What Is ‘Good Posture’? New Thinking from Physical Therapists

We have a mantra here at Hinge Health. (A bunch of them, actually.) One is, “There’s no such thing as perfect posture.” Another “ism” that our physical therapists say all the time: “Your next position is your best position.” Let’s unpack what we mean by both of these things.

First, let’s tackle the myth of perfect posture, because it surprises a lot of people. After all, didn’t we grow up being told to “sit up straight” and “don’t slouch?” We somehow learned to think that if we didn’t have “good” posture we’d devolve into some sort of hunchback, have chronic pain, and look like a slouch, too? 

“This sort of thinking has been ingrained in most people — possibly from some combination of parents, teachers, even healthcare providers. ‘Bad’ posture is an easy thing to blame when you feel tight and achy,” says Julianne Payton, PT, DPT, a Hinge Health physical therapist and ergonomics specialist. “When you look at the medical literature, however, there’s no hard evidence that posture on its own is a causal factor in pain, or that pain from sitting or standing a certain way means you’re damaging yourself.” 

According to research published in the Journal of Orthopaedic & Sports Physical Therapy, not only is there a lack of data linking poor posture and back pain, but for some people, trying to sit or stand stick-straight may actually trigger pain and tightness. The study authors concluded that there is no one “correct” posture. Instead, you should find various positions that feel right to you. “Helping people to adopt more relaxed postures, while reassuring them that these postures are safe, can provide symptom relief. Comfortable postures vary between individuals, so it is useful to explore different postures,” the researchers noted.

The more you move around each day, no matter what your posture is like, the less stiff and achy you’re likely to feel. In fact, regular physical activity is often recommended as the first-line treatment for people with musculoskeletal pain, which affects one in every two people. “Physical activity can lessen sensitivity in your nervous system — which is a good thing that could mean less pain,” adds Dr. Payton.  

Here, learn more about what physical therapists want you to know about “good posture,” how posture can affect pain and discomfort, and what you can do to have healthier posture.

What Does ‘Good Posture’ Mean, Exactly?

Posture simply refers to the way someone holds their body when they’re sitting, standing, walking, sleeping — whatever. Posture could look like rounded shoulders, a military-straight stance, or an arched lower back. In other words, posture is personal to you.

Yes, it’s true that certain positions are more ergonomic than others. The ‘proper’ stance you’ve probably seen a million times — with your ankles, hips, torso, and neck all aligned over each other — can, in fact, put less overall stress on your joints, tendons, and muscles because that posture takes less work for your body to maintain compared to others. 

“There is some merit there,” says Dr. Payton. “However, we also know that spending hours on end in a position like this isn't healthy, either. I like to think of the traditional ‘good posture’ as more of a base camp for your body: You should wander away from it at times during the day, but it's always a good place to come back to.”

But our physical therapists agree: Regular movement is more important than sitting or standing a certain, specific way.  

Inside the Posture Myth

So where did we get the idea about “good” posture in the first place? It’s kind of a fascinating story. So-called proper posture first became A Thing way back in the late 1500s, when it was associated with the way a person carried themself — including the quality and attitude of their bearing. It conveyed how dignified, respectable, and attractive (or not) someone was. Even then, posture had a certain aesthetic and moral value attached to it. 

Around that time, the term was also used as a way to describe the merits of soldiers standing at attention, and how they carried and wielded their weapons. “Good” posture was paramount because it signified strength, courage, and pride. 

Fast forward to the 19th century, when a German anatomist brought that rigid military posture into the medical literature. He took back measurements of people as they stood at attention and his data became the basis of “good” posture — defined as a straight line inside the body. (This had more to do with symmetry than anything related to pain and stiffness.) To this day, that old data remains the basis of many discussions about posture. Unfortunately, it also helped cement the notion that poor posture is a sign that something must be physically wrong with you. 

The point is that posture — and what’s “good” or “bad” — is a social construct-slash-old wives’ tale, versus a true medical concern. 

The Problem with ‘Perfect’ Posture

We’ll say it again: Studies show that there is no single “correct” posture. And ergonomic experts like Dr. Payton will tell you that everyone’s body is different. People come in different shapes and sizes. The curve of our spine is unique. So what a comfortable, natural posture is for you may not not feel good to another person.  

