Back and Posture Health: A Physical Therapy Perspective |

Back and Posture Health: A Physical Therapy Perspective

Photo by Jay Sullivan  It’s no stretch: A Danish study says exercise is significantly more effective than rest in reducing lower back pain.

It’s no stretch: A Danish study says exercise is significantly more effective than rest in reducing lower back pain. Photo by Jay Sullivan

BY JIM HARWOOD, P.T.  | “Sit up straight. Don’t slouch.”

“Bend at the knees when you lift.”

“You need bed rest when you hurt your back.”

These are common statements we hear from well-intended friends and family — and in some cases, health care providers — when we experience low back pain (LBP).

In some cases, following this advice can actually make the situation worse. So what can the motivated person do to either minimize their chances of hurting one’s back or recover as quickly as possible when injured?

While LBP can be experienced by people in all age groups (80 percent of all Americans will experience one episode of back pain in their life), seniors face specific challenges that may predispose them to LBP. These include:

• POOR BODY AWARENESS: Weak and tight muscles from a sedentary lifestyle, poor posture and poor bending/lifting technique can create strain on the joints, ligaments and muscles of the back (and perhaps not cause pain until much later). This leads to an often-heard statement in the clinic: “I have been doing this for years without pain.”

• OSTEOARTHRITIS: Degeneration of joints can cause pain and stiffness throughout the body, including the spine.

• DEGENERATIVE DISC DISEASE: This can cause changes in the spine that may make it more susceptible to disc herniation and pressure on a nerve, sometimes resulting in “sciatica.”

• SPINAL STENOSIS: This occurs when changes to the spine cause the space through which the nerves and blood vessels exit becomes smaller making it possible for a nerve to get compressed or “pinched.”

• BAD HABITS: Cigarette smoking, poor nutrition and poor conditioning can, at a minimum, restrict blood flow to the tissues of the body causing weakened structures and decreased healing.

LBP has the potential to become a serious health issue in seniors — particularly since a decrease in mobility that can accompany pain can lead to serious consequences for an older individual’s independence and overall health.

There are strategies that can be implemented that may reduce the risk of experiencing an episode of LBP and/or speed up recovery. They include being active, minimizing bed rest when injured and learning proper body mechanics.

A recent Danish study revealed that an active lifestyle can help protect against incidents of LBP. Numerous other studies have demonstrated that exercise is significantly more effective than rest in reducing LBP. There is also evidence that no single specific exercise is superior. Therefore, the exercise guidelines for people with LBP are the same as for those who are not experiencing LBP: increasing strength, aerobic capacity and flexibility.

So why not start walking? You should strive for 30 minutes a day of uninterrupted walking. In inclement weather, find refuge in a shopping mall (it is always advisable to be evaluated by your health care provider before beginning any exercise program),

Learn Proper Body Mechanics for Common Activities:
Understand bending from the hips with a “neutral” lumbar spine; neutral being the natural position of the spine when all three curves of the spine — cervical (neck), thoracic (middle back) and lumbar (lower back) — are present and in good alignment. This is the safest and strongest position for the spine and needs to become a fundamental movement pattern in your life. This can be practiced by focusing on how your body moves as you sit and stand at a chair.

When Lifting:
Check the weight of the object you are going to lift and, if necessary, seek help. Bend hips and knees — and keep the spine in a natural curve. Keep the object as close as possible to your body. Do not twist when lifting. Make sure you tighten your stomach muscles (but continue breathing) and lift with your legs.

When Standing:
When performing activities that require standing (such as cooking, doing dishes or ironing), try to break up the tasks to avoid fatigue. When possible, you can place one foot on a step or a ledge (switch feet occasionally) and try to perform the activity at a comfortable height. Do not bend in the back. Bend from your hips and knees.

When Pushing or Pulling:
When performing duties like vacuuming, sweeping, pushing a shopping cart or opening a door, keep the object you are moving close to the center of your body. When pushing or pulling, use your legs and not just your arms — while keeping back neutral and abdominal muscles tightened (keep breathing).

When Sitting for a Long Time:
When sitting for a movie or a long meal, it is important to remember that there is no “perfect” posture, and that the best advice is to change position(s) often. It is important to try to keep your spine supported in its natural curve (use a small pillow or towel in low back if necessary). When working at a computer, keep the monitor right in front of you and remember to relax your shoulders and “mouse-hand/arm” whenever possible.

Try This Posture Exercise:
If you are someone who spends a great deal of time sitting or if you feel stooped over when you are standing, you can try this posture exercise a few times a day.

• Stand facing a wall.

• Place your hands on the wall in front of you.

• Walk your hands up the wall as far as you can (make sure this causes no pain — especially in your shoulders). Walk towards the wall as your hands go up.

• Keep your chin down and tucked (you do not have to look at your hands moving up the wall).

• Try tightening your abdominal muscles.

• Hold this position for three to four breaths in and out.

• Then, relax.

• Repeat this exercise three times in a row

It is important to understand that while these few tips may not solve everybody’s back issue(s), they can be effective — if implemented properly and consistently.

If you are experiencing back pain and would like to start implementing these strategies but are not sure how (or if you have questions or need guidance to start an exercise program), you can call or stop in to see a Physical Therapist (PT) and schedule an evaluation. In the state of New York, Physical Therapists have Direct Access, meaning you do not have to see a physician and obtain a prescription before seeing a PT. This is true for all Medicare beneficiaries as well. However, if your back pain episode also includes a fever or pain/weakness in your legs or you note changes with your bowel or bladder, it is imperative that you see your doctor as soon as possible.

