Is there a perfect sitting posture?

The Truth About Sitting Posture: Physical Therapy Tips for Preventing Neck and Back Pain

When it comes to preventing neck and back pain, most people have heard the usual advice: sit up straight, keep your feet flat on the floor, and support your lower back. While these tips can be helpful, they don’t tell the full story of how to sit comfortably for long periods.

The truth is, there’s no such thing as a “perfect” sitting posture, and that’s a key principle in physical therapy. In fact, the best sitting posture is one that constantly changes. Our bodies are designed to move, not remain still for long periods, whether we’re sitting, standing, or lying down. Just as you naturally shift your weight when standing, sitting should involve frequent adjustments to prevent discomfort and long-term issues.

Why Static Sitting Causes Problems

When we sit for long periods—especially while working or focusing on a task—we tend to lock into one position. This prolonged stillness can lead to tension, stiffness, and ultimately pain, particularly in the neck and lower back. This is where physical therapy plays a vital role: teaching us how to adjust our habits and posture to reduce the strain on our bodies.

Sitting in one static posture for too long, even if it’s “perfect,” is not ideal. The key is to introduce small, consistent movements that engage the muscles and reduce pressure on certain parts of your body. It’s not about sitting in one way forever; it’s about finding ways to keep your body active, even while seated.

Physical Therapy-Backed Tips for Comfortable Sitting

Here are two simple yet highly effective tips that can help you sit more comfortably during long periods of work or study:

1. Keep Moving: Small Adjustments Make a Big Difference
While it might seem counterintuitive, fidgeting while sitting can be beneficial. Making small adjustments—such as shifting your weight from side to side, crossing and uncrossing your legs, or adjusting the height of your chair—helps prevent muscle tension from building up.

Physical therapists often recommend this kind of regular movement because it engages different muscle groups, reducing strain on your lower back and neck. The more often you change your posture, the less likely you are to experience discomfort later in the day.

In fact, if you’re experiencing ongoing pain from sitting too long, a consultation with a physical therapist could help you learn more personalized movement strategies to relieve discomfort and prevent future issues.

2. Give Your Eyes a Break: The 20/20/20 Rule
There’s a strong connection between extended screen time and discomfort in the upper body, particularly around the neck, shoulders, and eyes. This is known as visual strain, and it’s a common issue in today’s digital world. When your eyes are fixed on a screen for long periods, it leads to tension that can affect your entire posture.

To alleviate this, optometrists recommend the 20/20/20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away. This helps relax the muscles in your eyes and reduces tension in your upper body.

Incorporating this simple practice into your routine can significantly reduce the risk of neck and shoulder pain, especially if you spend a lot of time in front of a computer.

If you’re experiencing discomfort from long hours of sitting at work or school, I have great news. We’re offering a Low Back Pain Workshop on Saturday, October 5th at 9 AM. This workshop is perfect for anyone struggling with back pain and looking for immediate solutions that can be implemented at home or work.

During the workshop, we’ll cover practical strategies from physical therapy that you can use right away to relieve low back pain, improve your posture, and keep your body active—even when sitting for long periods.

Interested? Click here to sign up and get more information!

Common Myths About Physical Therapy – Debunked

Many people have misconceptions about physical therapy and those who have never experienced treatment often misinterpret what physical therapists can offer. The expertise of the physical therapy team at Cohen Health and Performance goes far beyond simple stretching routines. Here are 4 common myths about physical therapy that we hear at our Bethesda and McLean facilities.

Myth 1: “I Need a Doctor’s Referral to Go to Physical Therapy”

At least once a week I hear this one and I am always happy to shine a light on the most common physical therapy myth that we see. Thanks to legislation known as Direct Access, you can schedule an appointment with a physical therapist without needing a referral. The benefits of Direct Access are significant: faster treatment and less hoops to jump through. Instead of taking the extra time to see a physician, you can visit a physical therapy clinic and start receiving care immediately. This streamlined approach not only saves you time but also helps you address your pain or injury more swiftly.

Myth 2: “I can see another healthcare provider for physical therapy”

This is a dangerous misconception. Only licensed physical therapists are qualified to provide the specific care required in physical therapy. According to Move Forward PT, approximately 37 percent of people believe that any healthcare professional can perform physical therapy methods on patients. It’s crucial to understand that physical therapy requires specialized training and knowledge that other healthcare professionals do not possess.

Myth 3: “Physical Therapy Is Only for Injuries”

It’s a common misconception that physical therapy is solely for treating injuries. While treating injuries is a significant part of what physical therapists do, our scope of practice is much broader. Physical therapy can benefit a wide range of conditions and goals, from enhancing athletic performance to managing bone loss associated with aging. For example, at Cohen Health and Performance, we provide customized running analysis and training recommendations for runners looking to improve their performance or reduce future injury risk. Physical therapy is about improving overall well-being, not just recovering from injuries.