What’s more, trying to force yourself to use so-called proper posture could potentially make you feel worse. Yep, you read that right. 

“I see so many people with pain in their lower or middle back who say, ‘My posture is so terrible. I know that’s what it is,’” says Dr. Payton. “Sometimes that belief can cause even more soreness and tightness because they try to remedy it by sitting up as straight as they can. They arch their back and roll their shoulders back. That position winds up upsetting the muscles in their upper body and neck even more because they’re not used to sitting that way.” 

Why ‘Your Next Position is Your Best Position’

Okay, so if posture isn’t always the bad guy, then what else may cause the pain you feel when sitting or standing for a long time? We’ll give you a major hint: For. A. Long. Time. Dr. Payton explains that rather than just posture, it’s likely a lack of postural variety that’s making you achy. When you stay in the same position for ages — whether you’re sitting straight as a pin or slumped over your laptop — it can make you uncomfortable. 

“Static positions can be a problem,” says Dr. Payton. “Some of us need to move and change the way we sit and stand over the course of the day.” Even “healthy” positions can go too far. She points to evidence that standing desks — which are supposed to do good by getting you up out of your chair — can contribute to back strain and other problems if you stay on your feet all day, in the same place.

That’s what we mean by the second Hinge Health-ism: “Your next position is your best position.” It can be helpful to regularly switch positions. It will help you avoid that glacial human state, get your blood pumping a bit, and give your muscles and joints a break. 

What Healthy Posture Means for You

Here are some other tips from Dr. Payton about finding ways to sit and stand that feel comfortable and healthy for you:

1. ID what feels right. Now that we’ve gotten that “perfect” posture nonsense out of the way, we can focus on what matters — which is finding positions that feel good to you, whatever they may be. Experiment with different stances and seated positions. And remember: Slouching isn’t the enemy, but slouching all the time can be. Just as standing is healthy, but standing all day in the same position is not. It’s about variety!  

2. Take small breaks. We call them movement snacks. “When you start feeling uncomfortable, it’s time to make even a tiny change in how you’re sitting or standing,” says Dr. Payton. “Even if you’re not in pain, but have been on your feet or butt in the same position for 20 to 30 minutes, you should switch it up.” Set alarms on your phone to help remind you that it’s time to move.  

3. Listen to your body. It’s pretty good at letting you know when something isn’t right. “A telltale sign that a position isn’t working for you is if every time you sit or stand that way, even for five minutes, you feel the pain kick in,” says Dr. Payton. “That's your body saying ‘Hey, you need something different!’”   

4. Undo your day. “Try stretches that are the opposite of what you often do all day,” says Dr. Payton. If you work at a desk, for example, standing and gently bending backward can open up your chest and shoulders. Been standing for a while? Bend forward at the waist to stretch your back. 

5. Be supported. “If you need to sit for long spans of time, an ergonomic chair with armrests and back support is a good starting point. But it’s not the only position you’re ‘allowed’ to be in,” says Dr. Payton. Again, mix up your sitting positions, take breaks, and if you need extra low-back support, place a small pillow or rolled-up towel behind you. 

Feeling better yet?

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Slater, D., et al. (2019). “Sit up Straight”: Time to Re-Evaluate. Journal of Orthopaedic & Sports Physical Therapy, vol. 49, no. 8, pp. 562–564. doi:10.2519/jospt.2019.0610

2. Fullen, B. M., et al. (2023). Musculoskeletal Pain: Current and Future Directions of Physical Therapy Practice. Archives of Rehabilitation Research and Clinical Translation, published online. doi:10.1016/j.arrct.2023.100258

3. Gilman, S. L. (2013). “Stand up Straight”: Notes toward a History of Posture. Journal of Medical Humanities, vol. 35, no. 1, pp. 57–83. doi:0.1007/s10912-013-9266-0

4. Smith, P., et al. (2017). The Relationship between Occupational Standing and Sitting and Incident Heart Disease over a 12-Year Period in Ontario, Canada. American Journal of Epidemiology, vol. 187, no. 1, pp. 27–33. doi:10.1093/aje/kwx298