Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
15 Oct

How to Improve Your Posture

spineJust because Conventional Wisdom seems to get almost everything wrong when it comes to effective fitness, proper human nutrition, and preventing degenerative diseases, it doesn’t necessarily follow that all official recommendations and prescriptions are faulty. Cigarettes are bad for your health, for example, and drinking and driving actually do not mix. Those are two obvious examples of CW getting it right, and there are definitely a few others, but today, I’m mostly interested in the popular concept of good posture. What is posture? Is “good posture,” as defined by chiropractors, teachers, office ergonomic consultants, drill sergeants, and Grandma (“straighten up, sonny!”), actually good for us? Or have the experts gotten it wrong, once again? Looking around me, if people are listening to the professional advice, it’s bad advice. Slumping, slouching – I see it everywhere, every day, and not just when people are sitting. Can we apply the Primal Blueprint approach to posture and toss it all out?

First, let’s look at how posture has changed over the years in a developed nation like the United States. Before the turn of the 20th century, austere, rigid posture was very much in vogue – or, at least, it was heavily promoted by teachers and authority figures as the right way to sit and stand (corporal punishment, anyone?). Think Victorian. Think stiff and crusty. In the 1920s, though, an entirely new cultural phenomenon emerged. Jazz exploded and “The Great Gatsby” was written. The flappers – independent women who flouted convention, listened to jazz, wore short hair, and drank liquor – became the model for young American women to emulate. The hair, the fashion, and the dancing were all fair game, and rightly so, but so was the signature flapper slouch. Instead of standing prim and proper, the corset-less flapper thrust out her pelvis and slouched backwards, hands on her hips. It looked effortlessly cool enough, but it wasn’t good for back health.

Flappers2001230258

Look familiar? That’s the same pose you see at red carpet events in Hollywood, where every starlet seems to employ that bizarre half-turn followed by a tuck of the pelvis forward when faced with a camera. It’s “slimming,” or something. Anyway, focusing on chronic postural deficiencies in a subculture may seem odd, but the long-term reverberations can be felt for decades, if not centuries. Besides, it’s a simple fact that society is influenced by culture, especially youth culture. Cultural adoption of slouching certainly isn’t the sole reason our posture is so messed up, but it’s probably a contributing factor.

Another factor is the rise of sedentarism – all that sitting is hell on our backs. As I mentioned in the previous sitting post, most work takes place from the (dis)comfort of an unnatural office chair, whereas in earlier times we’d actually have to move around for our livelihoods. Even those formerly active jobs, in the manufacturing or farming sectors, have been largely automated. Physically demanding tasks demand correct posture, because they’re easier and more sustainable that way. They’re kind of self-policing in that respect. But it goes the other way, too; the easier you make the job, the easier it is to get by with poor posture. If all the “heavy lifting” is done by machines, the worker is free to slump and slouch.

Oh, and the fact that sedentarism leads to muscle atrophy and inadequate exercise doesn’t help, either. And when they do get to the gym, it’s usually to do bicep curls and tricep extensions for an hour. Very few engage their core in any meaningful way. Functional fitness is enjoying a resurgence, but the “biceps, chest, and tris” split-style training still dwarfs it in popularity. If everyone did deadlifts, squats, and Olympic lifts with perfect form on a regular basis, our backs would be a lot stronger and our posture would be a lot better.

So, we’ve got influential youth sub-cultures, sedentarism, and inadequate fitness to (at least partly) blame for our posture problems, but how do we fix it? And is posture really that important? We seem to be getting by okay, all things considered.

That’s what they say about the Standard American Diet: “Oh, but look at our life expectancy. We live longer than ever!” How’s that really working out for us?

Poor posture is incredibly damaging, both to the individual and to society at large. The very obvious downside to poor posture is the debilitating physical pain that accompanies it. If you spend your days sitting, standing, and walking with a fundamentally flawed posture, you are going to be hurting. It may not hit you right away, but it will catch up with you, and if you want to live a long, active life a healthy back is pretty much required. Remember, too, that the spinal cord is essentially a high-bandwidth system for the transfer of information between nerves, organs, and other parts of our anatomy. If your posture is poor and your spine is impacted, some experts even suggest your ability to process information and relay data will be compromised.

