Neutral Spine Tips

General

  • When sitting or standing try to maintain ears over shoulders and shoulders over hips.
  • Brace and breathe: Contract your abdominal muscles as if bracing for a punch to the stomach (100% contraction).  Now back off and contract to 15% of your max.  Ensure to maintain breathing throughout contraction.

Sitting 

  • When sitting ensure hips and knees are at 90 degrees.  Feet should just be touching the floor. 
  • Use a lumbar support for your low back.  It should be approximately 4-5 inches in diameter.
  • Lift your chest: picture a string being attached from the ceiling to the 3rd button on a shirt. 
  • Keep shoulders back and not elevated.
  • Keep your chin level.  Imagine balancing a book on top of your head.  The highest point on your body should be the back region of the head.
  • Remember to take “microbreaks” every 30 minutes to 1 hour.  Get up and take a quick 15-30 second lap around your desk or perform a few stretches.  Frequent breaks and movement give relief to postural muscles and decrease the chances of injury.
  • When arising from a seated position shimmy to the end of the chair, place feet shoulder width apart directly below your body.  This brings your base of support underneath body mass “nose between the toes”, and then stand.  Using hands to push on your legs or the arms of the chair can be helpful.  Try to use buttock and thigh muscles to push yourself up.
Standing

  • Wall test: Stand with your head, shoulders and back against a wall.  Engage your lower abdominals.  Try to maintain this upright vertical alignment standing away from the wall.
  • When walking try to maintain a neutral spine.  Brace and breathe, especially for sudden movements.  Ensure arms and legs swing naturally and smoothly.

Lifting

  • Hip hinge instead of flexing your back.
  • If the object is light use a golfers lift (balance on one leg, extend other leg back and hinge about the hip).
  • Hold loads as close to your body as possible (specifically the naval).  When lifting always engage your abdominal musculature for support “brace and breath”.
  • Avoid repetitive bending and twisting.  If you must twist, pivot with you feet instead of your back.
  • Never make sharp movements, keep them smooth and fluid with your abdominals engaged.

Driving

  • Adjust the seat so your back is vertical and your head is able to rest gently on the headrest with your chin level.
  • Knees should be slightly bent at the same level of your hips or higher.
  • When the hands are on the wheel elbows should be slightly bent and relaxed.
  • Avoid holding your shoulders in an elevated position.

Sleeping

  • A sagging mattress or use of multiple pillows will interfere with neutral spine positioning.
  • Lying on your back is the most comfortable when neutral spine is maintained.
  • For individuals with neck or back pain it is best to lie on the side or on the back.  When lying on the side place a pillow between the knees. 
  • When shopping for a mattress wear lose clothing, take your shoes off and don’t be shy.  Try to spend at least 10 minutes lying on your back, each side and your stomach. 
  • The mattress should mould to the contours of your neck, back, hips and knees and keep your spine in a neutral position. 
  • Don’t assume that a hard mattress is better for your back.  Some studies have shown that mattresses that conform to the contours of your body gave less back pain and allowed for greater sleep time.