A couple of months ago (April 26, 2024), the New York Times online edition posted an article titled, "Beth Linker Is Turning Good Posture on Its Head." The teaser read, "A historian and sociologist of science re-examines the 'posture panic' of the last century. You'll want to sit down for this." (Shhh, I copied and saved the text as a PDF here so you don't have to deal with the NYT paywall. Don't nobody rat me out!)
Any time I see or hear the word "posture," I think of my good friend Mary Bond, author of The New Rules of Posture: How to Sit, Stand, and Move in the Modern World, and Body Mandala: Posture, Perception, and Presence. Mary has spent a lifetime examining anatomy, posture, and the mindfulness of moving through life with elegance and grace. I steeled myself for an article that would totally torpedo all her work (and mine as well!). Does it do that? Well, sort of. Let's take a closer look.
First of all, just because an article or viewpoint is reported by the venerable New York Times, or the interview subject is a published author and holds a position of academic authority, does not make it gospel. The subject of this particular article, Beth Linker, is a historian and sociologist of science at the University of Pennsylvania, and she has a new book, Slouch: Posture Panic in Modern America. It's important to note that she is not a scientist or medical doctor herself, nor a physical therapist, movement artist or instructor, etc.
After you've finished reading this article, there are many aspects to consider.
History. This is where Linker's expertise lies, and there's certainly no disputing the light she has shed on this phenomenon. I learned a lot about the sociology and culture of posture. It's fascinating to read how these social movements began, starting with natural selection (Charles Darwin, 1859), and the rise of eugenics (Sir Francis Galton, 1883). Fast-forward a few decades to the now-absurd-sounding American Posture League (1914) and the renamed President's Council on Physical Fitness (1961, under John F. Kennedy).
Linker paints a picture of societies infatuated with pushing good posture for the health of their citizenry (at best), to the other extreme of sizing up a person's "character, intelligence, and health" via "posture assessments." As you can imagine, this contributed to documented discrimination across socio-economic and racial strata.
Especially extended into this day and age of social media, this could easily fall under the umbrella of body shaming: making judgements regarding attractiveness, personality, productivity, fertility, and other attributes due to the way someone holds their carriage.
So there has certainly been some irrational obsession with posture as a marker of a person's intangible qualities. But is it legitimate for the pendulum to swing the other way and say posture is not important?
Nature vs. nurture. Let's go back to Darwin, and Nature. Do posture, body language, and appearance play a role in the social structure and mating habits of "lesser" animals? The answer is an unequivocal "yes."
Look at the dominance hierarchy in animals like capuchin monkeys, mandrills, lions, even insects. (But not wolves; the idea of an alpha male and alpha female in wolfpacks has been debunked.) Can you tell who the dominant male(s) or dominant female(s) are? Oftentimes they are the biggest and/or most colorful. They'll be in the center of the pack, or leading at the front. The dominants get first access to the best food, their choice of mates, the best sleeping spots, and so on.
Among many species, appearance is the deciding factor in mating rituals. Nowhere is this more colorfully displayed than in the 45 species of birds of paradise, or one of my favorites, the peacock jumping spider (Maratus volans).
These are characteristics and behaviors woven into the evolution of species over millions of years. And rightly or wrongly, they will always persist, even in homo sapiens. Confidence is reflected in posture, but the converse is also true: posture may breed confidence.
This calls to mind the famous (but controversial) research study done by Amy Cuddy, social psychologist formerly of Harvard Business School. Cuddy is a proponent of "power posing," the idea that striking confident standing or sitting poses change people's feelings, behaviors, and hormone levels. In 2010, she published a study that showed exactly that: power poses increased testosterone, decreased cortisol, increased appetite for risk, and caused better performance in job interviews.
The study was controversial because it could not be replicated in other double-blind trials. But nevertheless, it underlies an inherent truth in human social behavior: people who stand tall and act confident draw attention and generate attraction, and if necessary, can "fake it till you make it."
Should we be better? As highly evolved animals, are there behaviors we should rise above? After all, there are many other actions and practices in the natural world we do not ascribe to in our social construct of laws and codes of conduct. In the above example of the peacock jumping spider, if the male is unsuccessful in impressing the female... he gets eaten! (Spoiler alert: even the successful males get eaten!) Among lions, infanticide is frequently committed by incoming males to ensure their lineage prevails.
So yes, we should be able to transcend sweeping generalizations regarding height, weight, skin color, posture — or any extreme action that might follow such judgements. But that doesn't mean there isn't an underlying, fundamental purpose for posture...