Myth 4: “Surgery Is More Effective”

Many people believe that surgery is the most effective treatment for pain relief. While, surgery is necessary in many situations, that is not always the case. Depending on the injury or health condition, physical therapy can be a more effective and less invasive option. For instance, conditions like low back pain or meniscus tears may respond better to physical therapy than surgery. Before opting for surgery, consulting with a physical therapist can help you explore all available treatment options. Physical therapy might offer a less risky and more holistic approach to pain management and recovery.

Unseen Benefits of Physical Therapy

Now that we’ve debunked these common myths, let’s explore the real benefits of physical therapy that often go unnoticed.

Enhanced Quality of Life

Physical therapists aim to improve your overall quality of life. This involves not just treating pain or injury, but also enhancing your physical function, mobility, and overall health. For athletes, physical therapy can optimize performance and prevent injuries, allowing them to excel in their sports.

Preventive Care

Physical therapy isn’t just reactive; it’s also proactive. Physical therapists work with patients to prevent injuries before they occur. Preventive care at Cohen Health and Performance often includes educating patients on proper body mechanics, developing strength and conditioning programs for sport, and providing ergonomic advice for work or daily activities. By addressing potential issues early, physical therapy helps you avoid future pain and injury.

Holistic Approach

Physical therapy takes a holistic approach to health and wellness. Physical therapists consider all aspects of a patient’s life, including their physical, emotional, and social well-being. This comprehensive approach ensures that the treatment plan addresses the root cause of the problem, not just the symptoms. For example, a physical therapist might recommend stress-reduction techniques or lifestyle modifications into a treatment plan to support overall health and recovery.

Personalized Treatment Plans

Each patient is unique, and physical therapists create personalized treatment plans tailored to individual needs and goals. This personalized approach ensures that the treatment is effective and aligns with the patient’s lifestyle and goals. Whether you’re an athlete looking to return to your sport, a senior aiming to maintain independence, or someone managing a chronic condition, your physical therapist will design a program that’s right for you.

Physical therapy is a dynamic and essential field that offers much more than most people realize. Physical therapists are highly trained professionals who provide comprehensive care that can improve your quality of life, prevent future injuries, and offer effective alternatives to surgery. By debunking these myths, we hope to shed light on the true value of physical therapy and encourage more people to take advantage of its many benefits.

So, the next time you’re dealing with pain, recovering from an injury, or looking to improve your overall health, consider seeing a physical therapist. You might be surprised at how much they can help.

What I learned by going to the ER

I woke up for the final day of a conference I had traveled to in Orlando. My wife, Deb, joined me for the trip, and the first thing I heard from her was, “What happened to your elbow?!”

I had a golf ball-sized bump on the back of my elbow, consistent with Olecranon Bursitis. I remember one of my professors in physical therapy school calling it “Popeye elbow.” This typically occurs because of a trauma or infection, and there hadn’t been any trauma, so it must have gotten infected, which needs to be treated immediately.

We flew back home that afternoon and went right to the emergency room. After waiting a few hours, they confirmed the infection, prescribed antibiotics, drained my elbow, and recommended that I consistently maintain compression on the area.

But I wasn’t confident in the recommendations….

The PA that treated me had a lot on her plate. She was running from room to room, and I could sense she was providing general recommendations because this wasn’t her area of expertise.

So, I later texted some of my colleagues here in McLean and Bethesda within the physical therapy/medical field, and they confirmed my suspicions.

The antibiotic I was prescribed was not the best option for my type of infection, and these areas of swelling should never be wrapped in compression garments.

This is not the fault of the people of the ER. I greatly respect their expertise, the stressful environments they work in, and the fantastic work they do to help so many people. This just wasn’t their area of expertise.

In fact, they did the most critical part of their job. They kept me safe until I could see a specialist.

Elbow conditions such as mine were his area of expertise. His recommendations were specific and clear, and most importantly, he took his time so that I could ask any questions I had.

What a refreshing experience. My doctor was present, and I didn’t feel like his hand was on the doorknob the entire time as he tried to leave quickly.

It is impossible to provide excellent care when we are rushing. As physical therapists, we learn so much just by being present. One of the first things I tell our doctoral students is that our patients will give us all the clues if we slow down, listen, and ask great questions.

Are your healthcare providers doing that? Can you ask all the questions that you have?

What about when you aren’t in their clinic? It’s normal to forget to ask something during an appointment. Will they answer your question promptly when you aren’t in their office?

If you need help, contact me to connect you with the right healthcare provider. I’ve made it a mission to connect with the healthcare community around the DMV because that will help us better serve you.

As healthcare consumers, we can see whomever we want. Look for an expert that provides you with the type of care that you expect to receive!

Why I’ve Been Training Like a Bodybuilder

If there is one thing that natural bodybuilders (aka those that don’t take steroids) know, it is how to build muscle.

One of my friends is a personal trainer and natural bodybuilder, and can compete with those that aren’t “natural” by being super bright, with a deep understanding of the science of hypertrophy (fancy word for building muscle).

Muscle helps protect against injury, and as physical therapists, we need to understand how to help our patients build more when necessary.

What better way to learn than to test yourself? All physical therapists should try it on themselves first, right? My friend and I have been designing my training routine for the past year, and my back feels great.

