There’s a lot of information out there about posture and different schools of thought. A more traditional way of thinking about posture is that there is an ideal “plumb line” for posture. Whereas, a more recent school of thought suggests that perhaps there isn’t one ideal posture and really any posture can work as long as there isn’t any pain associated with it. Let’s break this down further and see if we can get a clearer sense of posture and how to move.

What is a plumb line and what does it mean?

This diagram illustrates “ideal” posture using the plumb line, essentially the ear, shoulder, hip, knee and ankle joints are stacked up perfectly.

Neutral Spine

The term neutral spine is essentially posture that falls in keeping with the plumb line; it’s a position where the joints and ligaments are minimally stressed. Neutral spine can vary somewhat between individuals. This is a position that is often mentioned with respect to posture and often the starting point for most exercises, especially core exercises.

How important is keeping your posture in neutral spine?

The answer to this really depends on who you ask, and this is what we believe based on our clinical experience. It’s impossible to always be in so-called ideal posture, nor is it really necessary. We need to assume a variety of postures for all the different tasks we perform in a day. For example, children are often hanging out of chairs, lying rolled up on the floor, etc, and they typically do not suffer from low back issues. So it isn’t so much about assuming a perfect posture all the time. Rather it’s more about changing your posture, and this is what many of us struggle with, and this is related to low back pain. Many of us have sedentary jobs where we sit for hours in a slumped position that stresses our tissues; others of us have very repetitive jobs where we are doing the same thing over and over. These two things, sustaining a posture and repetitive movements are what’s troubling and can lead to low back pain. In these instances, posture correction may be appropriate to take strain off the tissues, as certain postures may help to alleviate symptoms and just as important, variety in postures may help with symptoms as well. This is when neutral spine becomes more relevant as staying in neutral spine, or close to, makes sense for sustained postures, the reason being that neutral spine places the least amount of stress on our joints or ligaments so stress doesn’t accumulate in an area causing strain.

So essentially, if you’re going to sustain a position (like sitting), varying positions that are close to neutral spine are not a bad idea. Each person is unique and a posture that works for one may not work for another, your physiotherapist can help direct what would work best for you.