It’ll hit you especially hard in the wallet, too. One study showed that for patients who complained of lower back pain – which was over a quarter of those polled – average medical expenditures were 73% higher than those without lower back pain. Those expenses don’t just disappear into the ether, either; they result in higher premiums across the board for all enrollees, so even if you have perfect posture, you’re paying for those who don’t. We’re all paying for it.

So what’s the answer? What is good posture?

Esther Gokhale has a pretty good handle on posture. She is a “back whisperer.” She grew up in India, earned a biochem degree from Princeton, and suffered with debilitating back pain for half of her life. When back surgery didn’t work (protip: it rarely works), she decided to get to the root of the problem and figure out what does work for back pain. She didn’t try every new-fangled treatment, though. Instead, Gokhale (unwittingly) channeled Weston Price and traveled to those cultures where back pain is virtually unknown despite men and women working long hours of backbreaking labor. She went to isolated African, Brazilian, and Indian villages to mimic the gait, the stance, and the posture of the inhabitants. These guys have been doing it right for centuries, and we all share the same genes and the same basic skeletal system, so it makes sense that what worked for them will work for the average Westerner (sounds pretty Primal, huh?).

The key to avoiding back pain (and, it turns out, achieving healthy posture) lies in the pelvis. Or, rather, the key lies in the positioning of the pelvis. Popular posture advice tells us to tuck the pelvis, to bring it forward. Tucking the pelvis is conducive to achieving that arched, S-curve back that the experts say is healthy and natural, but it’s actually counterproductive to sustainable, healthy posture. Gokhale blames medical professionals for that one, suggesting that the constancy of seeing patients with poor posture (which is almost everyone in developed nations) has conditioned doctors to consider the average S-curved back as normal and actually ideal. It’s not, though. The ideal posture should be mostly straight (or J-shaped, with the bottom curve of the “J” representing the curve of the anteverted pelvis), and it should be effortless and natural.

Instead of tucking the pelvis, think about “ducking” it, as in Daffy Duck. Look at his posture: pelvis back, butt slightly out, torso leaning forward. It’s exaggerated, but we want to keep that posture in mind. The technical term is anteverting the pelvis. Think about moving your pelvis back, as if you were a fat guy trying to look down at his toes. Allow your heels to bear your body’s weight as you move your torso slightly forward. Moving your torso forward may feel like excessive leaning, but that’s okay; this is a bit like going barefoot after a lifetime of wearing shoes, so it’s going to feel unnatural. Relax your abdominals. Now, check yourself out in a mirror. You may feel different (I did), but your back should be straight and you should actually look completely normal. It’s rather sad, but it feels strange because we’re just not used to standing with correct, natural posture.

I’ve rarely mentioned posture in the past, and I regret that. Going forward, I think we’ll be revisiting this subject with more frequency. I’m also going to give Gokhale’s ideas a trial run, but I’m pretty confident she’s on the money. After all, there’s always been a soft spot in my heart for research that uses anthropological evidence.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. http://www.solution4pain.com

    it works….that is all

    Chris wrote on October 15th, 2009
    • You’re a to0l… THAT is all.

      sp@m-revealer wrote on October 15th, 2009
    • I think that’s a bit spammy dude.

      Gordie Rogers wrote on October 15th, 2009
  2. “Popular posture advice tells us to tuck the pelvis, to bring it forward. Tucking the pelvis is conducive to achieving that arched, S-curve back that the experts say is healthy and natural, but it’s actually counterproductive to sustainable, healthy posture.”

    I’ve never gotten that advice. Based on my experience, your suggestion to “duck it” is the only good posture advice I’ve ever heard given.

    Hortense wrote on October 15th, 2009
    • Tuck, duck… are all these US-based terms? I find them not specific enough for those of us who do not live in the US. I pretty much thought by antevert you meant anterior pelvic tilt? More specific terminology and pictures would have helped!