New York Physical Therapy (NYPT) is located in Chelsea at 359 W. 23rd Street. If you are interested in starting PT (or if you have any questions about this article or other matters concerning your physical health), feel free to call us at 212-488-7300. You can also learn more about NYPT by checking out our website at

43 Responses to Back and Posture Health: A Physical Therapy Perspective

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  7. Janu Basti Therapy August 6, 2013 at 5:38 am

    This forms of exercise is good for health and will tend to keep the healthy and fit for longer time. Good guidance and proper take care on one body helps many problems go away.

  8. physical therapy August 23, 2013 at 11:07 am

    Great post! Thank you for your insight and experience into getting in to a physical therapy program.

  9. Mysite September 9, 2013 at 4:59 pm

    I need a program like this to help me with my back pain..

  10. bluepromocode September 19, 2013 at 2:51 pm

    Great article about proper posture. When I was in my 30s, I hurt my sciatic nerve and I have had to be careful ever since. I actual hurt my sciatic nerve while sitting in an office chair with my feet on the desk and I sneezed. I have never been the same since, so it is all too easy to hurt the lower back. One thing I was taught were some simple exercises to build the muscles of the lower back, buttocks and thighs. Those areas are also important to good posture. Also, tai chi is very good for anyone to do at all ages.

  11. BackPainHC September 27, 2013 at 6:34 pm

    Good post, exercise is a good option to relieve back pain.

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  13. Nathan Smith October 20, 2013 at 8:59 am

    This is a very essential article for me as well. I must follow article for knowing some useful discussion as well. I am very happy to know the article as well. Thanks a lot mate.

  14. Evan November 6, 2013 at 9:04 am

    Great statement has been made here indeed!! To develop health condition and reduce back pain above suggested ways are highly effective. I just enjoyed learning this post pretty much. Thanks.

  15. Diabetes Digest November 9, 2013 at 7:06 am

    It has been seen that sitting for long time on a chair specially on front of computer can cause the lower back pain, Its very common scenario these days in young guns.

  16. Graham November 22, 2013 at 4:49 am

    great advice – but how many people will seriously take note? Inevitably they will go through life doing it their own way – the way which is comfortable to them personally and reap the rewards sooner than later in life eg. cervical spondylosis

  17. Tony Tailor November 29, 2013 at 2:44 am

    While patients may be referred for physical therapy treatment by their primary care doctor, an orthopedic surgeon, or other doctor involved in their back care, most states have direct access laws permitting patients to seek help for low back pain from a licensed physical therapist without having to seek a written referral.

  18. cinnamon benefits December 9, 2013 at 11:17 am

    It has been seen that seated for quite a while on a seat exclusively on front side of computer can cause the lumbar discomfort, Its very common situation these days in young weapons

  19. Gluteos December 10, 2013 at 8:40 pm

    Dang, now i understand why i get so much chronic back and neck pain

  20. Mark December 14, 2013 at 12:38 am

    Your posture is very important! Not many people are aware of it, but a solid posture has great benefits to your overall health

  21. best paleo book December 18, 2013 at 12:26 am

    This is so important, especially as we grow older. Stretching is also very important.

  22. john December 23, 2013 at 5:06 am

    Physical therapy is helpful for mental health. Social Media Marketing Manchester social media marketing service.

  23. James Saylor January 8, 2014 at 11:58 am

    I really need that for my knee pain..

  24. physical therap. job January 16, 2014 at 2:43 am

    our solid posture is helping us looking good.. I must follow article for knowing some useful discussion as well. Thank you for this..

  25. CindyC MD January 16, 2014 at 1:53 pm

    Thank you for the very informative article. Lower back pain can be experienced by anybody at ANY age. I especially liked the tips you shared on maintaining some level of activity and flexibility and being aware of "how to" lift items and carry things as we age. We typically share this type of information with our patients as part of their recuperation and ongoing lifestyle). Thank you!

  26. mehwish January 20, 2014 at 2:58 pm

    i would like to thanks for sharing such an easy exercises. Specially the posture exercise you explained in this article, that is to be follow after sitting a great time. i am going to adopt it !

  27. guest January 20, 2014 at 3:01 pm

    After reading this article i found small and easy exercises to be adopted in daily life , for relief from back pain.

  28. Muscle Foods February 10, 2014 at 9:34 pm

    The core is a very important part of posture.

  29. Optometrist salary February 13, 2014 at 2:51 am

    thank you for bringing this issue and keep them motivated person do to either minimize their chances of hurting one’s back or recover as quickly as possible.

  30. sadieuro February 15, 2014 at 1:11 am

    This is the very good idea! Just want to say thank you for information, Just continue to the write such a position. I will be your faithful reader. Thank you again.

  31. aquaflexin February 19, 2014 at 7:47 pm

    nice read

  32. jeff February 21, 2014 at 2:01 pm

    Great post! Thank you for your insight and experience into getting in to a physical therapy program.

  33. Deborah February 21, 2014 at 2:04 pm

    Great info – thanks for the tips on keeping a healthy back :)

  34. Jordan February 23, 2014 at 4:56 am

    Very informal, nice article and proving the essentials of physical therapy

  35. como perder barriga February 25, 2014 at 8:53 pm

    I really liked the exercise! I experience back pains myself and I do stay sitting in front of the computer for more than 10 hours daily. And this exercise did make my back a little bit better. Thanks

  36. Deborah March 21, 2014 at 5:40 pm

    Wow, great post – my husband is actually a Physical Therapist here in Southern California – i'm going to share this with him! :-)

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  43. David August 31, 2014 at 8:39 am

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