“What sitting positions should I avoid if I have scoliosis?”
Great question! This is one of our most commonly discussed topics in a client’s 1:1 treatment sessions with their Schroth-trained Physiotherapist or Registered Massage Therapist at The ScoliClinic.
This answer greatly depends on your curve type, symptoms, and risk of progression, but there are some general suggestions that we provide to most of our clients.
Here are the top 3 sitting positions to AVOID if you have scoliosis, Scheuermann’s Kyphosis, are post-surgery, or have persistent back or neck pain in general.
1) Side Sitting (or Side Lying)
If you have a spinal curvature to the right, you can see how side sitting while propping on your right arm might emphasize your spinal curvature in that direction.
You might be thinking, “well if I have a curve to the right, then I’ll just side sit to the left, to correct the curve”.
We understand the train of thought here, however…
…consider what might happen to the areas above and below your single curve, or what might happen if you have two curves (many of our clients have a secondary or even tertiary curve that they weren’t aware of prior to having X-Rays and an assessment done!).
This is even more important if you have structural scoliosis – meaning where the vertebrae become physically wedge-shaped, causing the ‘rib hump’ or prominence when bending forward – it typically doesn’t work to overcorrect into the opposite direction as the wedging of the vertebrae alter the mechanics of the spine.
2) Laying on your tummy (prone), unsupported
Regardless of whether your scoliosis curve is in your thoracic or lumbar areas, laying on your tummy may be a position to avoid.
It can create a sensation of compression in your lumbar spine, and it also positions the spine into back extension (aka arching). Due to the vertebral wedging, many people with structural scoliosis already have too much flattening happening in the back, so lying in this position emphasizes that flattening even more.
If you’ve had spinal fusion surgery, your spine surgeon likely created the fusion to produce a more natural sideview alignment. After the fusion, your spine doesn’t have much movement in the fused area, so any back bending or twisting will likely happen in the areas above or below the fusion.
One of the long-term Physiotherapy goals following spinal fusion is to protect and strengthen the unfused areas, so consider how a sitting position like this one might position those unfused areas of your spine.
*If you’re unsure about the segments of your fusion, or have specific questions about sitting positions, please ask your spine surgeon
3) Heavily slouching with pelvis far from the back rest
Let’s face it – MOST of us start in a reasonable sitting position, and then as the Netflix show carries on, we end up in a position like this, and don’t even realize it!
Can you see how, in this photo, the pelvis is far away from the back rest, and creates a bowing of the back and neck?
In this position, the pelvis tilts backwards, causing ‘posterior pelvic tilt’ which leads to the rounding of the back.
The lumbar spine naturally has a gentle scoop, so prolonged periods of sitting where the lumbar spine is rounded results in the loss of that scoop (aka loss of lordosis). Research has shown that the changes in a person’s sideview alignment can be correlated with increase in symptoms*.
Additionally, a prolonged flexed position of the neck results in a loss of the natural scoop of the neck, which can also lead to symptoms.
*Glassman, Steven D. MD*; Berven, Sigurd MD; Bridwell, Keith MD; Horton, William MD; Dimar, John R. MD* Correlation of Radiographic Parameters and Clinical Symptoms in Adult Scoliosis, Spine: March 15, 2005 – Volume 30 – Issue 6 – p 682-688
“So… how SHOULD I sit on the couch?”
Learn 5 new strategies to try when sitting on the couch – watch this 5-minute video below that shows some suggested sitting positions that you can try if you have scoliosis, Scheuermann’s Kyphosis, or other spinal conditions.
Remember, try various combinations of options and find the sitting positions that feel best for your body.
Most importantly, break up your sitting times – stand up, grab a snack, walk around, and try a quick elongation stretch!