July 26, 2021

Common Habits and Activities that are Harming Your Posture in the Long Run

Written by: Amanda Cheong, M.D.

Our health does not always lean on big events like opening a gym membership or starting a new diet. Often, it is built on a dozen small habits we engage in daily. Health is in the decision to bike to the grocery store instead of taking the car. The habit of mindlessly snacking may open more bags of chips than we would consume otherwise.


The same is true with our bodies. It is an incredible machine that can engage in powerful and precise movements. But like any machine, it is subject to a certain amount of "wear and tear." And there are some habits that speed up this process-- especially with regards to your posture.


Why bother with posture?


Problems with posture don't sound as worrisome as other health problems like heart disease or infection. However, while bad posture symptoms don't cause death or organ damage, they do cause pain. Slumped postures while sitting down can cause chronic low back pain.[1] Those who always crane their neck forward can experience chronic neck pain.[2] Bending the wrong way can cause stiffness in the back muscles.[3]


No one wants to carry tension and pain in their muscles. Luckily, much of the activities that cause these chronic posture-related pain boil down to a handful of small habits. They can easily be changed to prevent the long-term effects of bad posture.


Being mindful of these habits can get you far in terms of posture. So what are they?


Posture at work (or work from home)


A considerable number of people spend most of their work hours on a chair, typing away at a computer. But that keeps you on your chair for most of the day for most days of the week. Think about how you sit in front of a computer. Chances are that your back isn't perfectly straight all the time, and you can have a slumped posture. If you're constantly staring at a computer screen that's below eye level for a long time, your head will gravitate forward to look down at your work. This forward head posture makes the slouch and a rounded back more prominent. You're also doing continuous repetitive movements in typing for work. Continuously maintaining this posture can result in chronic back pain and balance problems.[1,4]


Does that mean that you're saved if you're not working on a computer? Not quite. There are other sitting positions that could be harmful to the posture. Imagine yourself throwing a leg over the other to keep them crossed. In throwing your leg up, your hips would have to bend sideways. The spine would follow suit, tilting with the hips. Sitting cross-legged, especially for more than three hours,[5] can lead to a bent and asymmetrical posture. It can even promote the forward head posture we mentioned earlier.[6]


The best sitting position would be to keep both feet flat on the floor. Keep your back straight. Put your monitor at eye level so you're not always craning your neck to look down at your work.[4,6]


But, more often, the computer isn't the gadget you're looking down at.


Posture while using the phone


When people use their phones, they keep them in a position that is comfortable for their arms. This is typically much lower than the head. You end up looking down at the screen with your head tilted forward and your neck flexed. This posture has earned the name "text neck" for its prevalence among smartphone users.[7]


When the head is tilted forward, away from the support of the body, it feels heavier. Sometimes twice as heavy with just a 15-degree tilt.[8] But our forward-facing heads are not the only thing we carry on a daily basis.

Related Article: Back Straighteners: Posture Importance and How Tools can Help Achieve It

Posture while carrying heavy bags


Heavy backpacks can also insidiously cause posture changes in the long run. When there's a heavy load on the back, the center of gravity would no longer be at the center and resting at the hips. The head would compensate and tilt forward. Yes, that is the perpetual forward head posture once more. This alteration in neck posture, especially in children who carry heavy backpacks to school, can even cause respiratory problems where the chest isn't allowed to expand fully.[9]


This is even worse when you're carrying a shoulder bag or a handbag. This would create an unequal load and a corresponding postural deviation from multiple planes. This asymmetrical posture would not work well with a spine that tilts and twists in stressful angles.[10]


Posture while wearing heels


You knew this was coming. No article on posture would be complete without tackling heels. To keep the balance while wearing heels, there is a tendency to arch the back. Think of how pregnant ladies' posture would tilt back to support the baby. Now that the center of gravity has changed, the body compensates by moving the neck into a forward position once more.[11]


We've already discussed the kind of strains this can put into the body. When your daily routines have many of these habits in them, they can build up and make us more used to these poor postures. But what about things outside your daily routine?


