In the UK, the average adult spends around 9.5 hours a day sitting down. That’s more time than most of us spend sleeping each night! So, it’s no surprise that one of the most common questions our seating specialists get is about improving and maintaining posture.
“Sit up straight, or you’ll get a bad back!” is a phrase almost everyone will have heard at some point in their life. But posture is about more than just your back. The whole body is involved in maintaining good posture and poor posture can lead to problems with everything from your breathing to your circulation. Plus, for people with disabilities especially, it’s not as simple as ‘sitting up straight’. Many people cannot sit upright without support or reposition themselves whilst seated.
In this guide, we look at what good posture really means and provide practical advice on how to maintain proper posture whilst sitting.
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What is ‘good posture’ anyway?
Good posture will mean different things for different people.
One reason UK adults spend so much time sitting is because many people work office jobs that require them to sit at a desk. For this reason, a lot of postural advice focuses on maintaining good postural whilst sitting at a desk:
Proper posture when sitting at a desk
The ideal sitting position for an office worker will:
- Keep feet flat on the floor
- Maintain the natural curvature of the spine
- Keep the back and pelvis in the back of the chair where they are supported
- Allow the shoulders to relax
- Avoid straining or tilting the head and neck
However, someone with a spinal abnormality will not necessarily be able to achieve the same postural positioning as someone without any spinal issues.
To give an example, the ideal posture for someone with cerebral palsy who spends most of their day sitting in a care chair will not follow these guidelines written for an office worker sitting at their desk.
Three Criteria for Good Posture
Bearing this in mind, Pauline Pope, a research physiotherapist, set three key criteria for determining good posture for an individual:
- It facilitates effective functional performance
- It’s energy efficient
- It doesn’t harm the body systems
If you’re not an OT or physiotherapist that specialises in seating and posture, these criteria can seem quite complicated. But really, they just acknowledge that having one set standard for good posture won’t work for everyone.
Here are some questions you might ask when assessing someone’s posture using these criteria:
Facilitates effective functional performance
- Can they perform tasks and actions they are typically able to do? This can include things like…
- Eating
- Seeing around the room
- Talking
Energy efficient
- Can they sit comfortably in this position for a prolonged period?
- Are they having to physically support themselves to maintain this position?
- Are any parts of their body bearing too much weight?
Doesn’t harm the body systems
- Are any parts of the body at risk of damage or injury?
- Are they scrunched up making it harder to breathe?
- Is there too much pressure on one area of the body increasing the risk of tissue breakdown?
To sum it up, good posture is all about protecting the overall health and wellbeing of someone when they are sitting down.
If you’re interested in reading more research on the science of seating and posture, download a free copy of our Healthcare Professional’s Guide to Seating Assessments.
Now let’s move onto some tips for improving and maintaining good posture whilst sitting!
Can you correct poor posture?
At first, poor posture will present as discomfort, aching and sometimes a slight stoop or lean.
If caught early enough, this can often be corrected using physiotherapy exercises and supportive seating. For example:
- Slouching can be corrected using exercises to strengthen your core and back extensions e.g. the plank.
- Hunched shoulders can be corrected by strengthening your chest using stretches and pull up exercises.
- If someone tends to lean their head slightly to one side, it can be corrected by using a headrest with lateral supports.
You can get more advice on correcting mild postural problems on the NHS website.
Unfortunately, over time poor posture can develop into permanent spinal deformities and postural abnormalities. These cannot be corrected. Instead the focus will be on using specialist seating to prevent the problem from getting worse.
Medical drawings of curvature of the spine
We have some guides to the best seating for different spinal abnormalities if you’re looking for more specific advice:
Maintaining good posture
As the saying goes, prevention is better than cure. It might be a cliché but it’s definitely true when it comes to posture.
For many people, following the recommendations for proper sitting position (outlined in the first section of this guide) whilst at work and avoiding slouching on the sofa at home will be enough to maintain good posture.
However, for people with disabilities who are at risk of developing postural abnormalities, it is important that their OT and other care professionals work with them to find the right chair to help them maintain the correct seating position.
