“Stand & Sit Up Straight! Don’t slouch!”
“Stand up straight, sit up straight! Stop slouching!” You must have heard that a lot…but is bending your back really bad for you, or even dangerous??
The human lumbar spine (i.e. lower back) is highly compliant and made to perform complex dynamic tasks and undertake high loads during our daily activities.
It is assumed that maintaining a “proper posture” can protect spinal structures. These beliefs likely reflect the fact that sitting, standing, and bending “incorrectly” are often provocative for common complaints such as low back pain (LBP). Hence, it is widely believed that movement and posture are related to LBP.
Good posture for low back pain
Despite widespread beliefs about a “correct” posture, there is NO strong evidence that avoiding “incorrect” postures prevent LBP, nor is there any association between a single back curvature and pain. Without substantial evidence that one posture exists to prevent pain, working hard to achieve a ‘correct’ posture may set you up for failure. It may even create more anxiety, especially for those with persistent pain.
Is it ok to bend my back?
YES! Lumbar flexion (a fancy term for bending forwards from your lower back) is one of the most basic and necessary movements of the lower back. The function of the elements within and around your spine (i.e. vertebrae, intervertebral discs, muscles and ligaments) are to facilitate bending. Therefore, bending is a NORMAL activity, just like how you bend and straighten your knees, hips or wrists! Try standing or sitting with your back upright. Try wearing your shorts or underwear with your back upright. Chnaces are, you might need to bend in your low back to do so.
Is it bad to bend your back when lifting?
Think about it, it may be almost impossible to avoid bending forwards, especially in sporting activities such as golf, rowing, cycling, landing and jumping in basketball etc. Yet, people who engage in sports that require a lot of forward bending do not necessarily present with more low back pain.
Bending your lower back when lifting in particular, has since gotten a bad rep for many back problems and injuries. The prevailing notion that you should keep your back straight during lifting is very commonly advised as the safest way to prevent injuries.
However, multiple studies have shown that bending your back when lifting is unlikely to cause LBP or lead to its persistence. In addition, there is NO causal link that was found between forward bending or twisting, and LBP.
Why does my back still hurt when bending?! Are you sure it’s really safe to bend my back during heavy lifting??
Your spine is a robust and adaptable structure that’s to be trusted! The confidence to bend, lift, twist and move your back is essential, as it helps to allow normal spinal movements and desensitize the nervous system.
“use it or you lose it”…
Pain is not a sign of damage. More accurately, it is an individual’s response to a threat — real or perceived. While it may be painful to bend and lift with back pain, it’s important to develop the confidence to bend and lift. The fear of performing these movements due to pain or the intent to “protect my back” could lead to avoidance, and ultimately increase your level of pain and disability.
It is safe to bend while lifting BUT…
It’s not the position the back is in when lifting. Rather, it’s the load you are lifting, which is largely dependent on your physical capabilities — chances are if you are not used to lifting heavy loads, you are putting yourself at risk of injuries!
Start low, start slow!
It is important to listen to your body when managing high loads and activities that require heavy lifting.
Just like how you may get a sore knee after starting a new activity; likewise, you may get back pain when you lift something awkwardly, or something that you’re not accustomed to. That being said, training and practice can help your body to get used to higher loads. For example, the people who load and unload luggages everyday at Changi Airport become accustomed to the loads overtime. Their backs also get stronger and are more able to handle the required loads.
Still struggling with your low back pain…? Can Physiotherapy help?
In collaboration with your Physiotherapist at PhysioX, they will evaluate and start you on a rehabilitation program directed at restoring the mobility, flexibility and strength of your lower back. Advice and education may be given to minimise potentially provocative activities. Prolonged bed rest is definitely a NO-NO for low back pain!
Here are some exercises to improve your low back pain:
Knees to chest
4-point kneel cat-camels
Seated low back rotations
DISCLAIMER: These advice and exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.
Book now or give us a call to schedule an appointment to see our Physiotherapist who will be able to partner you to recovery as we address your low back pain or any concerns about it!
Otherwise…go ahead and just flex or chillax~ (your back)!
Ref:
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., … & Woolf, A. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, 391(10137), 2368-2383.
Saraceni, N., Kent, P., Ng, L., Campbell, A., Straker, L., & O’Sullivan, P. (2020). To flex or not to flex? is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. journal of orthopaedic & sports physical therapy, 50(3), 121-130.
Surprising Facts About Posture… ‘Sit Up Straight’: Time to Re-evaluate – Infographic. PainEd. (n.d.). http://www.pain-ed.com/blog/2019/08/02/postureinfographic/.
Filed under: Low back