      Pilates instructor
      (talking for the benefit of the masses)

      cis wrote on October 24th, 2012
  3. Great post, as usual! I am still working on the sitting posture, but welcome the new added info. I wonder how important head/neck positioning is? I notice I tend to look down a lot (so I don’t trip?) with my head slightly forward of my spine, shoulders slightly rounded forward. I am working on staying more upright and will try to pay attention to pelvis angle.

    The descriptions are always hard for me to visualize. A photo or diagram would do wonders for my comprehension.

    Rodney wrote on October 15th, 2009
    • Head and neck posturing are definitely important. I’ve just been trying to figure out my own issues with my shoulders rounded forward and my head forward. I spent a fair amount of time in bodybuilding websites to figure it out, because it’s actually an imbalance between your chest and back, specifically weaker back muscles. I’ve spent years in the military doing piles of pushups, but now have to figure out how to work my back without an expensive gym membership.

      Jesse wrote on February 26th, 2011
  4. I’m curious…

    Is laying on your stomach for an extended period of time bad for your back?

    Jess wrote on October 15th, 2009
    • It can be very bad for creating too much lumbar lordosis.

      Jai wrote on October 15th, 2009
    • Yes, I have often found that most people who have suffer from back pain (or an anterior pelvic tilt as their normal posture) tend to sleep on their stomachs.

      cis wrote on October 24th, 2012
    • If doing for too long, but here is the right way to lay on your stomach. slightly tense your glutes and you will see that your lumar lordosis goes back to neutral.

      Jeff wrote on January 12th, 2013
  5. Great post, Mark. Posture is so important yet so misunderstood and overlooked. I highly recommend the Egoscue method – an amazing yet simple way to get your body back into alignment and be pain-free.

    David wrote on October 15th, 2009
  6. Your posture can be influenced by muscle imbalances. Too much pushing excercises (guys doing too much benching) and not enough pulling can develop shoulder imbalance and create that classic hunch back chronic bench presser look. Tight hip flexors and tight hamstrings will influence hip alignment. So, the key could be optimal joint balance by creating optimal muscle balance.

    Kishore wrote on October 15th, 2009
    • Yes, we’ll be covering this topic in future posts. Thanks, Kishore!

      Mark Sisson wrote on October 15th, 2009
  7. Jess,
    A very primal Chiropractor that I visit claims laying on your stomache is bad for a number of reasons. Inorder to breath you need to keep head to one side for extended period of time (rather than stuffed in a pillow) causing neck and shoulder problems long term). Best sleep is obtained laying on your back with no pillow (like Grok?). back is in natural straight position and breathing is effortless. Fetal position is 2nd best but again tough on neck and shoulders.

    Which all brings me to the subject of Chiropractic. I beleive it is the best form medicine. Letting the body heal itself with out the use of drugs. Hey Mark how about a blurb on chiropractic? Good or bad. I vote good.

    Barney Rubble wrote on October 15th, 2009
    • Chiropractic the best medicine. Since when? I think you should do more research. Chiropractic care can shear your disc and joints.

      Its more about getting your muscles balanced and contracting and releasing.

      Jeff wrote on January 12th, 2013
      • Shear your disc and joints? Perhaps you are the one who needs to do some more research.

        Jay wrote on March 16th, 2013
  8. Mark, I cannot help but wonder if beds contribute to poor posture. Wouldn’t simple firm ground for sleep be analogous to walking barefoot?

    Wyatt wrote on October 15th, 2009
  9. I strongly disagreed with this advice the first time I read this post. I have been trying to improve my posture for about a year now, by consciously rotating the pelvis as suggested by conventional wisdom (CW) and keeping the abs tight, nearly constantly.

    this post makes me re-think this approach. natural weightbearing in the spine + allowing diaphramatic breathing = it must be right.

    mike wrote on October 15th, 2009
  10. I begun reading Esther Gokhale’s back book two weeks ago, mostly out of curiosity and also because she uses pictures and observations of traditional cultures as samples and to make her points. I believe that a slight anteversion of the pelvis is an important point to keep in mind, while relaxing the abdomen. In looking at the most active cultures untouched by modern technologies, you see this common pelvis position.

    Gokhale’s book should have a home on every primal bookshelf.

