The Back & Neck Handbook

An independent, plain-English guide to back, neck and sports-injury care

Everyday habits

Posture when sitting, standing and lying down

An empty wooden park bench under large leafy trees with dappled sunlight on the grass

Posture has a reputation for being about standing up straight and not slouching. The picture in public health guidance is more relaxed and more useful than that: posture is simply how you hold your body, it changes all day long, and the habit that matters most may be changing it often.

What posture means

MedlinePlus, in its guide to good posture, describes posture as how you hold your body and separates it into two kinds. Dynamic posture is how you hold yourself when you are moving, such as walking, running or bending to pick something up. Static posture is how you hold yourself when you are still, such as sitting, standing or sleeping. Both matter, and most days are a mixture of the two.

The same guide explains that the key to good posture is the position of the spine, which has natural curves at the neck, mid back and low back. Good posture keeps those curves without increasing them: the head sits above the shoulders rather than pushed in front of them, and the shoulders sit over the hips. MedlinePlus lists some of the problems it links with slouching or slumping, including neck, shoulder and back pain, reduced flexibility, and effects on balance.

There is no single perfect position

A common worry is that there is one correct way to sit or stand and that anything else does harm. The Occupational Safety and Health Administration's guide to computer workstations puts it plainly: there is no single "correct" posture or arrangement that will fit everyone. Bodies differ in height, proportion and flexibility, and a position that suits one person may feel strained to another.

What OSHA describes instead is the idea of a neutral body position, a comfortable working posture in which the joints are naturally aligned. Its page on good working positions adds a crucial point: however good a posture is, working in the same posture or sitting still for long periods is not healthy. It recommends changing position frequently through the day by making small adjustments to the chair or backrest, stretching the fingers, hands, arms and torso, standing up and walking around for a few minutes from time to time, and doing some tasks standing.

In other words, the best posture is often the next one.

Sitting

MedlinePlus's guidance on sitting is a short list of practical points:

  • switch sitting positions often, and take brief walks around the home or office;
  • gently stretch your muscles every so often;
  • keep your feet on the floor, or use a footrest if they do not reach, rather than crossing your legs;
  • let your shoulders relax rather than rounding them or pulling them back;
  • keep your elbows in close to your body;
  • make sure your back is fully supported, using a cushion or back support if the chair does not support the curve of the lower back;
  • make sure your thighs and hips are supported by the seat.

The desk setup page applies these ideas to chairs, screens and keyboards.

Standing

For standing, MedlinePlus suggests standing up straight and tall with the shoulders back, the stomach drawn in, the weight mostly on the balls of the feet, the head level and the arms hanging naturally at the sides. In practice, long spells of standing still, at a counter, a workbench or a till, bring their own aches, and people often shift their weight, rest one foot on a low step or rail, and take short walking breaks in the same way that desk workers stand up. Comfortable, low-heeled shoes come up in the MedlinePlus guide too.

Lying down

Most people spend a large part of every day lying down, so sleeping positions are part of posture too. There is no universally right way to sleep, but a few general ideas come up often. Side sleepers usually look for a pillow deep enough to keep the head in line with the spine rather than dropped or tipped up, and some place a pillow between the knees. Back sleepers often use a flatter pillow, and some place a pillow under the knees. Sleeping on the front turns the head sharply to one side for hours, which some people with stiff necks find uncomfortable. The neck pain page mentions awkward sleeping positions as one everyday source of a stiff neck.

Posture in motion

Dynamic posture is easy to forget, but it is where much of the load on the back comes from. Bending from the hips and knees rather than rounding the lower back, keeping loads close to the body, and turning with the feet rather than twisting at the waist all come up in guidance on lifting and carrying. MedlinePlus also suggests being mindful of posture during everyday activities such as watching television, washing dishes or walking, and making sure work surfaces are at a comfortable height, whether you are at a computer, preparing food or eating a meal.

Keeping it in proportion

Posture is one thread among many. Plenty of people with textbook posture still get back pain, and plenty with less tidy habits never do. It is best seen as one of the everyday things you can adjust, alongside staying active, breaking up long spells in one position, and paying attention to how your body feels. The staying active page picks up that theme.