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What is good posture? – Blog by Stephen Lee

Good posture is vital in the ongoing management of low back pain and neck pain. Physiotherapists often prescribe specific exercises for you to perform to help with your back or neck problem. However, many patients forget that we need to maintain our posture in everyday life and their pain reoccurs. Those with poor postural habits may find it difficult to sit well. Nevertheless as the old saying goes, “practice makes perfect” good posture can be achieved within a short period of time. I often tell my patients its like brushing your teeth. You need to do it daily for good oral health. The same goes with posture – you need to do it often enough to help with the healing and avoid structures being strained.

How to regain good posture?

In most cases, patients who have poor posture have a “flat” back and forward head posture as shown on the diagram below. Good posture involves maintaining a curvature in your low back and neutral head position. Imagining drawing a dotted line right through your body – you ideally want to maintain the dotted line all the way through.

What is good and bad posture?
                      What is good and what is bad?

The slouch over correct exercise

This exercise is apart of the Mckenzie exercises and is widely used with many Physiotherapists. *note it is recommended you seek a Physiotherapist before attempting this exercise to ensure it is the correct exercise for you. 

  1. You should ideally sit in a chair with a supported back
  2. Slouch your back all the way
  3. Unslouch and make a curve in your back as far as you can go, lifting your chest up (sitting upright)
  4. Relax around 10% and maintain that for a few seconds
  5. Repeat steps 2 – 4 around 10 repetitions every few hours


What else should I do to help?

  • We highly recommend that a lumbar roll (see below) is used throughout the day when sitting in a chair or in the car.
Mckenzie Lumbar Roll (available for purchase at all our clinics)


  • Make sure you move around if you’re in sitting job regularly and avoid sitting for prolonged periods.
  • Keep Active ! Staying sedentary definitely doesn’t help. Doing many forms of exercises like pilates, yoga will be beneficial
  • A supportive neck pillow (Mckenzie Cervical Roll) maybe used whilst sleeping
            Mckenzie Cervical Roll

Who should you seek in regards to your posture ?

At Total Physiocare, all our Physiotherapists are trained to help to identify issues with your posture. Other contributing factors like tightness in your muscles and joints may need to be addressed as well. Sometimes, you may need a work site assessment to look at your desk setup and chair as well. Please seek advice from your Physiotherapist, Mckenzie therapist or health professional for further assessment and treatment!


Book an appointment today for your assessment!


Blog by Stephen Lee (Director, Physiotherapist)

Lumbar Spinal Stenosis

What is Lumbar Spine Stenosis?

Lumbar Spinal stenosis is a common medical condition, affecting the lower (lumbar) region of the back. It is a condition that increases in prevalence in an aging population and is a frequent reason for spinal surgery for adults over 65.

Spinal stenosis is characterised as an abnormal narrowing of the spinal canal – which is where the spinal cord runs. This leads to the compression of neural (nerve) and vascular (blood) structures within the spinal canal. This compression results in a painful presentation that can greatly impact and limit a person’s participation in day to day activities.

It is important to highlight at this point, that although spinal stenosis can be a debilitating condition, it is not life threatening.



Patients with spinal stenosis often complain of pain and weakness in the lower back, buttocks, thighs and lower legs. Patients often describe their symptoms such as an ache in the back, cramping or heaviness in their lower extremities. Such discomfort is commonly aggravated by prolonged standing and with prolonged walking.

back 2

How does it occur?

Acquired lumbar stenosis occurs as a result of age associated degenerative and/or arthritic changes that affects the lumbar spine. This affects the vertebral bones, the spinal joints and the discs between each spinal segment. This phenomenon can be explained in four steps:

  1. The earliest changes occur in the discs in-between each spinal segment. These discs may dry out and begin to flatten which can lead to a bulging disc and/or collapse of the disc segment.
  2. The loss of structural integrity of the disc causes additional stress on the spinal joints and ligaments (which connect the spinal vertebrae together). One of the important ligaments affected is the ligamentum flavum, which has a role in preserving upright posture and returning the spinal column to its original position after flexion (bending) movements.
  3. As a result, the extra stress may promote bone growth (osteophyte formation) and thickening of the ligamentum flavum.
  4. The area within the spinal canal and as the spinal nerves exist the vertebral column becomes narrowed due to the combination of the disc bulging, bone formation and ligament thickening. These factors results in less space for the spinal nerves and blood vessels.


The spinal canal and space also narrows further when placed in extension, hence limiting standing, walking and similar activities.

Physiotherapy management and treatment:

Physiotherapy management to treat lumbar spine stenosis aims to maximise the vertebral canal space and minimise canal narrowing. This can be achieved by reversing or reducing tissue inflammation and oedema in the joint space, strengthening the abdominal muscles, avoiding aggravating movements and activities and commencing a flexion-biased exercise program. Physiotherapy intervention aims to reduce patient symptoms and improve physical activity and function.

Often in moderate to severe cases, surgery may be required. In this case, a procedure called a “decompressive laminectomy” may be utilised to reduce the pressure and narrowing on the nerve roots. Here at Total Physiocare, we have an excellent affiliation with leading spinal and orthopaedic surgeons. Your physiotherapist can assess the severity of your condition, determine the best method of treatment unique to yourself, organise pre and post operative care as required, and prescribe expert rehabilitation exercises.


Post by Christian Bonello. Copyright 2015.