March 27, 2021

A Trap in the Bend: Why Do People Keep Slouching When It Is Bad?

Written by: Iris Tabangcora, M.D.
Reviewed by: Mubashar Rehman, PHD

Everyone, at some point, has been told to keep their backs straight or else they’re risking themselves to a lifetime of chronic back pains. Yet, slouching has been almost universal among people no matter the age, background, and fitness level. It is deemed easier to maintain and more comfortable over time. So how does something so comfortable can actually be more damaging to us in the long run?

The answer lies in the anatomy of the backbone. When viewed from the side, our back has natural curves. It is designed that way to maintain an upright posture and to aid weight distribution. This architecture requires stabilization primarily by active contraction of muscles of the back, chest, and neck. Other connective tissues like the ligaments, tendons, and joints provide secondary passive support for this structure. Therefore, any factor that can cause structural and mechanical disturbances to this structure causes the back to exaggerate its curves to carry the load and cope with the stress. 

Now, this is complicated by our digital lives. Whether for work or leisure, we are glued to our devices. People slouch when they are fatigued, and this is causing them to be more fatigued. Thus, the phenomenon of bent shoulders and heads excessively leaned forward. The neck and back muscles are so fatigued they can’t hold the head up.

So how does slouching happen? Why is it that people find themselves and their loved ones more prone to slouching? Keeping an upright posture requires active muscle contraction of the back. People who work for long hours in one posture suffer from the strain of back muscles. 

Over time, back muscles become fatigued and are no longer able to maintain the active support, causing the chest and neck muscles to catch the load and begin contracting. This provides short-term relief to the back and therefore encourages more slouching.

The passive secondary support provided by other connective tissues is not enough to maintain an upright posture. Therefore, slouching is just a trap in the short-term comforts of the back but insidiously harmful in the long run. As it compromises breathing, compresses vital structures in the chest cavity, and affects balance, mobility, and self-esteem. 

In addition to this, a study by Lee et al. published in Annals of Rehabilitation Medicine demonstrated that slouching affects scapular movement, particularly during arm elevation. In this study, shoulder dyskinesis causes the middle and lower trapezius, the scapula’s prime movers, to be overactive and more easily fatigued. 

Degeneration and trauma can also negatively impact the integrity of these structures. Women are more likely to slouch as compared to men. Because females usually have lower muscle strength and smaller body size resulting in more musculoskeletal symptoms. 

Slouching in the younger population is often due to congenital causes which make their bones and muscles prematurely weak. Among teenagers, self-esteem issues complicate the posture. Whatever the underlying cause is, it should be identified correctly and addressed appropriately. 

In 2008, Vanderbilt University study published in the American Journal of Epidemiology found out that an average American spends too much time sitting for 7.7 hours. According to Mayo Clinic, sitting for eight hours a day without exercise increases the risk of dying just like obesity and smoking. 

In 2010, the American Cancer Society published a study that women who sit for six hours or more are 94% more likely to die due to metabolic conditions as compared to women who sit for 3 hours or less. This same risk is observed also among men but at a lesser yet still significant percentage of 48%. 

A careful examination of one’s environment should also be done to mitigate this risk factor of slouching. For instance, at work, ergonomics should be observed by providing adjustable and functional working spaces. Furthermore, Mayo Clinic recommends five minutes of standing activities (e.g. taking out the trash, folding laundry, etc.) for every hour of sitting to combat sedentary behaviour. Other things may include interrupting the prolonged sitting like walking around during television ads, going for the stairs if it is an option, and to have a 10-minute walk after meals. The key is to actively incorporate small bits of physical activity in between sitting. Physical therapy can also help to manage pain. 

Conclusion 

 Slouching is clearly detrimental to health. During prolonged inactivity, muscles lose their contractile power and become sore. People slouch to mitigate this fatigue. However, this only provides short-term relief from the fatigue caused by inactivity and sedentary behaviour. Over time, the back loses its support causing it to exaggerate its curves, compromising other organ systems in the process. 

Structural and mechanical injury to the body affects people of all age, background, and fitness level. Even the young and the physically fit people are not spared from this health risk. Technology complicates physical activity and encourages a sedentary lifestyle. People working in offices have to spend their whole day infront of computer screens. Athletes during their training may sometimes exploit their bodies to the point of fatigue. Children may have hereditary diseases that render their bones and muscles weak in the first place. Whatever the cause is, it should be examined carefully and addressed accordingly. 

However tempting to slouch, raising awareness on this faulty coping can effectively prevent people from falling into this trap. Incorporating a mindful attitude towards healthy posture is essential in this approach. A multidisciplinary approach composed of nutrition, pharmacology, physical activity and rehabilitation, and psychological support is the key to ensure that this generation does not end up crippled by pain because of slouching. A good posture is the key in social interaction, transportation, and carrying out activities of daily living. It is high time we stay upright for this health cause. 

 

References

  1. https://www.juststand.org/resource/infographics/sitting-disease-by-the-numbers/
  2. https://connect.mayoclinic.org/page/living-with-mild-cognitive-impairment-mci/newsfeed-post/sitting-is-the-new-smoking/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855127/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527832/
  5. https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590043/

 

Article written by Iris Tabangcora, M.D.
Iris is a Philippine-based physician currently training in Emergency Medicine. She has been writing for various health websites for the last 10 years. Also a Nursing degree holder, she has spent her energy in educating nursing students on Research and Pharmacology. Her interests lie in medical education, research, and public health.

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