00:00Which posture looks better to you?
00:01The left or the right?
00:03Well, if you've watched any YouTube videos on posture,
00:05you'd most likely say the right.
00:07And if you had to give the guy on the left any advice,
00:09you might say he should pull his shoulders back
00:11and lift his chest up.
00:12And then you might suggest that he add in
00:13some daily doorway pec stretches,
00:16or some chin tucks to fix his tex neck,
00:18and plenty of face pulls to get those shoulders back.
00:20And while some of this might make sense in some situations,
00:23this is one of those topics
00:24where the devil is in the details.
00:26So in this video, I wanna discuss four pervasive myths
00:28about posture, pain, and some of the flawed ways
00:31that trainers try to fix it.
00:32And then I'll give some more science-based recommendations
00:35from experts in the field.
00:36So the first myth is that upright posture
00:38is the good posture and slouching is the bad posture.
00:42This can come in other forms like anterior pelvic tilt is bad
00:44and a neutral pelvis is good.
00:46But overall, I do think most people have this knee-jerk intuition
00:49that slouched equals bad and straight equals good.
00:52But when I spoke with physical therapist, Dr. Sam Spinelli,
00:55he explained that it's not as black and white as that.
00:57And in fact, what we often think of as bad posture
01:00can actually be quite beneficial.
01:02Posture is essentially just positions.
01:04But then when we start to add on this delineation
01:06of good and bad, that's really morality.
01:09And something as simple as that nice, tall, upright posture,
01:12it has benefits, but it also has downsides.
01:14From a standpoint of efficiency,
01:16if you're sitting in a chair with a backrest,
01:18sitting up nice and upright is actually
01:20a less mechanically advantageous position to be in
01:22because it does take more energetic effect to maintain that.
01:25In contrast, if I sit in a more slightly slouched position,
01:29that's beneficial from a standpoint of how much energy
01:31I need to utilize.
01:32So if I have to sit there for eight hours a day,
01:35it's not to my advantage to sit upright
01:36for a very long duration of time.
01:38Now, of course, no one's saying that we should all slouch
01:40as much as possible, but the idea is to simply make an effort
01:43to vary your body positions throughout the day.
01:46There's a common saying that's utilized
01:48in this evidence-based physio crowd,
01:49that your next posture is your best posture.
01:52And it's just that by the nature of moving between them,
01:54you're gonna get benefit.
01:55One benefit that comes with slouching is actually
01:57that we get more discal fluid shift.
01:59And so if you were to maintain this nice upright posture
02:01for a very long duration of time,
02:03your discs actually don't get a lot of fluid shifted to them.
02:05And so when you go into that more slouch position,
02:07because of the change in gradient of pressure,
02:09we have some pressure moved from the front to the back,
02:11and that changes the circulating chemicals
02:13that allow for better healing,
02:14better maintenance of homeostasis, et cetera.
02:17So there's a lot of benefit that comes
02:18from just these natural little changes that you do.
02:21Now, this doesn't mean that posture doesn't matter at all.
02:23In fact, on my call with Dr. Nicola Comelli,
02:25he pointed out that posture can matter a whole lot
02:27in certain social situations.
02:29So if you go into an important job interview,
02:32you don't wanna be slouching,
02:33because that speaks volumes more than anything
02:35you're gonna actually talk out of your mouth.
02:37Walking into a room with your chest out, your chin up,
02:40that can all impact the way that people read you
02:43and interact with you.
02:44So posture gets more significant
02:46when we talk about things like that.
02:47But as far as correlating a good upright posture
02:50versus a bad slouching posture,
02:53we haven't really seen that in the evidence.
02:55And he pointed out that by far,
02:57the main reason people want to fix their posture
02:59is because they're experiencing some kind of neck,
03:01back, or shoulder pain,
03:02and they think fixing their posture is the solution.
03:05And that brings me to myth number two,
03:07which is that fixing your posture will fix your pain.
03:09But this common idea has been refuted
03:11by a mountain of scientific evidence
03:13over the last few decades.
03:14And I think this is probably
03:15the most potentially harmful myth of them all,
03:17because there's good evidence that if you think
03:19there's something wrong with your posture,
03:21that belief can create or worsen pain
03:23that you otherwise might not notice.
03:25This is called the nocebo effect,
03:27and it's similar to the placebo effect,
03:29where you become more fragile
03:31and more vulnerable to pain
03:32because you think your posture needs fixing.
03:35But in reality, it's probably fine,
03:37because like I said,
03:38the link between posture and pain
03:40isn't very strong, to say the least.
