., Williams, M., Teng, M. L. W., and Lipp, O. V. (2019). Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous. Musculoskeletal Science and Practice, 39, 107 to 114.
- Korakakis, V., O'Sullivan, K., O'Sullivan, P. B., Evagelinou, V., Sotiralis, Y., Sideris, A., Sakellariou, K., Karanasios, S., and Giakas, G. (2019). Physiotherapist perceptions of optimal sitting and standing posture. Musculoskeletal Science and Practice, 39, 24 to 31.
- Nolan, D., O'Sullivan, K., Stephenson, J., O'Sullivan, P., and Lucock, M. (2019). How do manual handling advisors and physiotherapists construct their back beliefs, and do safe lifting posture beliefs influence them? Musculoskeletal Science and Practice, 39, 101 to 106.
- Slater, D., Korakakis, V., O'Sullivan, P., Nolan, D., and O'Sullivan, K. (2019). Sit Up Straight: Time to Re-evaluate. Journal of Orthopaedic and Sports Physical Therapy, 49(8), 562 to 564.