Posture when sleeping


We spend as much as 8 hours in bed, often in the same position for the whole night. As such, our habits during the evening play a crucial role in shaping our posture. The best sleeping position is one that supports the spine, reduces stress, and relaxes muscles.


As such, sleeping on your belly is the biggest no-go in terms of sleep positions. Having your head tilted to one side for the whole night keeps the spine misaligned and creates tension around your neck and upper back. For those with lower back pain, the recommended position is lying on one side with your legs extended and a pillow between the legs. Those with neck pains can sleep on their back with a pillow under their neck and their knees. Keeping your knees bent while lying down relaxes the muscles of the back as well.[12] However, that pillow behind the neck shouldn't be too high as this can cause increased pressures on the too-extended neck and poor alignment.[13]


They say identifying the problem is already half the battle. Knowing the little habits that strain and harm your posture (especially that perpetually present text neck) is your best start towards taking care of your body.


  1. Meziat Filho N, Coutinho ES, Azevedo e Silva G. Association between home posture habits and low back pain in high school adolescents. Eur Spine J. 2015;24(3):425-433. doi:10.1007/s00586-014-3571-9
  2. Falla D, Jull G, Russell T, Vicenzino B, Hodges P. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther. 2007;87(4):408-417. doi:10.2522/ptj.20060009
  3. Creze M, Bedretdinova D, Soubeyrand M, et al. Posture-related stiffness mapping of paraspinal muscles. J Anat. 2019;234(6):787-799. doi:10.1111/joa.12978
  4. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012;36(1):98-104. doi:10.5535/arm.2012.36.1.98
  5. Park Y, Bae Y. Comparison of postures according to sitting time with the leg crossed. J Phys Ther Sci. 2014;26(11):1749-1752. doi:10.1589/jpts.26.1749
  6. Jung KS, Jung JH, In TS. The Effects of Cross-Legged Sitting on the Trunk and Pelvic Angles and Gluteal Pressure in People with and without Low Back Pain. Int J Environ Res Public Health. 2020;17(13):4621. Published 2020 Jun 27. doi:10.3390/ijerph17134621
  7. Eitivipart AC, Viriyarojanakul S, Redhead L. Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence. Hong Kong Physiother J. 2018;38(2):77-90. doi:10.1142/S1013702518300010
  8. David D, Giannini C, Chiarelli F, Mohn A. Text Neck Syndrome in Children and Adolescents. Int J Environ Res Public Health. 2021;18(4):1565. Published 2021 Feb 7. doi:10.3390/ijerph18041565
  9. Ellapen TJ, Paul Y, Hammill HV, Swanepoel M. Altered cervical posture kinematics imposed by heavy school backpack loading: A literature synopsis (2009-2019). Afr J Disabil. 2021;10:687. Published 2021 Jan 22. doi:10.4102/ajod.v10i0.687
  10. Bettany-Saltikov J, Cole L. The effect of frontpacks, shoulder bags and handheld bags on 3D back shape and posture in young university students: an ISIS2 study. Stud Health Technol Inform. 2012;176:117-121.
  11. Silva AM, de Siqueira GR, da Silva GA. Implications of high-heeled shoes on body posture of adolescents. Rev Paul Pediatr. 2013;31(2):265-271. doi:10.1590/s0103-05822013000200020
  12. Desouzart G, Matos R, Melo F, Filgueiras E. Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work. 2015;53(2):235-240. doi:10.3233/WOR-152243
  13. Ren S, Wong DW, Yang H, Zhou Y, Lin J, Zhang M. Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment. PeerJ. 2016;4:e2397. Published 2016 Aug 31. doi:10.7717/peerj.2397
Article written by Amanda Cheong, M.D.
Dr. Amanda Cheong spent her formative medical years within the walls of the Philippine General Hospital, a high-volume tertiary institution built to serve the underserved. After graduating with a degree in medicine, she went on to write, edit, and compile healthcare stories from the start of the COVID-19 pandemic for an online anthology. Currently, she is involved in medical research as well as volunteer telemedicine consults. She enjoys writing fiction on the side when she’s not tending to her plants and three pet turtles.

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