    Ogg the Caveman wrote on October 15th, 2009
  11. This “ducking” posture sounds exactly like the posture I (and everyone else?) uses while standing at the top of a heavy squat lift. Maybe it is just natural that your posture is forced to be correct when you have a lot of weight to held up by your back.

    Shawn wrote on October 15th, 2009
    • Great observation.

      Josh Roman wrote on October 16th, 2009
  12. I just got over a period of bad posture. It was hard, but over time I was standing and sitting correctly, no slouch. One of the awesome benefits besides just feeling better is that you stand a couple inches taller!

    Martin P. wrote on October 15th, 2009
  13. Conditing Research blog had a really good post about this some time ago, complete with a movie!
    http://conditioningresearch.blogspot.com/2008/12/more-posture-stuff-this-time-from-jean.html

    jennifer wrote on October 15th, 2009
    • The video no longer exists. Boo

      sjoshua wrote on September 23rd, 2013
  14. Thanks for this post Mark. I have read so many conflicting advice on posture it is maddening. I’ll try the Daffy Duck, but I must say that my hip and back pain after doing intervals (which I chaulk up to bad posture) have all but gone since I started training barefoot!

    HIIT Mama wrote on October 15th, 2009
  15. Good post, Mark. I’m glad you wrote that posture isn’t everything. I’m a physical therapist with lots of rather primal thougths on this. I probably could write a book.

    Just a few thoughts:

    – the best posture is the next one! (Best tip you can get!!!!)

    – good posture is better than bad, but variety of postures is better, and variety between posture and movement is best! (I think Grok would say: Duhuh)

    – there’s a lot of inter-individual difference. Some need to flatten, some need to hollow the back.

    – there’s actually not very much literature (peer reviewed) relating pain to posture. This is probably because of some reasons:
    – there is no relationship
    – there has not been done any good research
    – the interindividual differences create a sort of wash-out effect (minus one + plus one = zero)

    – many people with ‘good posture’ experience have chronic back pain, some with bad posture haven’t

    – motor control (coordination, technique, …) is more important (and correlated) than posture!

    Some on the paleo/primal/… talk about n=1 lifestyle. Posture is something to experiment with.

    cheers,

    pieter d wrote on October 15th, 2009
  16. Oh, one more thought:

    Correcting posture could be a bit like correcting your omega6/3 ratio. It is important pain free functioning or health, but there’s more to it.

    pieter d wrote on October 15th, 2009
    • Thanks for chiming in for the physical therapists out there! Variety of movement and function is key!

      JulieD wrote on October 16th, 2009
  17. Hi Mark,
    This is unrelated, but pertains to your Crossfit presentation. I’d love to see the video! Just hoping you will post it on the blog.

    Mikeythehealthycaveman wrote on October 15th, 2009
  18. Mark (or anyone) please post pictures/diagrams. I’m having trouble visualizing a proper posture.

    Jolly wrote on October 15th, 2009
    • So’m I. I tried doing the daffy pose, but that just jutted my gut out and I hardly doubt that’s strong and healthy. Not to mention unattractive.

      paleo_piper wrote on October 15th, 2009
  19. Mark,

    Are you sure your butt should be out like Daffy Duck for proper posture? I’ve always thought I’ve had pretty solid posture, but I definitely don’t do that.

    In fact, I just tried it and it really looks sort of funny.

    -Rafi

    Rafi Bar-Lev at Passionate Fitness wrote on October 15th, 2009
  20. The tilting back of the pelvis may be a bit more easily achieved with a simultaneous lifting of the ribcage (while allowing the shoulders to sit down and back.) This occurs more easily with well-developed core strength.

    Some of you may laugh, but learning to dance Ballroom and Latin is a good way to improve posture; and Argentine Tango, which is danced from a strong core with the hips back, is ideal. There’s also an additional advantage of having to learn to breathe properly while maintaining good posture.

    There was an article just in last few days somewhere about good posture and its positive effect on brain function; if I can remember where I read it I’ll post a link.

    KC wrote on October 15th, 2009
    • There’s nothing like trying to learn Argentine Tango to find out your posture and balance are totally off.

      The posture work is 95% of learning the dance — at least for me.