As many of you know, my history of low back pain, beginning as a collegiate athlete, led me to become a physical therapist. In the past, strenuous weight training programs would irritate it. But I have been training harder than ever over the past year and feeling great.

People often experience back pain as they use their backs to support or lift weights. If I was using my back during an exercise, I wasn’t placing enough stress on my muscles to stimulate growth.

It is easy to cheat as exercises become more challenging. Maintaining quality technique when tired is a great way to remain resilient to injury. Check out this video for more on this.

Besides reducing injury risk and building strength, adding muscle is helpful for other reasons, including:

Increased metabolism: More muscle equals a higher metabolic rate. This doesn’t just mean your body will burn more calories at rest. A higher metabolic rate provides more sustainable energy to the body throughout the day.
Decreased fall risk: Increased muscle mass helps to reduce fall risk in the elderly population, and it is best to start this process early.
Reduced risk of chronic disease: Increasing muscle mass has been shown to help reduce the risk of chronic diseases such as diabetes and heart disease. Muscle tissue helps to regulate blood sugar levels, blood pressure, and cholesterol.

Ready to join me and enter a bodybuilding competition?! Just kidding. That is not necessary, but there is a lot we can learn from unexpected places!

My jaw pops, is that bad?

Have you noticed joints making more noise as you have gotten older? One of the strangest ones is the random popping I get in my jaw.

Does that ever happen to you? If so, and if it is painful, you may want to investigate it (our physical therapy team in McLean and Bethesda treats this!).

Open and close your mouth while feeling in front of your ears. Search until you feel the joint moving, called your temporomandibular joint (TMJ). This joint allows you to open and close your mouth and move your jaw from side to side.

The TMJ has a small shock-absorbing cartilage disc between the jawbone and your skull. If this disc moves out of alignment or there is arthritis in the joint, clicking, popping, and pain can occur.

The alignment of the TMJ is a product of everything below it. When I see physical therapy patients experiencing TMJ pain, I first check the position of the head, neck, and rib cage and look at posture. Check out this article to learn more about how to get your head, rib cage, and pelvis in the proper position.

This sometimes corrects TMJ pain, but we can’t stop here. Here are some factors that may also need to be addressed.

Malocclusion: Malocclusion is when the teeth do not fit together correctly, resulting in jaw misalignment. This is when your dentist needs to work with your physical therapist as part of the healthcare team!
Stress: Teeth clenching is associated with stress. Caring for your mental health is essential to helping TMJ issues. Many dentists also suggest nightguards for those of us that clench when sleeping.
Chewing gum: stay away!
Posture, especially while working: What posture is best? Does that even exist? Check out an article I wrote on that here.

Popping, clicking, and jaw pain is most likely a result of several different factors. TMJ issues usually require a healthcare team such as a physician, physical therapist, and dentist. Popping and clicking without pain likely isn’t much to worry about. Still, please see a healthcare provider if pain is associated with it.

At CHP, our physical therapists we evaluate patients with TMJ discomfort. If you or anyone you know would like help solving these challenging problems, contact us today!

The Best Sitting Posture

This is the best sitting posture.

Many physical therapy articles and rehab blogs discuss the importance of sitting posture and how perfect sitting posture is essential to avoid neck and back pain. Here are a few examples of what I found in several articles online.

Sit with your feet flat on the floor. This position helps to distribute your weight evenly and reduces pressure on your lower back.
Support your lower back. If your chair doesn’t provide enough support for your lower back, consider using a lumbar roll or cushion. This can help maintain the natural curve of your spine and prevent low back pain.
Sit up straight. Sitting up straight helps to maintain good posture and reduce strain on your back. Avoid slouching or leaning forward.

While these may be helpful recommendations as part of the physical therapy process, they miss the most important thing.

There is no perfect sitting posture, and the “best” posture is the one that is constantly changing.

When standing, we naturally sway and shift our weight forward and back or from one foot to another. Unfortunately, this goes away as we sit and concentrate on something…like this blog I’m writing!

The longer we concentrate on something, muscular tension increases. This keeps us still and helps us focus better on what is in front of us. Unfortunately, too much muscular tension leads to discomfort.

Does this mean you must get up every 10-15 minutes and move around? In a perfect world, sure, but there may be better solutions if you try to get stuff done.

As I am writing this article, I am fidgeting. My sitting posture is changing, and I am shifting my weight from one side to the other. I sometimes cross one leg under the other and raise or lower my chair.

But one more part of sitting posture may be most impactful.

Give your eyes a break.

Research shows a connection between high levels of focus on a screen and discomfort in the upper body.

Optometrists recommend the 20/20/20 rule to help with this. The 20/20/20 rule states that for every 20 minutes of focus-intensive work, you should take a 20-second break and look 20 feet away.

This helps to reduce your focus on a single point and, as a result, reduces tension in your upper body.

Our bodies typically don’t respond well when we ask them to be still for long periods. A more active approach to sitting helps us avoid the discomfort that may come with it.

If you are interested in learning other strategies that can be used to sit comfortably throughout your day, contact us!