to fix that pain in your back, you might have to change ... · or to put another way — your butt....

To Fix That Pain In Your Back, YouMight Have To Change The WayYou SitMichaeleen Doucleff August 13, 20185906 AM ET

My back hurts when I sit down.

It's been going on for 10 years. It really doesn't matter where I am — atwork, at a restaurant, even on our couch at home. My lower backscreams, "Stop sitting!"

To try to reduce the pain, I bought a kneeling chair at work. Then I gota standing desk. Then I went back to a regular chair because standingbecame painful.

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I've seen physical therapists, orthopedic surgeons and painspecialists. I've mastered Pilates, increased flexibility andstrengthened muscles. At one point, my abs were so strong myhusband nicknamed them "the plate."

All these treatments helped a bit, at first. But the pain never really wentaway. So a few years ago, I decided to accept reality: Sitting down is —and will always be — painful for me.

Then back in November, I walked into the studio of Jenn Sherer in PaloAlto, Calif. She is part of a growing movement on the West Coast toteach people to move and sit and stand as they did in the past — andas they still do in other parts of the world. For the past 8 years, Shererhas been helping people reduce their back pain.

I was interviewing Sherer for a story about bending. But she could tell Iwas in pain. So I told her my story.

Her response left me speechless: "Sitting is a place where you canfind heaven in your joints and in your back," she says. "It's not sittingthat's causing the pain, it's how you're sitting.

"Do you want me to show you how?"

Do hunter-gatherers sit less than we do?

Recently there's been a lot of talk about how much Americans sit.

There's a perception that we sit way more than any other culture outthere — or even any culture throughout time. For the first time inhuman history, we sit for these long stretches, day after day.


Anthropologist David Raichlen at the University of Arizona says that isnot accurate.

"No. Not from our data," says Raichlen.

Raichlen studies modern hunter-gatherers called Hadza, in Tanzania.They live primarily off wild foods, such as tubers, honey andbarbecued porcupines. And to acquire this food, there's no doubt theyare active.

They climb and chop trees to get honey. They dig for tubers andpound nuts.

"They do a lot of upper body work," Raichlen says. "And they spendquite a bit of time walking — at a pretty high rate of speed."

On average, Hadza adults spend about 75 minutes each dayexercising, Raichlen says. That amount is way more than mostAmericans exercise. Many of us can't muster a measly 2.5 hours eachweek, as recommended by the Centers for Disease Control andPrevention. So there's no doubt the Hadza are in better cardiovascularhealth than most Americans.

But do the Hadza actually sit less than we do?

A few years ago, Raichlen and colleagues decided to find out. Theystrapped heart-rate monitors onto nearly 50 Hadza adults for eightweeks and measured how often each day, they were just, well ... sittingaround. The results shocked Raichlen.

"The Hadza are in resting postures about as much as we Americans


are," he says. "It's about 10 hours a day."

By comparison, Americans sit about nine to 13 hours each day, onaverage, a study reported in 2016.

But here's the thing: The Hadza don't seem to have the back issuesthat we Americans have, even as they age.

"Not that we have found," Raichlen says. "There hasn't been a ton ofstudies looking into muscle and joint pain in the Hadza groups, butpeople are highly active across the life span. There are some declinesin activity with age but nowhere near what you get in the U.S."

Not how much, but how we sit

So maybe Sherer is right. Maybe the problem, when it comes to backpain, isn't how much Americans are sitting, but the way we're sitting.

"Yes, I think that's probably a big part of the story," Raichlen says.

Orthopedic surgeon Nomi Khan agrees.

"Most of us do not sit well, and we've certainly been putting a lot morestress on our spines," says Khan, who operates on spines at SuttersHealth's Palo Alto Medical Foundation.

If we change the way we sit, Khan says, it will help to decrease backproblems.

"We should sit less, and we should sit better," he says.

Over the past century or so, many Americans have lost the art of


sitting, he says. Most people in the U.S. — even children — are sittingin one particular way that's stressing their backs. You might not realizeyou're doing it. But it's super easy to see in other people.

Here's how: Take a look at people who are sitting down – not face-onbut rather from the side, in profile, so you can see the shape of theirspine.

There's a high probability their back is curving like the letter C — orsome version of C. Or it might make you think of a cashew nut, sittingin the chair. There are two telltale signs: Their shoulders curve overand their butts curve under. That posture is hurting their backs, Khansays.

"Most people tend to round out their backs when they sit," Khan says."Their spine is in an improper position, and they will tend to have moreback problems."

Back problems crop up because sitting like a C — or a cashew nut —can damage the little shock absorbers in the spine, called theintervertebral disks.

"You can think of a disk as a jelly doughnut," Khan says. "Sitting like aC puts a lot more pressure on the front of the doughnut than on theback."

And what happens when you press down on one side of a jellydoughnut but not the other side? Jelly can squirt out.

Your spinal disks aren't much different. Sitting in a C-shape, over time,can cause disk degeneration. Or one side of a disk can start to bulge.


"The disk can then push against nerves, or it can rupture," saysbiomechanist William Marras, who directs the Spine Research Instituteat Ohio State University.

"When the disks get messed up, you've got real problems," Marrassays. "So everything we do in biomechanics is to try to protect thedisks."

Straightening out the C

At Sherer's studio, she pulls a up a photo of gray-haired man sitting ata loom. He must be at least in his 60s.