      KD wrote on October 16th, 2009
  21. Mark,

    You and Esther are right, but there’s a very large discrepancy between “ducking it” as a result of functional muscle strength/tissue health, and “ducking it” by forcing a non-functional pelvic girdle into that position.

    I think it’s important to make that note, and help people to get into functional strength and stability. Then the pelvis will naturally fall into the position you describe.

    Josh wrote on October 15th, 2009
  22. Can you post pics of humans “tucking it” vs “ducking it” because I’m really not getting it. Tucking the pelvis flattens the butt but also gets rid of the S-curve, from what I understand. And I don’t get how you can flatten the S-curve while putting the butt out.

    Sonya wrote on October 15th, 2009
  23. I agree with the pics thing.

    While I can picture it, I would like to look at the specifics…

    Tara tootie wrote on October 15th, 2009
  24. I actually have the opposite problem – after injuring my back in 2006 I developed spinal lordosis – or “duck butt” according to my girlfriend! Example picture here: http://www.pilates-et-al.com/assets/images/photos/workshopsLordosis.jpg

    It is very detrimental when it comes to exercise – anything overhead (shoulder presses, overhead squats, etc.) are very difficult as a spine with too much lordosis cannot properly support the weight. The common advice is to “keep the weight over your spine” which cannot be safely done when the base of the spine is pushed back further than the rest.

    Every day, especially while working, I have to make a conscious effort to “straighten” my spine, eliminating the exaggerated curve and tightening my core. I have yet to see much improvement after almost 3 years of physical therapy and CrossFit so I am debating getting a lower back scoliosis brace.

    Mark wrote on October 15th, 2009
  25. Mark, Would be great to see pics of each position as Sonya requested.

    dave wrote on October 15th, 2009
  26. There’s a youtube video with Esther Gokhale giving a lecture at Google… worth a look.

    The part I found most useful was when she talked about rolling the shoulders up and then back.

    Also (not relating to posture) there’s a guy who did a study and came up with the most effective exercises to prevent lower back pain, I forget who it was, but it seemed like a good thing.

    soop wrote on October 15th, 2009
  27. Hey Mark,
    How about ppl with Limb Lenght Discrepancy?
    Should we continue to use our shoe lift?
    have you any thought on this issue?

    ian wrote on October 15th, 2009
    • I have a leg length discrepancy on 15mm. My chiropractor recommended shoe lifts, which I used for years. Then when I had some back pain when I was at university, I went to a physio therapist and he said get rid of them. He said the body adapts. Since then I have tended to have less back pain on average. However, I’m not sure if it’s right.

      Gordie Rogers wrote on October 15th, 2009
      • hmm 15mm is exactly what I have.
        My back pain and sciatica have disappeared since using a 10mm heel lift for all activities, and being treated with ART.
        I really wish my body would adapt, but looking at x-rays of the functional scoliosis in my spine when standing without the lift does not make me happy.
        with the lift my spine in x-ray looks fairly straight.
        my chiro says to use the lift, but it does not let me be barefoot to much!

        ian wrote on October 15th, 2009
      • The key to using a lift in the shoe is don’t just lift the heel you need to lift the whole foot. And your body will adapt to inequity but not always in a good way. My daughter has a LLD and her body has developed rotoscoliosis because of it. The key to posture is in the pelvis but you want the sacrum and SI joints to bear the weight because thats how we are designed, and the eyes will always seek out the horizon, the brain will figure out a way to do this any way possible, this can cause a lot of muscular inequity,resulting in pain. I believe strengthing core muscles is the most important way to relieve back pn.

        ronda wrote on October 19th, 2009
  28. Esther’s Authors at Google talk has lots of example pictures: http://www.youtube.com/watch?v=-yYJ4hEYudE

    Her book is chock full of pictures too.

    George wrote on October 15th, 2009
    • I know this is a crazy-late reply, but I found this so helpful! Thanks for the link!

      Paleo-curious wrote on March 18th, 2013
  29. Just wondering if you would be able to post a video or images of someone moving into the correct position in a seated &/or standing position..

    I can understand the instruction however it would be beneficial.

