Posture

About five years ago, I decided to start working out at home since I wanted to get in better shape. About three years ago, I got more serious about it as I realized my health was slipping (specifically, recurrence of asthmatic symptoms after 20 years of being clear). But I only started weight lifting 1.5 years ago, and the reason was simple: back pain.

Like many people in our industry—our industry being the "sit in front of a computer all day" industry—I suffered from chronic lower back pain. I'd been having problems with it on or off since I was a teenager (yeah, I was sitting in front of a computer then too). But over the preceeding few years, it got significantly worse. I had many episodes of waking up unable to get out of bed without significant pain. I had a few cases of my spine turning S-shaped for days on end, unable to stand up straight at all.

I have a strong family history of back pain. Like going bald, I'd taken it as a given for many years that this would happen. I went to an orthopedist, who prescribed painkillers. And that could have been the rest of my life: regular pain, popping pills, waiting to see if I'd kill my liver with the pills before something else got me. And most likely, inactivity due to back pain could have led to plenty of other health problems.

Today is a different story. I won't claim that I'm totally back pain free—problems still crop up from time to time. But the debilitating level I had previously is gone. And when some negative event occurs (like getting knocked down and back slammed by a wave this Sunday), I'm far more resilient to the damage. I'm writing this blog post since I strongly believe many of my friends, family, colleagues, and general fellow programmers suffer terribly from back pain, when they could greatly improve the situation. I'll tell you what I've done, and what I continue to do.

If you suffer from back pain, I strongly recommend you consider being proactive about it. Feel free to take my experiences into account, but also do your own research and determine what you think is your best course of action. There is unfortunately—like most things in the health world—quite a bit of contradictory advice out there.

Two pronged approach

From my research, I decided that there were likely two things I could do (outside of pill popping) that I could do to improve the situation with my back:

• Improve the muscles in my posterior chain (lower back, glutes, hamstrings) to better support my spine
• Change the way I was moving my back, though I didn't really understand yet how

The first bit is easy to explain. I'd been doing bodyweight workouts at home until then, which—according to the program I was following, don't really offer a good alternative to the deadlift for posterior chain work. That's why I switched to Stronglifts 5x5 and put a large emphasis on the deadlift, also focusing on stabilizing my core a lot during the squat.

I'll be honest: I threw my back out badly a few times on the squat. I almost gave up. I'm glad I didn't. I (finally) figured out how I was misusing my back on the exercises, and now can squat and deadlift almost twice the weight that had previously thrown my back out. I consider it a huge success.

In addition to the muscle improvements, the other takeaway is: lifting weights taught me how to use my back in a safer way.

Posture

But now on to the (for me) more complicated bit. I watched tons of YouTube videos, read articles, browsed forums, and spoke with doctors and chiropractors about proper posture. The problem is that there are different schools of thought on what it means to stand or sit correctly. From my reading, the most contentious point comes down to pelvic tilt. To demonstrate visually:

There's a basic question: should your pelvis tip slightly forward, slightly backwards, or be neutral (perfectly vertical). As far as I can tell, the most mainstream opinion is a neutral pelvis. I'm always nervous to give anything close to health advice, especially contrary to mainstream opinion, so instead I'll say: I found a lot of success with the Gokhale Method, and specifically Esther's book "8 Steps to a Pain Free Back."

The reasoning Esther uses to arrive at her conclusions is solid to me. Analyzing the shape of the vertebrae, and specifically the L5-S1 joint, does make a good case for the pelvis needing to be slightly anteverted. In addition, I buy her argument of the source of back pain being the predominance of slouching introduced in the western world in the earlier 20th century. The evidence of more uniform posture among cultures unexposed to this slouching epidemic, and their relative lack of back problems, is compelling.

I won't try to describe the method here; her book and YouTube videos do a better job than I ever could. I will, however, comment on some of the takeaways that I try to keep in mind throughout the day:

• Keep the spine in a stretched position as much as possible
• Stack the bones: try to ensure that your weight is being distributed down your spinal column, through your pelvis, and down your legs, instead of relying on your muscles or (worse) joints to keep you stable

Keep in mind that this is not an overnight change. You'll need to practice better posture and get it to the point of muscle memory. I think it's worth every second of investment you can give it. It's not worth living your life in pain, afraid to move, and constantly doped up.

Why now?

Two things happened this week that made me want to write this blog post. I took my kids to the beach on Sunday, and as I mentioned above, got knocked down hard by a wave, which twisted my back in a bad angle. For the next few seconds that I was under water, absolute fear went through my mind. "Oh no, did my back just go out? How am I going to drive the kids home? How will I work this week? What if one of the kids gets pulled under the water and I can't save him/her?"

The wave subsided, my feet touched the floor, I stood up... and everything was fine. I know in my bones (hah!) that that kind of impact would have put me out for a week just a few years ago. I'm sitting at my desk typing this now, after having done a deadlift session in the gym, and everything is fine.

Yesterday I took a trip to the doctor (not the topic of today's post). I sat in the patient's chair in his office, and noticed that—contrary to prior visits—I was sitting perfectly upright. I hadn't thought about it. The chair wasn't really well designed either: using the back support would have required leaning back and no longer remaining straight. It was a minor victory, but I'll take it.