Functionality and holism. Homo sapiens is built upright on two legs, and is the most highly evolved animal on the planet because of this. The thought is that our vertical height was an advantage in spotting prey or danger. Locomotion on two legs also allows for greater endurance and less energy expenditure than using four limbs.
With this skyward evolution — directly against the line of gravity! — came a change in the size, shape, and placement of structural tissues and bones. Things had to be "stacked" on top of another in a way that would create efficient support. In this new mode of bipedal movement, structure and posture had to be functionally compelling.
And with the forelimbs now free to partake in actions other than being on the ground — like a tai chi push! — expressing/receiving force or leverage through the hands also affected postural development. Not to mention the tall task (pun intended) of holding up a head at the top of this stack that weighs 10-12 pounds.
So structure, posture, and alignment matter. Having a slightly forward head posture (FHP) by 15 degrees turns that 10-12 pounds into effectively 27 lbs. And it gets worse. The typical "text neck" angle of 60 degrees turns that spinal load into 60 pounds!1
That FHP and rounded upper back (slumping, slouching, also known as kyphosis) can diminish diaphragm mobility, lung capacity, and respiratory function by 13%.2
Then there's posterior pelvic tilt (PPT) — this one drives me crazy. I see it so often, and it frequently accompanies FHP. (PPT is when the hips are thrust forward and the front of the pelvis is higher than the rear of the pelvis — soup would spill backwards out of the pelvic bowl.) PPT flattens the natural curve of the lower back and compromises the shock absorption of the lumbar vertebrae. And of course, this can lead to lumbar disc problems.
What leaves me dumbfounded about PPT is that when I ask people to bend their hips, they stay in PPT; they have no idea what it means to bend their hips. And in most cases this can't be blamed on tight hamstrings or any other anatomical accomplice; this is a learned pattern. From Orthopedic Massage by Whitney Lowe: "More often, posterior rotation is an adapted pattern that is reinforced by poor mechanics in sitting and standing."3 (Bolding mine.)
Same goes for FHP: except in rare cases, this is not something people are born with; it is cultivated through excessive and unusual use. The aforementioned "text neck" is of course a new phenomenon with the advent of digital devices. But even before smartphones and computers were a thing, FHP could still be introduced by many hours over a typewriter, textbooks, practicing piano or other musical instruments for hours, etc.
We are all shaped by our history and experiences. The piano player who slouches a bit will probably always be that way. It's their choice, it's part of how they functionally use their body for their life's profession. And no, we shouldn't make judgments about their beauty or personality based on their bearing. But it doesn't mean that piano player is in the most natural alignment and posture for optimal health.
Back pain. This is where I take exception with Linker's assertion that poor posture is okay: "Posture crusaders ... would blame a back pain sufferer for having caused the problem, for failing to sit and stand properly, for being a slouch. There was really no proof of causality, then or now."
Oh, but there is. I don't know what studies she's looking at, but here's one example. A 2017 systematic review of 12 other studies came to this conclusion: "In summary, we found that a restriction in lateral flexion and hamstring range of motion as well as limited lumbar lordosis were associated with an increased risk of developing LBP."4
Let's break down that conclusion. "Restriction in lateral flexion" means a limited ability to bend sideways at the waist/spine. "Restriction in hamstring range of motion" means tight hamstrings (back of the thighs). And "limited lumbar lordosis" means less of a natural curve in the lower back. Sound familiar? It should! Posterior Pelvic Tilt!
And if all of this is "associated with an increased risk of developing LBP," then it is scientifically valid to say the converse: a healthy range of lateral flexion and hamstring range of motion, plus more of a natural curve in the lower back, may be associated with a decreased risk of developing LBP.
Another bone to pick: "What I question is how much posture correction can do for a healthy, pain-free person in terms of preventing future ills and the inevitability of aging. Not until recently have certain studies shown that you can adopt all kinds of posture, even the occasional slouching, and be just fine." First of all, "occasional slouching, and be just fine," is a far cry from her "fake news" stance elsewhere in the article.
In epidemiology, being in the minority does not equal zero. We all know the stereotypical anecdote of, "My granddaddy drank whiskey and smoked cigars every single day of his life, and he lived to be 100 years old!" That doesn't mean we should all adopt this practice.
