The PT Handbook: Posture & Pain

Stand up tall!

Author

Dr. Gerry Robles PT, DPT
October 17, 2024

Welcome! The PT Handbook is a physical therapy newsletter discussing all things physical therapy/sports medicine. This newsletter is an extension of our philosophy at Art of PT Sports Physical Therapy LLC where our patient population includes combat athletes and gym lovers. We are a PT private practice that prides itself on providing true one on one service.

This handbook will provide practical PT tips and dive into hot topics surrounding the sports rehab world. If you have questions about the field of physical therapy or need to schedule an appointment (virtual/in person), contact us with the link below!

Dr. Gerry Robles PT, DPT

Founder, Art of PT Sports Physical Therapy LLC

PT Handbook Conversation: Posture & Pain

I bet your posture is horrible. Yes, you reading this. But in all seriousness, does “bad” posture really promote increased pain or painful patterns? As I always say, it depends. But first let’s discuss just how important posture is in general.

Despite the mainstream belief that there is a “correct” or more optimal posture for humans, there is no concrete research supporting this idea (in terms of relating to pain). In other words, avoiding “bad” or “incorrect” posture isn’t that important when talking about someone’s pain (low back pain for example). There technically isn’t a right or wrong posture according to the research. It’s more so the prolonged positions/lack of movement the “modern” human is stuck in all day that cause pain. Let’s pick on office workers since they sit all day.

That prolonged sitting for an office worker is what will be their downfall (ok that’s a bit dramatic). Same can be said about prolonged standing or prolonged laying down. It’s the lack of movement, not the inherent posture itself. We as physical therapists say it all the time, “motion is lotion” or “your next posture is your best posture.” There also the psychological conditioning that may play a role. Thinking you’re “out of alignment” because of your “bad posture” is no way to live yet these are still terms that are very mainstream. It can very well become a self-fulfilling prophecy and can affect your pain levels (pain can very well be affected by your thinking patterns).

Now for the “it depends” part. It is also ok to find a less sensitive or painful posture with an acute injury that is highly sensitized/painful. Back pain is the classic example and it’s usually bending over after a painful episode. It’s ok to avoid painful positioning at first but its imperative to retrain your body and mind to not be afraid of bending over in the long term. Our spines are very resilient and are meant to move in all different directions. This is just one example but can be applied to all of the body (shoulder, neck, hip etc.). So it may be ok at first to find a comfortable posture and let your pain desensitize a bit in the short term. But long term, work with your physical therapist to be strong and resilient in all postures/positions.

If you need more detail, the “Journal of Orthopaedic & Sports Physical Therapy” (JOSPT) has a great article entitled “Sit up Straight: Time to Re-evaluate.” So check it out, it’s linked below.

Until next time,

Dr. Gerry Robles PT, DPT

Founder, Art of PT Sports Physical Therapy LLC