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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)

Cervicogenic Headaches

Cervicogenic headaches are headaches that originate from the cervical spine (neck). Patients with this condition usually experience a gradual onset of head and neck pain associated with a sustained posture or causative movement. Pain is typically experienced on one side of the head, usually at the back of the head, but it may radiate over the temple or behind the eye and spread to both sides of the head.

Most patients will experience tenderness upon palpation of their upper neck joints and tenderness through the surrounding muscles.
Cervicogenic headaches are often accompanied by stiffness and pain in their neck, particularly in the upper three vertebrae. Some patients may also experience associated pain, pins and needles or numbness radiating into their upper back, shoulders or arms.

Contributing Factors:

There are many factors that may cause patients to experience cervicogenic headaches. Your physiotherapist will thoroughly assess and help you to address these factors. Such factors may include:
• Poor sitting posture, excess slouching and rounded shoulders.
• Inappropriate desk set up
• Poor lifting technique or poor workplace ergonomics
• Previous history of whiplash injury
• Poor sleeping posture or inappropriate mattress/pillow
• Muscle imbalances
• Muscle weakness
• Muscle tightness
• Neck and upper back stiffness
• Increase in stress


In most cases a thorough clinical history and physical examination by your physiotherapist will be sufficient to diagnose cervicogenic headaches. In some cases your physiotherapist or GP may request an MRI, X-Ray or CT scan to confirm the diagnosis. Specialists and surgeons may also request a diagnostic nerve or joint block in some cases, where pain is chronic and does not respond to conservative.


Treatment for cervicogenic headache is multi-faceted and will depend on each individual’s contributing factors. Treatments often will include:
• Postural re-education including exercises, taping and/or bracing
• Clinical pilates
• Exercises to strengthen postural muscles, improve flexibility and strengthen the deep cervical neck flexors
• Soft tissue work and trigger point therapy
• Joint mobilisation or manipulation
• Dry needling
• Ergonomic advice
• Recommendation of appropriate pillow and sleeping posture
• Advice regarding analgesia and referral to pharmacist or GP where appropriate


Most patients who experience cervicogenic headache will make a full recovery with appropriate physiotherapy intervention. Rate of recovery may vary depending on severity of pain, how long it has been happening, and compliance to treatment. In the case of acute cervicogenic headache you should experience relief in symptoms within a few days, although pain may take several weeks to resolve completely. More chronic pain will generally take longer to resolve and may take weeks to months.

In the event that despite appropriate physiotherapy management symptoms remain persistent,  your physiotherapist may suggest referral to a specialist who can offer other treatments including injections and in some cases, surgery.

Feel free to contact our clinics to help relieve some of your neck pain.

Blog by Claire De Vos.