A recurring question usually comes when I train office workers: what is the right distance to the desk when sitting? The picture below illustrates 3 situations that I will comment below: at the right distance, a bit too close, much too close.

On this website as well as on our Facebook page, I tend to post more scientific than opinion papers. However, an article named How the Back Pain Industry is Taking Patients for a Dangerous Ride has come to my attention this week, and it is worth sharing it. The authors Danielle Venton and Jon Brooks make there a few important points:

• surgery should not be treated lightly;
• all hands-on treatments (cracking joints, massaging, etc.) are symptomatic and not causal;
• relying on accessories for getting better is not the road down to patients' autonomy and empowerment.

We do share these views. This is the reason why most of our treatment is solely based on the use of gravity, as the only freely available resource everywhere on the planet. Sometimes (and only after the patient masters his/her own body perfectly well) technical solutions may come into play for coping with the last bits of unresolvable pain. In this case, we will make sure that their use does not require any third party, and that the patient develops the necessary expertise to use the solution without creating new damage. 
A strict adherence to our "hands off paradigm" is key to being able to provide distance treatment for postural disorders.

"Text neck" is an umbrella concept to describe the neck (and head) symptoms of those spending too much time on their smartphone (typically to write text messages). The March 2017 issue of the Spine Journal rings the alarm bell: practitionners notice an increase in the prevalence of the issue.

We absolutely agree on the fact that mobile screen devices (smartphones, tablets, etc.) are a health hazard. Our main and most effective recommendation is therefore to limit their usage time. One way to do so is to call rather than to text, another one is to send vocal messages (e.g., via Whatsapp) rather than to type. Teenagers need particular attention from adults in this respect.

Once  this is done, it is indeed true that raising the phone helps avoiding a forward head posture. However, holding the phone at eye level may also create strain in the neck and shoulders area. Hence, placing the phone on an elevated surface (e.g., shelf), inclined if possible, is surely a healthier option.

Finally, a good body awareness will help you keeping the neck aligned: make sure that your thoracic spine is not rounded, that your shoulders are not pushed forward, and that you keep your chin drawn slightly  inwards. It will also help you slowing down when your body tells you it has enough...

Many people and companies purchase office chairs without really knowing how to recognize good ones from less good ones. Let's have a look at what field experience teaches us.

First of all, never buy a chair without testing it: online, everything looks beautiful and comfortable. Secondly, there is a difference between buying a chair for one person and buying a chair for a population. If you buy it for one employee, the chair may be less adjustable, as long as it is the right size! If you buy it for a population, it needs to fit a wider range of morphologies. Hence, the adjustment ranges may need to be larger. These technical specifications will help you choose a chair for a population. 

Bear in mind that the more adjustment possibilities, the bigger the risk that it is not adjusted properly. One may rightfully ask whether more is always better. On the video below, you will discover the usual adjustments possibilities of a good office chair. 

Next, let's see the usual flaws of many chairs on the market:

• too wide: chairs are getting wider and wider. Whilst the width of the seat is per so not very problematic, the armrests tend to be too far apart. Using them will force you to spread the elbows, creating neck strain;
• too deep: if the seat is too deep, you will not make full use of the lumbar support and you will tend to slouch. Some chairs have a backrest that moves above the seat pan, but most chairs have a sliding seat pan. Make sure that you don't feel a gap under your buttocks (i.e. between the seat pan and the backrest) when you sit at the back the chair. Along the same lines, be careful with slippery fabrics: if your pelvis glides away, it is not supported;
• non-adjustable lumbar support: some chairs a backrest, which you cannot adjust up and down. If the backrest is made of foam, don't buy the chair. If it is made of elastic fabric, it was intended to "adjust automatically" to the shape of your back. However, the support will be less than a well adjusted traditional foam backrest, and it might be less durable. To resolve this, some manufacturers use a reinforcing bar behind the elastic fabric: make sure that it does not create pressure points in your lower back;
• basic armrests: armrests tend to be too far apart, too high and / or hard. Good armrests will be 3D or 4D armrests (i.e. they can be adjusted in width, height, depth, and for 4D rotated inwards). Make sure that they go low enough to not lift your shoulders, and that they are soft padded.

An office chair will last for many years (8-10). If you have the cash (400-800€), I advise you to buy a good one: the real monthly cost is actually quite low. Some shops also offer reconditioned or used quality office chairs, which are often a better deal than a new cheap chair. 

Many brands are on the market. Here are two recommendations:

• in 2017, Dauphin has asked me to review 4 chairs: my conclusion was to recommend the Speed-o for light users, the Shape for more intensive users.
• I have been working with Kinnarps for many years because of their great quality-price ratio (incl. an excellent adjustment range). My personal chair is a +8. A cheaper alternative is the Temo. 

A study published this year in the JAMA describes the evolution of the healthcare costs in the US since 1996. The results are clear: "spending on diabetes, ischemic heart disease, and low back and neck pain account for the highest amounts of spending by disease category".

The same trend can be observed in all Western countries. This shows the societal relevance of a new prevention paradigm, based in our opinion on

• empowerment of patients with musculosekeletal disorders e.g., by posture therapy
  
• early prevention (see our program in schools).
  

A new research article investigated the link between "sitting upright" (a concept to be more clearly defined) and psychological state: 

“Compared to sitting in a slumped position, sitting upright can make you feel more proud after a success, increase your persistence at an unsolvable task, and make you feel more confident in your thoughts,” Dr. Broadbent explained. "Research also suggests that sitting upright can make you feel more alert and enthusiastic, feel less fearful, and have higher self-esteem after a stressful task.”

The clinical practice indeed often shows a strong psychological impact of posture therapy.  [...]

Dr. Vera Baadjou (university of Maastricht, the Netherlands) has been granted a prestigious award for a scientific study that was designed and performed in close cooperation with the TIPM and Mrs. Ans Samama: she will receive the Alice G. Brandfonbrener Young Investigator Award at the June 2017 conference of the Performing Arts Medicine Association.

The Presto project aims at measuring the health impact of a prevention program based on the "Mensendieck 3.0 method". The target population consists of conservatory musicians in the Netherlands. The intervention program is compared to a traditional physical activity program.

Participating in such projects shows our commitment to reinforcing the scientific documentation of the mechanisms and benefits of posture therapy.

In 2016 I have been approached by 3 patients that I had never met in person: one in Paris and two in New York. All three suffered musculosekeletal disorders (neck pain, lower back pain and elbow pain respectively). They wanted to be treated by the TIPM Mensendieck therapy but could not travel to Lausanne (Switzerland).

Their medical diagnosis was requested beforehand, and we tried individual treatment by Skype. After a few months, the conclusion is clear: they are now doing well. [...]

I always explain that my job is to teach people how to use their body well. I am well aware that this sounds very abstract at first, so let us see a practical example.

One of my patients recently asked whether he may snowboard during his holidays, despite his bad back (he has seriously damaged lumbar disks, with chronic radiating pain). What are the risks inherent to snowboarding, and the potential damage to his back in view of his condition? [...]