The normal healthy spine has a naturally curved
shape. Like a coiled spring, these curves
help to absorb some of the forces that are placed on your spine
while standing erect. When looking at the spine from the side, there
are four normal curves, two anterior curves (Kyphotic curves) and
two posterior curves (Lordotic curves).
Maintaining good posture allows you to maintain these
healthy curves in your spine and reduces the long term stress placed
on the spinal joints. Keeping good posture can make a considerable
difference to the long term health of your spine. With degenerative
changes the bones of the spine actually start to deform. Once
degenerative changes have taken place, it is very difficult and
often impossible to restore the spine back to full health.
Degenerative arthritis of the neck
Degenerative arthritis of the low back
Proper posture is essential for reducing the
risks of developing degenerative changes in your spine.
The ears should be directly above your shoulders. The head
weighs approximately 10 pounds. When positioned directly over the
shoulders this weight is balanced and causes minimal stress on the
spine. If your head is forward it can put excessive stress on the
joints in the lower neck which over long periods of time can lead to
degenerative changes. The lower neck is where the nerves that feed
the arms exit the spine. Degenerative changes in this region can
therefore cause serious arm problems.
The shoulders should be back. Slouching draws the head
forward and leads to increased stress on the lower neck.
The hips should be over the ankles. Some people sway the
abdomen forward. This leads to an increased curve in the low back
which can increase the stress on certain low back joints. The low
back is naturally the area of highest stress in the spine and most
prone to problems. Poor posture increases the stress on this already
vulnerable area. The low back is also the region where the nerves
that feed the legs exit the spine. Low back degeneration can
therefore lead to serious leg problems.
Proper posture while sitting should preserve the
natural curves in your spine. Many people slouch when they are in a
seated position. This is an easier way to sit because it allows the
muscles of the back to relax and transfers all the stress to the
non-muscular, ligamentous tissues of the body. Our ligaments, if
pulled on for long periods of time, will
permanently lengthened which can lead to instability around the
joints they stabilize. This is why it is recommended that you sit up
straight and use your muscles to support
your posture as you sit. Although this is more
tiring, it takes the stress off the ligaments of the spine. Proper
posture takes awareness and effort.
Using a chair with a built in lumbar support or purchasing a lumbar
support will help to maintain the lumbar lordosis during prolonged
sitting. It is also essential to keep the head over the shoulders to
reduce the stress on the neck. There is a tendency to round the back
and shoulders and bring the head forward. This posture leads to
increased low back and neck stress.
Head up over shoulders.
Back straight and low back supported with a lumbar
Eyes level with top of monitor.
Hands and wrists relaxed and in a neutral position.
Shoulders back and relaxed and elbows resting at the
Thighs and forearms perpendicular to the floor.
Feet resting on the floor.
Monitor 18 - 30 inches away and directly in front.
Take regular breaks when sitting for prolonged
IN THE CAR
Many people notice increased low back symptoms when driving in the
car, especially for extended periods. Here are some tips for
reducing the stress on the spine while driving.
1. Use a lumbar support to maintain the proper curve in
the low back. If your car does not have a low back support built
in, it is a good idea to consider purchasing one. Many car seats are
not designed with posture in mind. The rounded seats found in many
cars do little to support the natural curves of the spine.
2. Do not sit too far away from the steering wheel. You arms
should comfortably reach the steering wheel without having to
stretch your arms out in front of you. Your shoulders should be back
and relaxed. If you can't reach the steering wheel without rounding
your shoulders forward, you are sitting too far from the steering
3. Stop and take breaks when driving long distances. Getting
out of the car and stretching your back on occasion will help to
avoid excessive stress from being in one position for a prolonged
period of time.
4. Your head rest should be adjusted to the proper position.
Whiplash is a very common cause of neck injury and can be very
serious. You can reduce your risk of whiplash by properly
positioning your headrest. Your head should be positioned no more
than 7 cm in front of your head rest and the top of your head should
be level with the top of your head rest.
We spend approximately 1/3 of our lives sleeping, so there is no
doubt that incorrect posture while sleeping can negatively impact
the health of our skeletal system. Just as with standing and
sitting, it is important to consider the natural curves of the body
when sleeping and make sure that they are supported. Purchasing a
high quality mattress that will provide good support while you sleep
is a wise investment.
Sleeping on your back - Lying on your back allows you to
maintain your spine in a relatively neutral position. When lying on
your back, your knees should be bent in order to reduce the stress
on the low back. Keeping your legs straight causes an increased
lordosis in the low back. Over long periods of sleeping this
increased stress can lead to problems. It is therefore recommended
to place a pillow under your knees to help maintain them in a bent
position throughout the night. A cervical pillow can also be used to
help support the natural curve of the neck as you sleep.