03:42This was shown in a 2018 study
03:44where there was no association
03:46between so-called text neck,
03:48where you tilt your head down to look at your phone,
03:50and neck pain in 150 young adults.
03:53No association.
03:54Yet a lot of the internet
03:55seems to be really worried about this.
03:57A more recent study published in 2020
03:59once again found that text neck
04:01was not associated with prevalence of neck pain,
04:03neck pain frequency, or neck pain intensity
04:06in over 500 adults aged 18 to 65.
04:09And a systematic review
04:10combining the results of 10 studies
04:12found moderate evidence of no relationship
04:14in thoracic kyphosis, or upper back rounding,
04:17between groups with and without shoulder pain.
04:20Now, to be fair, you can find studies
04:21that show a correlation between posture and pain,
04:24but it usually isn't present
04:25in the highest quality studies.
04:27And there certainly isn't enough evidence
04:28to say that poor posture is the smoking gun cause of pain
04:32that many people think it is.
04:33But still, even if the link between bad posture and pain
04:36isn't clear in the science,
04:38no doubt some of you still feel pain
04:40because of the postural stresses imposed by your job.
04:43For example, my dad worked as a dental hygienist
04:45for 30 years and would feel back pain quite often
04:48from the bent over positions
04:49that he'd need to be in.
04:50So I wanted to ask the experts
04:52about common cases like this.
04:53How do you square that circle?
04:55Like, like, it's like you say, okay,
04:56well, posture and pain may not be that related,
04:59but then you have someone come and say,
05:00well, I work at a grocery store
05:02and my back's freaking killing me.
05:03So what's up?
05:05Yeah, exactly.
05:05And I think like a good example,
05:07there's if you ask anybody to hold a bag
05:10for a very long duration of time,
05:12their biceps going to get lit up.
05:13But if it's your job to hold that bag
05:15for eight hours a day,
05:16your bicep is going to get lit up every single day
05:19on a very regular basis.
05:20But you'd probably not think anything crazy of it.
05:22But it seems to be that there's just certain body parts,
05:24such as our back, our neck,
05:26where we really start to freak out about these things.
05:28There's a whole book from one of the leading individuals on pain,
05:31Stabbed in the Back.
05:32And he talks all about how we have this weird perception of the back.
05:35If you do almost any sort of other activity
05:38and you have a lot of muscle soreness,
05:39you often don't freak out.
05:40But when it comes to the spine, people are very concerned.
05:43In the case of that person that's working on the bottom shelf a lot,
05:46maybe they need to take more frequent breaks,
05:48they need to stand, they need to walk.
05:50They might need to actually go and do deadlifts,
05:52improve their capacity of their lower back.
05:54So that way, when they go and do that stuff on the bottom shelf,
05:56it's not as challenging.
05:58That's where we do see a lot of individuals
06:00that regularly do resistance training,
06:02often have a lot less general aches and pains in the research body.
06:06It could be for a lot of different reasons,
06:08but one of which is theorized that
06:09because they have a general greater capacity at different muscular tissues,
06:13they can often handle more daily tasks easier.
06:16I also asked Dr. Nick about a receptionist who sits at a desk
06:19and feels neck or shoulder pain.
06:21He explained that it's first crucial to understand that pain is multifactorial.
06:25And while postural stress at work certainly can be a contributing factor,
06:29other factors like sleep and stress can play in enormously as well.
06:32If we've kind of had the conversation about sleep,
06:35workload management, all those things,
06:37then it's really just as simple as setting a reminder on the phone and saying,
06:41okay, you know what, if you have to sit for this long,
06:43what I want you to do is every time your phone blinks,
06:46shift your weight to the right or shift your weight to the left,
06:49or put a little box under your chair and prop one foot up on it,
06:54and then switch feet and prop the other foot up, stick a towel roll under your back,
06:58and then take it out.
06:59So at some point you're arching, some points you're slouching.
07:02If you are forced to have your head down on a phone or something,
07:06stand up, bring your shoulders back, move your neck around the other way,
07:09like just kind of do what feels good almost.
07:12And that brings me to myth number three, which is that you can fix poor posture with simple,
07:1610-minute daily drills.
07:18This was something Dr. Spinelli spoke about quite critically on our call.
07:21We see that you have this slouch posture and we want to change it.
07:25Maybe your posterior musculature has not enough strength to be able to maintain that upright posture.
07:29Okay, well, are those drills that you're doing sufficient for them?
07:33Probably not.
07:34They're probably pretty bad options for strengthening.
07:37I wouldn't say that they're a waste of time because,
07:40you know, you're being physically active, you're moving,
07:41you're doing something for your health.
