Have you ever experienced back or neck pain after sitting in a car or at a desk for hours? That's because how you sit matters. Whether it's a long car journey or hours at a desk, most of us have felt that back ache or neck pain after the event if not during. For those who regularly drive or sit for extended periods, this discomfort can become acute. This was my experience. After years of repetitively flexing my spine, bending over a massage couch as a sports masseuse, it was a five-hour drive back from Cornwall that triggered the neural pain from a prolapsed disc injury in my low back. I was 35 years old.
I am pain free and put this down to a regular pilates exercise regime. By training my deep, postural core muscles to support my back on a daily basis, I am able to move more efficiently and am less prone to injury. I enjoy rowing and do my fair share of lifting heavy boats!
What causes low back pain?
The most common cause (after structural) is postural stress. This means:
sitting for a long time in a poor position
prolonged bending in a bad working position
heavy lifting
relaxing in the wrong way after vigorous activity
standing or lying down for a long time in a poor position
Sitting Poorly
Most of us spend a large amount of time sitting - either for work (desk job, potter, dentist, musician, commute etc), or for leisure on a sofa in the evening or at a table if you enjoy arts and crafts. Most people who sit for long periods are likely to develop a poor posture as the muscles that support your low back and neck become tired, you relax into a bad position!
Think of the classic slouch, leaning backwards into a chair or leaning forwards away from a chair. This overstretches your ligaments causing stiffness and pain. Habitually done, it can change the shape of a disc which acts as a cushion between each vertebra in the spine and cause it to bulge in one direction or other. Whatever the cause of back pain, sitting poorly will aggravate and worsen the problem.
Many with desk based jobs that require sitting for prolonged periods can develop low back problems. A rounded back causes the spine to lose its natural curves. A lordosis is the natural hollow or inward curve of the spine in the low back and neck when standing upright with a good posture. See Pic A below. When you don't stand correctly (which is most of us!), your pelvis tips too far forwards creating too big a lordosis (B), too far backwards creating a flat back (C) and shifts too far forwards, moving your centre of gravity (D).
How to Sit Well
Be decerning when buying a car, a chair or sofa. The design of a lot of seating is not ideal! Chairs rarely give adequate support to the low back. You have to make an effort to sit correctly otherwise you are forced to sit poorly. Ideally all chairs provide lumbar support to allow that natural lordosis to be there when you sit down.
It would be fabulous if all seat manufacturers were like the Toyota Corporation in 1994 which upgraded the front seats of the Toyota Corona, to include an adjustable McKenzie lumbar support. "Drive the new Toyota Corona and do away with back trouble" was their slogan at the time.
Practical Tips for Sitting Well in a Car Seat & Desk Chair
Adjust Your Car Seat & Posture
Raise your seat as high as is comfortable to ensure maximum vision of the road. Head is an inch away from your head rest, neck is comfortable.
Move the seat forwards so you can fully depress the clutch, accelerator and brake pedals. Elbows will now be bent.
Adjust cushion tilt angle if possible so the thighs are supported along the length of the cushion. Avoids pressure behind the knee.
Adjust angle of back rest so it provides continuous support along the length of the back to shoulder height. Shoulders can relax.
Avoid reclining the seat too far as it will cause excessive forward bending of the head & neck.
Make sure a lumbar support "fits" your back, and is comfortable with no pressure points or gaps
Adjust Your Office Chair & Posture
Seat height & tilt: feet flat on floor. Thighs parallel to floor.
Seat Depth: There needs to be a 1–2 inch space between the back of your knees and the edge of your seat
Back Contour: The back of the chair should make full contact with your back and support the lumbar spine (low back)
Chair able to sit under the desk, elbows are relaxed at a right angle
Head directly over shoulders, about an arms' length from the screen
Wrists relaxed in a neutral position
3 Exercises to Ensure Pain-Free Comfort When Driving & Sitting at a Desk
Learn how to form a lordosis in your low back (Pic 1). Sit on a stool or the front edge of a chair with your feet flat on the floor. Your thighs are horizontal to the floor. Slouch completely & relax with your arms resting on your thighs for 5 secs. Then draw yourself up and accentuate the hollow in your back as far as possible and pull your chin back so your head is directly over your pelvis for 5 secs. Return to the slouch. Repeat the words "pressure on" as you slouch, "pressure off" as you arch that low back. This is moving from an extremely poor seated posture to a n exaggerated upright posture. Do this exercise until you feel a release in your back/neck. Several times a day if seated.
Move More! Back bend (Pic 2). Take regular breaks to minimise the risk of back pain and before it starts. Every hour on a car journey or sat at your desk, get up and bend backwards x 5 gently with your hands on your bottom.
Move More! Hamstring stretch (Pic 3). While you're waiting for a kettle to boil or when you stop at the services take a minute to stretch your legs. All that sitting tightens the muscles at the back of your thighs. Step onto a stool or chair, hold the back if need to. Straighten leg, flex toes. You may not even need to flex forwards to feel the stretch. Hold for 30 secs. Swop sides.
The exercises above will help you short-term. Long-term fitness for good posture and for helping to prevent low back pain, requires a weekly exercise routine to improve your flexibility, mobility, balance, core stability and core strength. Rehab Pilates (APPI) is an answer! Find an instructor with good anatomical knowledge, lots of experience and someone you enjoy.
In Summary
Your spine isn't straight! It has inward curves at the neck and low back . These curves are important for spine health and when lost through poor posture, can cause pain. If you sit a lot for work or leisure, take regular active breaks and stretch more. Make sure you have the right office chair or car seat for you that is adjustable and comes with a lumbar support so you sit well. Be proactive in exercising well to develop a better posture, and a stronger and more flexible body that is less prone to injury.
Give your low back the support it needs. Join my weekly 30 minute Pilates classes on Zoom. Beginners class is on Mondays at 8.30am and intermediate is on Fridays at 9am. Don't worry if the class time doesn't suit you, you''ll receive a weekly recording that you have 7 days to watch. Book via the contact form here
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