does posture matter?
Is posture related to lower back pain. The answer, as usual, is “It depends”.
Part of the reason there is so much angst about whether posture plays a role in lower back pain is a misunderstaning about tissue capacity, and a failure to recognise the biomechanical advantage of “neutral spine”.
Anyone watching Olympic weightlifting events can’t help but marvel at their ability to lift such enormous weights. That they – and other sports such as powerlifting and strong men competitions – can do so is because of neutral spine. This is simply the position in which there is a relaxed, comfortable inward curve (lordosis) of the lumbar spine.
If posture didn’t play a role in lower back pain, then why don’t you see these athletes lifting with a flexed spine?
The spinal discs are composed of a material called collagen. The disc is composed of rings of collagen in which the fibre direction changes with each layer, and with each layer tightly bound together.
Constantly flexing the spine can gradually delaminate these rings, and lower the tissue failure threshold to nil, so that even a relatively minor event like bending over to pick up a pencil causes back injury.
But there is also a load component to bending tasks. Someone who bends over to tie their shoes may never delaminate the collagen in their discs. If they worked in a specific job such as a storeman, and were constantly bending forward with load, the delamination happens more quickly.
So there are a variety of factors in play in regards to posture and low back pain. Body type, disc shape, hobbies and sporting activities, occupation and mobility can all affect how you move, how much you move and whether it is more or less likely that some form of disc injury may occur.
Bending over for daily tasks such as tying shoes or looking in the refrigerator may or may not cause low back pain. It depends upon a variety of other factors, such as body shape and load.
The hips are a ball and socket joint, with both joint surfaces lined with an extremely slippery tissue called hyaline cartilage. These surfaces and structures are clearly designed to facilitate bending and other movements. In comparison, the circular nature of the lumbar discs, allows flexion for daily tasks, but the discs are not designed to be prime movers.
Poor posture can lead to what is termed, appropriately enough, posture-related back pain.This is generally a muscular disorder, in which people who slump in their chairs at work, or sit on the edge of a chair too much, develop a fatigue-based pain because the muscles of the spine are having to work harder to stabilise the spine.
The hip hinge pattern is one of the fundamental ways of moving in cultures where back pain is rare.
According to the world’s foremost spinal expert, Dr Stuart McGill, not only is the technique spine-sparing, but it mimics the way our bodies are designed to move.
Individual factors such as flexibility and mobility will determine how far you can actually hinge, which is why other movement patterns such as the lunge and golfer’s lift, are trained.
The disc is part of the passive system of spinal stability. Once a disc is injured, it can heal, but it cannot be strengthened, which is why the active and neural systems are emphasised in rehabilitation. Constantly bending forward using the lumbar spine means the posterior lumbar musculuture switches off, which is termed the flexion-relaxtion phenomenon. As a result, the discs are exposed to excessive load and injury results.
Whilst neutral spine is the best way to lift things in life, when seated, a variety of postures is actually more important than maintaining a single posture throughout the day. What is also important is not to spend more than about an hour sitting in any one position before getting up and briefly moving around. Even more importantly, if you do sit and then have to lift, it is advisable to wait a few minutes before heavy lifting to allow the hydrostatic pressure within the disc to return to normal.
The golfer’s lift, squatting patterns and the lunge are all superior movement patterns that are part of Stuart McGill’s spine hygiene approach, reserving spinal flexion for those times it is needed.
Back pain isn’t for life – unless you want it to be.
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Does lifting technique matter? Yes. However, depending upon the object, individual mobility and strength, there are several methods to safely lift things from the floor or ground that minimize stress on the lumbar spine.
Does posture matter? Generally, yes. Poor posture - however that is defined - leads to a gradual deterioration in the quality of the lumbar spine tissues, which lowers their failure threshold.
Weak gluteal function may be a contributing factor to your lower back pain. Why? The reason is actually simple. If our glutes are weak, then the lumbar spine has to compensate to extend the hip.
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