    Steve wrote on October 15th, 2009
  30. Rodney,

    Yes, head and neck posture is extremely important. I say that having suffered excruciating pain in my shoulder, arm and hand last August related to brachial plexus nerve compression due to a forward head position/slouching at my desk for hours. I got better using posture, sleep and exercise suggestions from Esther Gokhale and Jolie Bookspan, (after many useless trips to the chiro, doctor and accupuncturist). *You do not ever want to have this problem.* I suggest Googling “forward head position” and “Bookspan forward head neck pain”, and of course Gokhale’s book is great.

    I had posture issues for years (I am 42) before this affected me. Now, while you don’t have a bad problem or pain, is the time to fix your head position!

    LietaB wrote on October 15th, 2009
  31. LietaB,

    Thanks for the information. I have no pain, but my neck is crunchy sounding when I rotate it in circles. Not sure what is crunching, but I certainly need to address it now!

    I would love to see a post on Primal Beds and sleeping positions as suggested above. I recently started online researching as I prepare to replace my old sagging mattress. As a stomach and side sleeper, I wish I could sleep on my back, but I just can’t do it. Lots of confusing info out there.

    Rodney wrote on October 15th, 2009
  32. Classically trained stage actors tend to have amazing posture. Alexander technique is amazing for fixing your posture, natural walk and gait. Guess what this technique teaches: the forward lean and and the butt slightly out. Also, best done on bare feet.
    All very primal!!!

    Nirmal wrote on October 15th, 2009
  33. Posture is the result of actions. Good posture is the result of good actions.Since everyone here is into the primal thing it is fundemental that we realize that on its own the body has perfect posture. “we” get in the way with tension, emotions, fatigue, and lack of body awareness. Learn to relax and move your body and realize you cannot seperate the body from the mind.

    OLDDUDE wrote on October 16th, 2009
  34. Coincidental post. I just had a back X-ray and have an extra vertebra!

    Dave, RN wrote on October 16th, 2009
    • Ive seen that before, do you have alot of back pain? You might want to seek out a massage therapist,one with neuromuscular training,go to nmtmidwest.com to check out
      Doug Nelson’s web site.

      ronda wrote on October 19th, 2009
  35. Just hooked up via podcast. Not BS. Very interesting and beneficial stuff. I’ve now got on the boat.

    tim wrote on October 16th, 2009
  36. This solves a problem for me. I am able to run medium distances barefoot, but walking barefoot has been a little uncomfortable for me because it’s harder to walk on the forefoot than to run on it. These posture adjustments make it a lot easier to walk on the forefoot.

    bonesheal wrote on October 17th, 2009
  37. Pregnancy is giving me a lot of back soreness, and I’m still in the first trimester. I bet it has everything to do with how I’m sucking in my belly and tucking my pelvis to avoid looking pregnant. I guess it’s better to let it all out?

    caitlin wrote on October 17th, 2009
  38. @caitlin: there is a fairly recent published study in Nature showing how the pregnant body changes structure – precisely to accommodate that growing fetus – so yes, let it hang out (remember there are only 4 ligaments that support the uterus).

    if you have much more than the usual pregnancy-related lower back pain, and your pain extends into your groin, you should also consider symphysis pubis dysfunction (most OBs will pooh-pooh it, but there is a treasure trove on the internet).

    jennifer wrote on October 17th, 2009
  39. Mark, I found lots of support and advice on my walking/ligamentous laxity/ knee/ foot arch strengthening vs, stretching “its complicated'” in forum threads on glidewalking & feet. How and when to practice what, when to use arch supports as you’re building strength…her work is not only for those with back pain! You really are such a good judge of quality and a wonderful “connector”—i think it was Malcolm Gladwell who wrote about the genius of people who are like hubs to create communities–in your case, of discerning concern.

    Mahala wrote on October 17th, 2009
  40. Have you checked out Pete Egoscue? He too, has some fabulous advice on everything related to this. He even has simple exercises that you can watch and perform to treat immediate problems on his website. I literally felt my neck shifting back into alignment! His exercise routine reminds me so much of yours, also! Thank you for this site, I’m excited about learning more!

    greensgirl wrote on October 18th, 2009

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