Sleeping on your side - Sleeping on your side also allows you
to maintain your spine in a relatively neutral position. The back
should be straight and not rounded. Placing a pillow between the
knees can help to maintain a neutral position of the pelvis.
When sleeping on your side or on your back a cervical pillow can be
used to help support the contours of the neck.
Sleeping on your stomach - Sleeping on your stomach is not
recommended. If you sleep on your stomach, your head must be turned
considerably to one side or the other. This can put excessive stress
on the ligaments of the neck. Sleeping on the stomach also puts a
lot of stress on the low back. Some of this stress can be reduced by
bringing one leg out to the side and lying in a semi prone position.
Although this reduces stress on the spine, sleeping on the back or
side are considered more ideal sleeping postures.
The spine is a remarkable structure combining strength, protection
and flexibility. This complex array of bones and joints however, is
not without its limits. When we lift it is important that we do not
exceed the limits of the spine. In order not to exceed its limits,
we must consider its weaknesses. What are the vulnerable areas of
the spine? Particularly vulnerable while lifting, are the discs of
the spine. The discs are made to absorb the shock of standing with
an erect posture. They are very effective shock absorbers and
difficult to injure as long as the spine is kept in an untwisted
If the spine is bent or twisted the discs are put into a more
vulnerable position. If we attempt to lift things when the spine is
bent over or twisted we increase the risk of injury to the disc.
Injuries often occur from simple activities done with poor
biomechanics: lifting a baby from a car seat, lifting groceries from
the back of a car reaching and pulling weeds. These activities, if
performed properly, should not create excessive stresses. It is
important to realize that relatively small loads can become
dangerous to the discs when the spine is in a compromised position.
Bend at the knees so you can keep the back straight.
Never bend or twist while lifting.
Avoid quick, jerking movements.
Keep the load close to your body.
Place heavier loads somewhere they will be easy to
If it is too heavy, get help.
Lift smart, use a pull cart etc.
Lift loads symmetrically - carry equal weight in each
Think before you lift - many injuries occur when
people get careless with everyday loads. Make it a habit to always
lift with proper posture.
Avoid bending over and twisting while lifting.
CHECK YOUR SYMMETRY
Stand in front of a mirror and assess your postural symmetry. Close
your eyes and march on the spot for 2 or 3 seconds. Stop marching,
put your feet shoulder width apart and open your eyes. Check the
Is your head shifted or tilted to one side or the
Are your ears level? Can you see both ears equally?
Are your shoulders the same height?
Can you draw a straight line from between your eyes,
through the center of your nose, the center of your chin, your
sternum, your belly button and down to between your feet?
Do your arms hang evenly at your sides? Is there
equal space between your arms and body on both sides.
Are your hips level?
Do your hips and knee caps face straight ahead?
Do your feet point straight ahead?
There are many different reasons why your body may
not be perfectly symmetrical: leg length inequalities, structural
abnormalities, muscular imbalances, etc. If you notice considerable
imbalances, a professional may be able to assist in correcting some
of these. Chiropractors, physiotherapists, and massage therapists,
are all well trained in postural assessment and use a combination of
techniques to assist in restoring your body back to balance.
Keep ears over shoulder, shoulders over hips and hips
Stand as though there is a string pulling the top of
your head toward the ceiling.
Put one leg up and change positions if standing for
prolonged periods in one position.
Keep the curves of your back supported.
Sit up straight and do not slouch.
Make sure your work station is adjusted properly.
Make sure your head rest is adjusted properly in your
Use a book stand when reading.
Sleep on your back or side.
Use a cervical pillow to support your neck.
Keep the curves of your spine in a neutral position.
Make sure your mattress provides appropriate support.
Keep your back straight by bending at the knees.
Do not twist or jerk quickly.
If it is heavy, get help.
Keep items being lifted as close to the body as
Do not place heavy things where they will be
difficult to pick up.
Lift smart - use a cart - take more than one trip.
• White AA, Pajabi MM. Clinical biomechanics of the spine. 2nd
ed. Philadelphia: J.B Lippincott Co., 1990.
• Plaugher, Gregory. Textbook of Clinical Chiropractic.
Baltimore: Williams & Wilkins., 1993.
• Taylor JAM, Burke J, Gavencak J, Pervinder P. Knowledge and
application of correct car seat head restraint usage among
chiropractic college interns: a cross-sectional study. JCCA
• Krames. Arranging Your Workstation to Fit You. San Bruno:
The Stay Well Company., 2000: pg 8.