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Wellness & Prevention

Cleveland Clinic Center for Spine Health offers tips to help you keep your back healthy.

Posture is the position in which you hold your body upright against gravity while standing, sitting or laying down.

What is good posture?

Good posture involves training the body to stand, walk, sit and lie in positions where the least strain is placed on supporting muscles and ligaments.

Proper posture:

  • Keeps bones and joints in the correct alignment so that muscles are being used properly.
  • Helps decrease the abnormal wearing of joint surfaces.
  • Decreases the stress on the ligaments holding the joints of the spine together.
  • Prevents the spine from becoming fixed in abnormal positions.
  • Prevents fatigue because muscles are being used more efficiently, allowing the body to use less energy.
  • Prevents backache and muscular pain.
  • Contributes to a good appearance.
Proper posture requires:
  • Good muscle flexibility.
  • Normal motion in the joints.
  • Strong postural muscles.
  • A balance of muscles on both sides of the spine.
  • Awareness of your own posture, plus awareness of proper posture which leads to conscious correction.
  • With much practice, the correct posture for standing, sitting, and lying down (as described below) will gradually replace your old posture.
What is the correct way to stand?
  • Hold your head up straight with your chin in. Do not tilt your head forward, backward or sideways.
  • Make sure your earlobes are in line with the middle of your shoulders.
  • Stretch the top of your head toward the ceiling.
  • Keep your shoulders back, your knees straight and your back straight.
  • Tuck your stomach in. Do not tilt your pelvis forward.
  • The arches in your feet should be supported.
What is the correct way to sit?
  • Sit up with your back straight and your shoulders back. Your buttocks should touch the back of your chair.
  • All three normal back curves should be present while sitting. A small, rolled-up towel or a lumbar roll can be used to help you maintain the normal curves in your back.
Here's how to find a good sitting position when you're not using a back support or lumbar roll:
  • Sit at the end of your chair and slouch completely.
  • Draw yourself up and accentuate the curve of your back as far as possible. Hold for a few seconds. Release the position slightly (about 10 degrees). This is a good sitting posture.
  • Distribute your body weight evenly on both hips.
  • Bend your knees at a right angle. Do not sit with your knees crossed. Keep your knees even with or slightly higher than your hips.
  • Keep your feet flat on the floor.
  • Try to avoid sitting in the same position for more than 30 minutes.
  • At work, adjust your chair height and work station so you can sit up close to your work and tilt it up at you. Rest your elbows and arms on your chair or desk, keeping your shoulders relaxed.
  • When sitting in a chair that rolls and pivots, don't twist at the waist while sitting. Instead, turn your whole body.
  • When standing up from the sitting position, move to the front of the seat of your chair. Stand up by straightening your legs. Avoid bending forward at your waist. Immediately stretch your back by doing 10 standing backbends.

It is ok to assume other sitting positions for short periods of time, but most of your sitting time should be spent as described above so there is minimal stress on your spine.

What is the correct way to sit while driving?
  • Use a back support (lumbar roll) at the curve of your back. Your knees should be at the same level or higher than your hips.
  • Move the seat close to the steering wheel to support the curve of your back. The seat should be close enough to allow your knees to bend and your feet to reach the pedals.
What is the best position for sleeping and lying down?

The best lying or sleeping position may vary, depending on your symptoms. No matter what position you lie in, the pillow should be under your head, but not your shoulders, and should be a thickness that allows your head to be in a normal position.

  • Try to sleep in a position which helps you maintain the curve in your back (such as on your back with a pillow under your knees or a lumbar roll under your lower back; or on your side with your knees slightly bent). Do not sleep on your side with your knees drawn up to your chest. You may want to avoid sleeping on your stomach, especially on a saggy mattress, since this can cause back strain and can be uncomfortable for your neck.
  • Select a firm mattress and box spring set that does not sag. If necessary, place a board under your mattress. You can also place the mattress on the floor temporarily if necessary. If you've always slept on a soft surface, it may be more painful to change to a hard surface. Try to do what's most comfortable for you.
  • Try using a back support (lumbar support) at night to make you more comfortable. A rolled sheet or towel tied around your waist may be helpful.
  • When standing up from the lying position, turn on your side, draw up both knees and swing your legs on the side of the bed. Sit up by pushing yourself up with your hands. Avoid bending forward at your waist.

Exercise is an important part of improving and maintaining normal, comfortable back function. It is important to practice these exercises regularly so you can maintain your fitness level.

Exercise can be divided into three basic groups:

  1. Strengthening: repeated muscle contractions until the muscle becomes tired.
  2. Stretching or Flexibility: slow, sustained lengthening of the muscle.
  3. Aerobic: steady exercise using large muscle groups.
General guidelines for proper exercise

All exercises should be performed slowly and comfortably to avoid injury. When performing strengthening and flexibility exercises, remember to breathe naturally and do not hold your breath; exhale during exertion and inhale during relaxation.

A program of strengthening, stretching and aerobic exercises will improve your overall fitness level. Research has shown that people who are physically fit are more resistant to back injuries and pain, and recover quicker when they do have injuries than those who are less physically fit.

Strengthening exercises

Strengthening exercises help increase muscle tone and improve the quality of muscles. Muscle strength and endurance provide energy and a feeling of wellness to help you perform daily, routine activities.

Adequate strength of abdominal and back muscles helps stabilize the spine, allows proper spinal movement and makes it easier to maintain correct posture. Strong hip and leg muscles are important to perform proper lifting techniques and body mechanics.

Stretching and flexibility exercises

Flexibility is the ability to move your arms and legs through their full range of motion. Stretching will help improve your flexibility.

Adequate flexibility of tissues around the spine and pelvis allows full, normal spinal movement, prevents abnormal force on the joints and decreases the possibility of injury. Stretching also prepares muscles for activity; stretching should be done before and after each vigorous workout to prevent muscle strain and soreness and to help avoid injuries.

When performing flexibility exercises, stretch as far as you can and hold the stretch for 10 seconds and then ease back. Each stretching exercise should be performed slowly, with no sudden jerking or bouncing. Bouncing is more likely to injure or strain a muscle or joint.

Aerobic exercises

Aerobic exercise provides cardiovascular conditioning. It strengthens the heart and lungs and improves the body's ability to use oxygen. Some other benefits of aerobic exercise includes increased energy levels, improved mood, better sleep habits and decreased blood pressure. Aerobic exercise also burns calories and improves your metabolism, helping with weight loss.

Some examples of aerobic exercise include:

  • Jogging
  • Cycling
  • Skating
  • Rowing
  • Swimming
  • Walking
  • Cross-country skiing
  • Dancing

In general, to achieve maximum benefits, you should gradually work up to an aerobic session lasting 15 to 60 minutes, 3 or 4 times a week. Please check with your physician before starting any aerobic program. Ask your physical therapists how to start an aerobic exercise program.

Your exercise routine should consist of a 5-minute warm-up (including stretching exercises) before the aerobic activity and 5 to 10 minutes of a cool down (stretching and slower activity) after the activity.

Here are some precautions with aerobic exercise:

Jumping rope puts too much pressure on the discs and should be avoided. Running can be done as long as it doesn't increase lower back pain. When walking or running, wear supportive, well-cushioned shoes and walk or run on a level surface.

What should I know about pain during exercise?

Do not ignore pain – if you feel increased pain or pain spreading to the legs, do not continue the activity. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage on your joints. Seek the advice of a physician or physical therapist. Fear of pain can cause unnecessary inactivity. Learn to "read" your body and know when you need to stop an activity.