Transcript

[00:00] Tim Beames (TB):
Hello and welcome to The Pain Podcast. I’m Tim Beames, and I’m here with Bart van Buchem. Today, we’re tackling another popular myth – the link between posture and pain, specifically, whether “bad posture” even exists. Bart, I wonder if many of your patients believe their pain is related to “bad posture” or if they’ve been told as much?

[00:45] Bart van Buchem (BvB):
Absolutely, it’s a common belief. I think the idea of “bad posture” is ingrained in society, especially here in the Netherlands. People are often genuinely surprised when they hear something different. I always ask them, “Where did you hear that this posture is causing your pain?”

[01:20] TB:
And what do they usually say?

[01:22] BvB:
Sometimes it’s something they were taught as children – maybe their mother told them, or they were corrected in school, with teachers saying, “Sit up straight, shoulders back, chin in.” It’s similar for me; I probably believed the same things until I started studying physiotherapy.

[02:05] TB:
Yes, and it’s fascinating to observe children’s natural, unrestricted movements. I often see my kids experimenting with every possible way to sit or drape themselves over furniture. They’re constantly exploring.

[02:30] BvB:
Absolutely, and they learn to self-correct over time – like when they get pins and needles from sitting oddly. They figure out what feels best through their own exploration.

[03:05] TB:
This podcast is really about finding a balanced view. On one hand, I want to say to my kids, “Sit up properly,” but I also want them to move freely and naturally. Shouldn’t we all have that freedom?

[03:35] BvB:
Exactly. We call it “motor abundance” or “variability” – the freedom to move in various ways. Reflecting on my own habits, I spend a lot of time at a desk, so I have to be intentional about getting up and moving regularly.

[04:45] TB:
It’s so true. I definitely feel it more as I get older – sitting for long stretches affects me much more than it used to.

[05:00] BvB:
Yes, sometimes we can sit comfortably for hours, and other times, even 10 minutes feels like too long. It’s really about maintaining flexibility and not being too rigid about any one posture.

[06:15] TB:
A lot of patients seem to apologise for their posture, as if they’re expecting me, as a physio, to criticise it. It’s fascinating how this perception is attached to our profession.

[06:45] TB:
And there’s often a sense of self-blame. People think of posture in terms of “good” or “bad,” but is it really that simple? Who decides what’s “good” or “bad” posture?

[07:30] BvB:
Maybe part of it comes from societal expectations – sitting straight might signal confidence or strength. And as parents, we might feel uncomfortable if our children don’t “sit properly,” fearing others’ opinions.

[08:45] TB:
Marketing plays into this, too, with slogans like “sitting is the new smoking,” aiming to create emotional impact to change behaviour.

[09:30] BvB:
Posture also reflects personal expression. When someone is in pain, they may naturally move or sit differently, and that’s something we see change as they recover.

[10:30] TB:
Exactly. Instead of telling someone to sit “correctly,” maybe we could encourage a joyful, expressive approach to movement.

[11:00] BvB:
Yes, social media is full of images showing what “good” posture should look like, often featuring young, fit models. It can create unrealistic expectations for those who actually struggle with pain.

[12:15] TB:
Encouraging people to explore different postures can be empowering. Some people feel guilty for slouching – but should they? Many times, they’re surprised when they realise that what they think is “bad” posture isn’t that extreme.

[13:30] BvB:
Helping people experiment with posture can give them a sense of control, especially if they’re dealing with pain.

[14:10] TB:
Exactly. I often work with patients who find certain postures challenging due to their pain. Ignoring those difficulties wouldn’t help. Sometimes small adjustments, like using a cushion or a supportive chair, can make a big difference.

[15:40] BvB:
People often struggle with certain sleep postures as well. It’s all about finding what works for them without rigidly labelling postures as “bad” or “good.”

[16:25] TB:
Yes, experimenting is key, especially if someone has pain in certain positions. Instead of fixating on “bad” posture, it’s more helpful to explore what allows them to be comfortable.

[17:20] BvB:
Exactly. It’s about recognising that posture reflects more than anatomy – it can show fatigue, emotions, or personality. Using words like “bad posture” can create a nocebo effect, making people feel worse.

[18:40] TB:
And on social media, posts often link posture issues to products designed to “correct” it, which is convenient marketing but not always helpful for the person in pain.

[19:10] BvB:
Some devices, like cushions, can help, but there’s no one-size-fits-all solution. Many of my patients have tried every device out there, and they often feel let down when these don’t meet their expectations.

[20:25] TB:
Exactly. Sometimes simple solutions, like a lumbar roll or a towel, can provide support for back pain without all the hype. It’s about what works for the individual.

[21:00] BvB:
It’s also worth noting that posture might have served someone well before their pain began, and the pain can change how they feel about their posture and movement.

[22:40] BvB:
Yes, just showing someone a video or picture of their own posture can be transformative. Often, they’re surprised to see how they actually look – it’s usually not as “bad” as they thought.

[23:25] TB:
Absolutely, we need to avoid terms like “bad posture” and encourage positive language instead. I like to say, “Your next position is your best position.”

[24:50] BvB:
Exactly, getting people to experiment with their posture is empowering. Sometimes, small adjustments can help people feel less strained and more at ease in their own bodies.

[26:00] TB:
In summary, when someone’s in pain, it does affect their posture, but it’s not about “bad” or “good” posture. Pain can influence how we move, but having the freedom to explore different positions is key.

[27:45] BvB:
Yes, and encouraging self-efficacy and experimentation helps people to feel empowered. Embracing movement variety and flexibility is essential.

[30:30] TB:
Thanks for listening! Don’t forget to subscribe, share, and if you want to build confidence in treating pain, visit lepubscientifique.com. We’ll see you in a couple of weeks. Take care!