"This is taken in Rajasthan, India," Sherer says. "The man sits at theloom weaving, for hours and hours every day, just like we do at acomputer," she says. "And yet his spine is still elongated."


No special chair required: A man in Rajasthan, India, sits at his loom, weaving for hours eachday with exemplary posture. He untucks his pelvis and elongates his spine.

Jean Couch

Elongated is an understatement. This man's spine is straight as anexclamation point. His shoulders are rolled back. His muscles lookedrelaxed and flexible.

I've seen similar sitting postures in other rural pockets around theworld — for example, in eastern Liberia during the Ebola outbreak andin the Yucatán countryside. (Basically anywhere people still do a lot ofhip-hinging when they bend over. Because what do you do when you


sit down? First you bend over.)

In fact, you don't have to go back very far in history to find the sameposture here in the U.S. Photos and drawings from the early 20thcentury show that many Americans sat with straight backs andshoulders rolled back, similar to the man at the loom. Today, you canfind a similar posture with babies and young children.

So what happened?

One of the problems, Sherer says, is our culture focuses on trying tofix the upper body. "Sit up straight," parents and teachers say, andmost of us immediately stick our chests out.

But that's the last thing you want to do, Sherer says.

"Even just hearing the word 'spine' makes people lift their chestbecause they want to have 'proper posture,' " she adds. "But when Isee it, I'm like, 'No! That's what causes back pain. Lifting your chest isgoing to make your back pain worse.' "

Instead of focusing on the chest or shoulders, Sherer says, we need toturn our attention to a body part that is lower down, below the waist:the pelvis.

Or to put another way — your butt.

"The most important thing to change to reduce back pain is yourpelvis position," she says. "It's like a stack of toy blocks. If the blocksat the bottom aren't sturdy, then the top has no chance."

Pull your tail out so it can wag


Sitting in Sherer's studio, I glance over at my profile in the mirror. Andright away, I see the cashew shape. It doesn't look pretty. Myshoulders are rolled over my chest, and my pelvis is tucked under myspine.

To figure out how to shift your pelvis into a healthier position, Sherersays to imagine for a minute you have a tail. If we were designed likedogs, the tail would be right at the base of your spine.

"When you sit with a C shape in your spine, you're sitting on this tail,"Sherer says. "It's kind of like a dog with its tail between its legs, who isscared and frightened."

To straighten out the C shape, Sherer says, "we need to position thepelvis in a way that this tail could wag."

In other words, we need to untuck our tails. To do that, Sherer says,you need to bend over properly when you go to sit down.

"Bend over?" I ask. "Do I bend when I sit down?"

"Yes!" Sherer exclaims. "Every time you sit down, you bendsomewhere."

And where you bend determines how you will sit.

If you bend at the waist, which many Americans do, then you will likelysit with a C or cashew shape.

If you bend at the hips (as we learned about in a previous story), you'remore likely to sit correctly with your tail untucked.


"Bending at the hips can be hard for many people to figure out,"Sherer says. "It's a bit counterintuitive."

But she has a trick to help people learn.

"Stand up and spread your heels about 12 inches apart," she says.Now, put your hand on your pubic bone — like a fig leaf covering upAdam in the Bible, she explains.

"When you bend over, you want to let this fig leaf — your pubic bone— move through your legs," she says. "This creates a crease betweenyour pelvis and legs."

This action also pretty much pokes your butt out, behind your spine."Now go ahead, sit down," Sherer says.

Now my butt — or my imaginary tail — is behind my spine.

The next step is to relax the muscles in your back and chest. "Stopsticking your chest," Sherer says. Then the rest of the spinal vertebraecan stack up in one straight line, like an I instead of a C.

The crazy part, Sherer says, is that when the tail comes out, some ofthe tight muscles in your legs will actually start to relax or stretch.

"If you untuck your pelvis while you sit, your quadriceps muscles canrelax, and then your hamstrings can stretch," Sherer says.

I could definitely feel my quads relax. The muscles felt like butter seton a warm pan: They softened and seemed to melt.

Man, this felt good. "Oh wow!" I exclaimed, as a chill went up my body.


If you don't feel your hamstrings stretch — and your quads don't relax— you're probably not doing the action correctly, Sherer says.

"Then you're probably using your lower back muscles to push yourbutt out," she says. "That can cause more back pain. You don't want todo that."

How am I sitting now?

After leaving Sherer's studio, I realized that I had been sitting with mytail — or pelvis— tucked for decades. And it wasn't easy to fix. I had toreturn to Sherer's studio for many appointments and work hard, everyday, to learn how to untuck my pelvis while sitting at my desk.

But little by little, the muscles around my hips started to loosen up.The pain began to dissipate, very slowly.

After mastering the new sitting position, I decided to visit Khan to gethis opinion. "Do you want to look at my pelvis and see what you thinkabout how I'm sitting?" I asked the spine surgeon.

Khan took his hand and placed it on the base of my spine, right at thetop of my pelvis.

"You're sitting perfectly," he said nonchalantly. "Because you'rebasically sticking your butt back and creating this little curve at thelower part of your spine."

"If you sit like this, you're going to put a lot less stress on your spineand have less back issues," Khan added.

And as an added bonus, I feel like I'm following the spinal pose of


Jennifer Lopez: curvy on the bottom and straight on top.


to fix that pain in your back, you might have to change ... · or to put another way — your butt....

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