07:43Like those are great things still,
07:44but you'd probably be better off, like you mentioned, doing resistance training.
07:48Probably for the vast majority of people who have neck pain,
07:51doing a nice clean row is going to have more return than all these weird little drills.
07:57Now, I'm sure some of you might be thinking,
07:58well, I did such and such exercise and it really did fix my posture or my back pain.
08:03And if you fixed your pain, then I think that's great.
08:05But I think it's also important to keep in mind that research shows that 75 to 80% of pain
08:11improves within four to 12 weeks on its own.
08:13So you probably could have done just about anything and the pain would have gone away.
08:17Then if you add in the placebo effect,
08:18where you really believe the drills you're doing are working,
08:21then it's not surprising that you'd credit them for your results.
08:24And again, my point isn't to say that every drill or exercise is completely useless,
08:28but instead to direct your course of action toward things more likely to be productive.
08:32So prioritizing basic compound lifts, meaning your routine should include a squat type movement,
08:38a hip hinge like a deadlift or RDL, a horizontal row, a vertical pull like a pull up or pull down,
08:44a horizontal press, and a vertical press like a dumbbell press or OHP.
08:48And then after that, if you want to sprinkle in some specific drills or exercises for your specific
08:52weak points, then there's no harm in doing that as long as you're not viewing them as a quick cure-all
08:56or catastrophizing your situation.
08:58And that brings me to the fourth and final myth, which is that posture is always a problem worth fixing.
09:03Sometimes if you just want to make a better first impression or feel more confident,
09:07then there's nothing wrong with making an effort to stand tall and lift your chest up.
09:11But if you're someone who's given these posture drills and stretches an honest shot
09:14simply because you've been told that you should, but they haven't made any noticeable difference
09:18to how you feel, then there's no shame in just giving up on them.
09:21Posture might not be a real problem worth fixing for you.
09:24And this is something I had to ask Dr. Spinelli about just to be sure.
09:28So I sit at my desk a nice bit.
09:30A lot of people on the internet would tell me that I need to get my shoulders back and sit more
09:33upright, you know, do I like, should I be worried about that at all?
09:36Like I don't have any real pain or any, I suppose my lower back gets a little tired,
09:40but then I'll just stand up for a bit, crack my back and then sit back down again.
09:44And I'm fine.
09:45Should I be cognizant of the fact that I'm slouching and should I make an effort to sit up more upright?
09:50I would make a strong argument.
09:51You should not be very consistently.
09:54We see that individuals who hyper focus on their posture are more likely to catastrophize
10:00or more likely to be fear avoidant or more likely to have pain, whether it's acute or more persistent
10:06pain. And so just by the general act of being less concerned with it and naturally moving,
10:10changing postures, you're probably in a good position.
10:13Okay. So putting all this together, what are the best science-based recommendations?
10:17Well, first resistance training at least two to three days a week with a focus on foundational
10:22compound exercises will help you be more prepared for daily tasks and postural challenges.
10:27Second, having some kind of regular cardio routine or step count goal
10:31is a good idea to promote general muscle and joint health and reduce back pain.
10:34It's also a good idea to make an effort to vary your posture throughout the day
10:38and do your best not to be in any one position for longer than you need to be.
10:42Now, when it comes to posture and pain, recognize that the perception of pain can be impacted by many
10:46factors such as how well you're sleeping and managing stress.
10:49And finally, don't catastrophize pain when you feel it.
10:52Be patient and work on modifying the tasks that you need to do in a less painful way.
10:57And a good physical therapist should be able to help you with this until the pain subsides.
11:01And if any of these red flags are present during an episode of pain,
11:05then you may want to speak directly with a doctor or physical therapist.
11:08Also, my full conversation with Dr. Spinelli is out now on my podcast,
11:12so you can listen to that on my podcast channel, which I'll link over here next to my head,
11:16or you can also listen on Apple Podcasts and Spotify.
11:19You guys should also go ahead and follow Dr. Spinelli and Dr. Nick on Instagram and YouTube,
11:23so I'll link their platforms down below.
11:25And they both put out great content on this stuff regularly.
11:28Don't forget to leave me a thumbs up if you enjoyed the video.
11:30Subscribe if you haven't already.
11:31And I'll see you guys all here in the next one.
11:33I would say give it one more shot, man. Give it one more shot.
11:57Are you not even me or him?
11:58You are. It's so funny if you saw that.
12:07Come on.
12:08It's fine. I can't do it.
12:12Damn it.
12:13It's fine. It's fine. You can just cut.
12:16Seems like a bad idea.
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