Today's guest post is brought to you by Pure Performance Training Physical Therapist Mike Demille.

Sitting is inevitable; most of us do it at work, then we sit on the car ride home, and then do it again while watching TV at the end of the day. When your day is made up of mostly sitting and you also lack movement and exercise in your daily routine you’ll often notice that your body feels tired, lethargic, and tight.

In this post you will learn: what it is about sitting that can be problematic, how to alleviate pain that can be associated with prolonged sitting, and long term solutions to combat sitting related problems.

Muscle Imbalances

When you sit a lot and don’t perform a variety of movements with your joints each day you’re more likely to develop muscle imbalances. The lower crossed syndrome is one of those imbalances and describes when one set of muscles that become tight and shortened while their opposing muscles become weak, lengthened, and inhibited.

Lower Crossed Posture

Lower back is over arched leading to tight back extensors and hip flexors

The shortened muscles in lower crossed posture include: hip flexors (front of the hips) and spinal erectors (low back) while the abdominals and hamstrings become over-lengthened and inhibited.1,2

“Correct” sitting posture, or what we have been told growing up to be correct by arching your back and sitting as tall as you can, can actually exaggerate a lower crossed posture. As you can see in the picture above the hip flexors become even SHORTER and the hamstrings become even LONGER when you over extend your lower back and pull your chest tall. Also, the lumbar spine (lower back) is under quite a bit of compression and the abdominals are not in a position to provide any stabilization.

So now that we know arching too hard and pulling your chest too tall can be a problem, is the opposite posture ok?

Upper Crossed Posture

Over rounding your upper back and reaching your head out towards your computer can lead to your pecs and neck feeling tight

Of course not! Leaning forward and reaching your head out towards your computer screen will increase stress on the upper body due to a similar muscle imbalance described above. When you lean forward and round your upper back with your head moving far in front of your body muscles like your upper traps and pecs are shortened while your anterior deep neck flexors (front of the neck) and the middle/low traps (mid back) are lengthened.

So what are we supposed to do about this?

If arching too much or slouching too much can lead to unwanted imbalances you need to understand that ideal position likely falls somewhere in the middle. Here are four strategies that I have used to help patients who sit frequently feel better and deal with sitting related pain.

The Sitting Strategies

1) Get Up Every 30 Minutes (or Whenever you Start to Experience Pain)

This goes without saying but when you feel pain you should… well… stop the thing that is hurting you! Go for a walk, lie down, stand, whatever you need to do to take a break from a painful sitting position. If you work a job that does not allow these kinds of breaks stand at your chair every 30 minutes to off-load the spine. Learning exercises that allow your hip and spine to move through their full ranges of motion can also help combat static sitting positions.

2) Sit in a “Neutral” Position.

This statement becomes tricky because what is comfortable for one individual when sitting may be miserable for a different person. One recommendation that has worked wonders is to move the seat closer to the working surface (or steering wheel). This allows the lumbar spine to stay relaxed on the back of the chair and avoids reaching forward with the neck. It also puts your abdominal muscles in a better position to work and stabilize your spine.

3) Rebalance Your Imbalance

Performing exercises that work in the opposite direction of the upper and lower crossed syndromes mentioned above can do wonders in terms of taking stress off of long muscles and lengthening short ones. One example is the kneeling hip flexor mobilization. You can see here how the hip flexors become lengthened and in turn abdominals become shortened, restoring balance to the lower crossed syndrome.

Another good example here is a deep squat with breathing. As you can see in the video this position allows the lower back to lengthen and the spine to decompress.

The below exercise is a great way to to counteract upper crossed posture by training your lower traps and back of your shoulders.

4) Set Yourself Up For Long-Term Success

The exercises above are a good way to help reduce stress induced by the muscle imbalance. Once balance is restored there is no better way to lock in these new positions than with strength training. One great exercise to maintain strength with full hip extension is a weighted glute bridge. Be sure to squeeze the glutes and abs HARD with this one.

For the abdominals a couple of go to strengthening exercises are dead-bugs and bird-dogs. With these variations make sure to avoid excessive arching of the lower back.

When it comes to strength training for upper crossed posture rowing variations are a must and can be used to train your upper back and shoulders to balance out the constant tension this posture places on your pecs.

In Summary

Sitting posture can cause pain both in the lower back and neck due to the upper and lower crossed syndromes
Correct sitting posture is neither straight up and down nor hunched over, but is most likely somewhere in the middle and changing posture and bringing your joints through their full pain free range of motion daily are great strategies for combating long days of sitting.
Exercises that reverse the crossed syndromes such as bridges and rows can help decrease the postural adaptation that is leading to pain.
Get Up & Move- Put aside time in your life to get outside go for walks, exercise, move your joints and get away from the desk and screen.

References

1. Assessment and Treatment of Muscle Imbalance: The Janda Approach: Phil Page, Clare C. Frank, and Robert Lardner

2. Diagnosis and Treatment of Movement Impairment Syndromes: Shirley Sahrmann

3. Musculo-Skeletal and Pulmonary Effects of Sitting Position- a Systematic Review: Sczcygiel et al. (2017)

4. Testing and Function with Posture and Pain: Florence Kendall

ABOUT THE AUTHOR

Mike is a Physical Therapist and Strength and Conditioning Coach who places an emphasis on return to sport play and prior level of function following injury. Mike graduated from Springfield College with a Doctor of Physical Therapy where he also pitched for the varsity baseball team.

As a Physical Therapy student, Mike participated in an internship working as a Strength and Conditioning Coach at Champion Physical Therapy and Performance. There he gained valuable experience working with college and professional baseball athletes as well as general population clients.

He completed his clinical orthopedic rotation at Central Mass Physical Therapy and Wellness where he continued to develop his manual therapy and post-surgical care skills. He has also completed advanced coursework through the Postural Restoration Institute (PRI) and the Selective Functional Movement Assessment (SFMA).

Mike uses his unique skill set and knowledge base to provide manual therapy, corrective exercise, neuromuscular re-education, and capacity training while recognizing the natural asymmetries of the human body to provide a custom plan of care and optimize results.

During his free time Mike still continues to play baseball, weight train, and hike to remain fit.

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The Truth About Sitting