Head to Toe Support
If someone cannot sit up without support or reposition themselves, then specialist seating which can be adjusted to fit their body is the best way to maintain their posture.
The Lento Care Chair is highly flexible to offer head to toe support to the user. The seat sizing, backrest, recline & footplate angle can all be quickly adjusted to suit an individual’s postural support needs
Here are some tips for providing the correct support for each part of the body whilst sitting:
Head, Neck and Shoulder Support
Avoid neck ache by supporting their head properly whilst they’re sitting. This will allow them to breathe and swallow effortlessly.
If the user requires head support, ensure the neck is kept straight, and the chin slightly elevated, to make sure they are stable. This position also allows the user to interact with the environment comfortably. Make sure you consider the shape and firmness of the support.
The head cushion on the Lento can be re-positioned and resized to support the user’s head and neck positioning
Look for a headrest that you can adjust to accommodate someone’s head position i.e. by changing the shape of the head cushion or by resizing it by adding/removing padding.
Don’t be tempted to add another cushion to fill the gap between the neck and the headrest. This forces the head forward.
Arm Support
The chair’s armrests should fully support the user’s arms, without pushing up the shoulders. If the shoulders are pushed up, it indicates the armrests are too high.
You also need to avoid setting the armrests too low as this can cause the user to hunch forwards.
The arm height on the Lento can be adjusted from 6 – 9”, without any tools, to ensure it is comfortable for the user
It is also important that the user does not have to control their trunk position with their arms for long periods of time, as this will put pressure on the neck and shoulders.
Back and Torso Support
Make sure their back is resting fully against the back of the chair. Any gaps between the user and the chair back mean their weight will be concentrated onto smaller contact areas. This increases pressure, and means they will have to work harder to maintain the position they are sat in.
To avoid this, check for gaps behind the pelvis area, at the small of the back and under the shoulder blades. Adjust the size of the chair to fill the gaps, using lateral supports if necessary, to gain full contact with the chair.
Pelvis Support
People often think the back is the most important thing when it comes to posture. We’ve already discussed how the entire body determines your posture whilst sitting, but good posture actually starts with the pelvis!
If the pelvis isn’t positioned properly, then the whole body ends up misaligned. Ensuring the seat depth and width properly fit the user are key for supporting the pelvis.
The Lento’s seat height, depth and width can all be adjusted in seconds to ensure the user is in full contact with the chair to support their pelvis and torso
Positioning Aids
For those with low body tone, it may be beneficial to start using supporting accessories such as belts, pommels, wedges and lateral supports, to ensure the patient maintains good posture and comfort.
A 4-point belt can be particularly helpful for keeping the pelvis aligned for someone at risk of sliding forward in their chair.
Leg Support
Positioning their legs in the right way will stabilise the pelvic position and improve circulation to the lower legs.
For best results, adjust the leg rest to keep knees at the same height as the hips. This increases stability and keeps the soft tissues on the underside of their thighs supported but not overly compressed.
Foot Support
The most important thing when it comes to foot support is ensuring the feet rest fully on the floor or a footplate. Without this support, their body weight will not be properly distributed.
Avoid putting too much pressure on their heels and support the calf muscles fully by resting their feet lightly on the footplate.
Posture & Seating Assessment
As you can see, there are many factors to consider when it comes to posture and seating!
We hope this guide has explained what good posture means and given you some ideas for improving and maintaining good posture.
However, each individual will have different needs which affect their posture and seating requirements. We always recommend getting a professional seating assessment.
Please get in touch if you’d like to book an assessment! Our specialist team have over 30 years’ experience and will be more than happy to help.
Graeme has worked alongside the public sector for much of his working life, helping departments improve efficiencies and deliver on projects. In his role at Vivid.Care, Graeme used his experience to tackle some of the most challenging issues in the healthcare sector, from falls through to winter pressures. He was also a guest speaker and a number of different conferences, including at the Falls Prevention Summit in London.
