Features March 2003 Issue

Good Habits Can Save Your Back

Learn to sit smart, lift smart and sleep smart to reduce your risk of future back pain and problems.

You don’t have to wait for a problem to occur before getting involved in the care and maintenance of your back. Whether you’re in bed, in front of the TV, driving to work, or simply bringing groceries in from the car, there are a number of immediate steps you can take to improve the alignment of your back and reduce risk of injury, even after years of bad posture.

All of the advice for better ways to sit, sleep or lift comes down to alignment—getting into a posture that helps ensure that your spine and supporting ligaments and muscles are aligned so that they maintain the natural curves of your back. A healthy back has several natural curves, including the inward one of your lower back; this one is called the lumbar lordosis and is key, since it is often lost through poor posture.

“Maintaining the natural curves of your back is important,” says Ilona Heintz, P.T., clinical supervisor of outpatient rehabilitation at the Cleveland Clinic Spine Center. “When you’re in correct posture, the muscles that support your spine work most efficiently. This helps diminish stresses on deeper structures and minimizes muscle strain.”

If you flatten or reverse your normal curves, the postural muscles become less effective at supporting your spine. This can lead to extra wear-and-tear on your vertebrae and intervertebral discs and puts you at greater risk of arthritis and pain. Keeping your bones and joints in proper alignment allows your muscles to work efficiently, lessening abnormal wear on the surfaces of your joints.

Sit Smart
Good posture seems to go out the window most often when we sit, whether in the car, at our desks, or in front of the TV.

“Many people are so accustomed to slouching that they don’t know how to sit up straight anymore,” says Heintz. “For them, correct posture may not feel normal at first but, like any good habit, it will get easier over time.”

To get a feel for correct sitting posture, the next time you sit in a chair, first get in a slouching posture, then exaggerate sitting upright, then back off that about 10 percent to find your neutral or natural position. Go through this sequence at least ten times to become more aware of your posture and conscious of correcting it. This slouch-to-overcorrect exercise also begins to train your postural muscles, front and back.

To sit smart and keep the curve in your lower back, make sure you choose a chair or car seat with good lumbar support, and then scoot your hips all the way to the back of the seat, lift your chest slightly, lower your shoulders, and keep your chin level. Keep your chair close enough to your desk so you don’t have to lean forward to reach the keyboard, mouse or view the monitor. Move your car seat far enough forward so that you don’t have to slide forward in the seat to reach the pedals.

No matter how good your posture, you shouldn’t sit in the same position for more than 30 minutes. Heintz recommends that whenever you stand up or get out of a car, after a longer period of sitting, take a few minutes to do a few back bends. Stand with your feet slightly apart, and place your palms on the small of your back. Then, keeping your knees straight, bend backward at the waist as far as possible and hold the position for two seconds. Repeat this eight to ten times.

“This helps counteract the forces of sitting,” says Heintz. “It’s kind of a rebalancing exercise.”

Sleep Smart
Sleeping is another daily activity in which you can take steps to ease the strain on your back. Heintz discourages against sleeping on your stomach because, if your mattress is soft, you tend to over-arch your lower back. This position also subjects your neck to added strain, since it is sustained in a position of extreme rotation.

Instead, learn to sleep on your side. A pillow between your knees reduces twisting of the spine, and a small pillow or towel roll placed under the waist helps keep the spine from sagging sideways. Sleeping on your back is acceptable, too. A pillow or towel roll can be placed beneath the small of your back to support the lumbar curve. And when it’s time to get out of bed, avoid straining your back by turning completely to the side and then raising your upper body by pushing off with your arms as you lower your feet from the mattress.

Lift Smart
The risks of poor posture and alignment are multiplied when you lift an object and put added stress on your spine. All the more reason to take extra steps to stabilize your back before lifting.

The first rule is to bend at the knees and hips instead of the waist when you start to pick something up. Plant one foot slightly ahead of the other, and keep your shoulders back and your spine as steady as possible.

“When you’re about to begin lifting, consciously tighten your abdominal muscles and reach back with the hips to maintain your lumbar curve,” says Heintz. “This gives added support to your spine.”

To further minimize strain, carry the load as close to your body as possible, and avoid twisting or turning at the waist when changing direction. Instead, first point your feet where you want to go, then move in small steps.

Whether in bed, in front of the TV, or in your car, there’s a lot you can start doing right now to help protect your back from unnecessary stress and strain.