Here's another example. We are surrounded by carcinogens in our atmosphere, oceans, the food we eat and the water we drink. But only a minority of people develop cancer. Does this mean we should be dismissive of good practices that might help us avoid carcinogens? I don't know about you, but I'm going to continue to filter my tap water and buy organic produce. You can choose not to be as careful, and maybe you'll be just fine and live a long life. Or maybe not. Gambling with the odds is not the same as saying the odds don't exist.
These truths we hold evident... Linker says, "Do we even have a good definition of what is good or bad posture? We don't. No one can agree on what the standards are. Also, the human body is incredibly dynamic, and each of our anatomies are, to some extent, distinct. To say that there's, like, some kind of static norm is not in keeping with the reality. You have certain anatomical markers in line with each other. But we're never static. How long can you really hold a posture that is 'good'?"
This might be the best and most truthful thing Linker utters in the entire article. From The New Rules of Posture:
Most people think about posture as the body's alignment or position when sitting or standing still. Good posture is commonly defined in terms of the contours of the upper body — the chest shoulders, spine, and neck.
I see posture not as how you hold your body when you're still, but as how you carry it while you're moving. This distinction reveals posture to be a dynamic activity rather than a static attitude. Your posture is generated by your movement — by the way you carry yourself as you proceed through your life.
And Linker really self-owns here with this admission: "I'm not a posture denier. I think posture therapy can be a powerful tool when used to alleviate existing back pain. I myself frequent a physical therapist for my own back pain, and I use standing desks, ergonomic chairs and yoga to contribute to my sense of well-being. But these devices and remedies offer much more than a fixed notion of good posture."
What's maddening is that even with this admission, she backhands good posture to a "fixed notion," and does not recognize that it contributes to the very sense of well-being she's referring to!
Presentation. Outside the substance of the material the New York Times wants us to consider, I want to address how the article is exhibited. I would describe the title and teaser of the online edition as clickbait. One could not be blamed for thinking, "Oh, this article is going to tell me that 'good posture' is a complete myth!" And if you notice, at the bottom of the PDF I kept the Times' own reference to the print edition, where the title of the article was, "Relax With the Confidence of Knowing You're No Slouch." Which is far less provocative than the online title!
I am also appalled, frankly, at Beth Linker for using the term "fake news." Does she not have any clue, any self-awareness, as to who she sounds like? Ever since 2016, the term "fake news" has been corrupted into an orange-haired sneer at anything rational, intelligent, considerate, sensible. A complete dismissal of any opinion, without looking at the evidence or having any compassion for the opposing argument. I can imagine certain people now looking at the title of Mary Bond's book, The New Rules of Posture, and dismissing it as "woke bullsh-t" or something, without even reading it. Come on, Beth. Do better. You're better than that, or at least I hope you are. With two words, you've given people license to think that the idea of good posture is completely worthless.
What's even more infuriating is that the article ends with Linker saying (and this may lay more at the feet of the NYT author or editors): "In terms of long-term health, I think the jury is still out on that." So in other words, Linker and/or the NYT want to generate controversy and get online clicks, and say good posture is "fake news," but then she/they backtrack and basically chicken out by ending with that statement.
Summary. Let's recap:
Beth Linker sheds light on the sociological history of posture, and the unreasonable "posture panic" that swept through many societies and institutions. True.
She claims there is no proof that certain postural shapes can cause lower back pain. False.
Similarly, she claims there is no proof good posture can prevent lower back pain. False.
Linker channels her inner Mary Bond and says there is no standard of "good" or "bad" posture, and that we're never static. True.
She says good posture is "fake news." False. (Her fake news is fake news.)
My question to you. How do you view your posture now through the lens of the NYT article, or even through the filter of this blog post? How do you feel in your body, and how do you feel about your posture?
1Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014 Nov;25:277-9
2Zafar H, Albarrati A, Alghadir AH, Iqbal ZA. Effect of Different Head-Neck Postures on the Respiratory Function in Healthy Males. Biomed Res Int. 2018 Jul 12;2018:4518269. doi: 10.1155/2018/4518269. PMID: 30112389; PMCID: PMC6077663
3Whitney Lowe, Orthopedic Massage, Mosby, 2003, Pages 217-235, ISBN 9780723432265
4Sadler SG, Spink MJ, Ho A, De Jonge XJ, Chuter VH. Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies. BMC Musculoskelet Disord. 2017 May 5;18(1):179. doi: 10.1186/s12891-017-1534-0. PMID: 28476110; PMCID: PMC5418732
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