Headache Part Two: Desk, Driving and Sleeping Posture
There’s a lot of talk about how good posture is crucial for a healthy body, but it’s tough to know what exactly is good posture. In this article, we will discuss the best posture for sitting at a desk, driving and sleeping. These tips are especially important if you suffer from headaches because the position of your head and spine have a huge impact on how you feel. If you’re new to this blog, I recommend looking back to the previous article Headaches Part One: A Pain in the Neck for some background on how headaches can be caused by posture.
A “normal” spine has 4 curves – the inward (lordotic) curve of the cervical spine or neck, the outward (kyphotic) curve of the thoracic spine, the inward (lordotic) curve of the lumbar spine or low back and the slight outward curve of the sacrum.
Between time, gravity, our jobs and hobbies, we tend to develop a forward head and shoulders posture which changes the forces through the spine. Our chin pushes forward, followed by our upper back resulting in increased strain on the joints and muscles as well as weakening of the deep stabilizing muscles of the neck. This can result in headaches at the base of the head, the temples, radiating up the back of the head and aching in the neck and shoulder blades. Keeping your spine in a neutral position helps minimize the extra forces on the neck and prevent aches and pains as you work and play.
To maintain good posture, imagine a vertical line being drawn down through your body from head to toe. That line should pass through the center of your ear, your shoulder, your hips and your ankles. This puts your spine into a strong, stacked column which distributes the pull of gravity evenly and reduces strain in the joints and muscles.
Sitting at your desk
- Position your monitor so your eyes are looking 2 to 3 inches below the top edge, keeping your chin parallel with the floor.
- Squeeze your shoulder blades together gently to support the upper back, then pull your chin directly backwards into your spine like you’re giving yourself a double chin. The goal is to keep your chin level (not letting it drop toward the floor as you pull it backward) and reverse the curvature that was caused by the forward-head posture that was mentioned earlier.
- Sit with your hips against the back of the chair with a small towel roll supporting the natural curve of the low back.
- Finally position your chair so your hips are slightly higher than your knees and your feet can rest solidly on the floor.
This posture is similar to sitting at your desk and the goal is to maintain a tall, neutral spine.
- Adjust the height of your seat so you can keep your eyes looking straight ahead with the chin level with the horizon. Pull your chin back toward your neck to prevent the forward head posture. Use the headrest as a cue – the back of your head should gently rest on it, while keeping your chin level
- Relax shoulders and let them drop toward the ground
- Recline the seat to no more than 30 or 40 degrees
- Support the low back with a small towel roll
- Adjust the steering wheel so that your arms are supported on the wheel with roughly 90 degrees of bend in the elbow and shoulders relaxed
People often ask what’s the best position for sleeping and my answer is whatever position you can sleep in.
Left-sided or right-sided – the key is support
Imagine lying on your favorite side…start with the pillow under your head only (not under your shoulders). Next, tuck one end under your chin, pulling the middle section into the crook of your neck and the end around to the back of your head. Picture a horseshoe shaped pillow wrapping around from your chin to your upper back. A great way to achieve the support of an expensive feather or memory foam pillow is to take a hand towel and roll it into a log, then slide that into the pillowcase at the base of the pillow. This creates support for the neck while also being adjustable to your comfort.
Next, support your top arm. Grab a standard pillow and tuck it all the way up under your armpit and so the length of your arm is comfortably resting on the pillow. Make sure all of it is supported by the pillow – upper arm, elbow, forearm and hand.
If you’re a back sleeper:
The goal is to support your head and neck while also keeping your neck in line with the rest of the spine. In the picture below, you see how too many pillows can raise the head so it’s no longer in line with the rest of the spine. Another important point about this picture is that the pillows are there to support your head and neck, and need not be under your shoulders. Pull the pillow under your head so that it fills the curve under your neck.
Finally, if you have any shoulder issues, you can put a pillow under your arm from your armpit to your belly button to support the weight of the arm. This support will allow the muscles in the neck to turn off at night and rest because they no longer have to hold the weight of the arm.
If this sounds like a lot of information all thrown at you at once, try it out one tip at a time – spend a few days at work focusing on getting your desk chair set up just right and see how you feel at the end of the week. Do the same with adjusting your car seat and being aware of where your shoulders are while driving. If you notice an ache in your head or shoulder blades, take a deep breath and let your shoulders drop toward the ground. The more often you check your posture, the more awareness you will develop and will be able to avoid headaches from the start. Also, experiment with pillows and sleeping position because a good night’s rest is crucial for health.
If you’ve tried all of these tips and still aren’t feeling the relief you hoped for, consult a physical therapist. It’s so easy to ignore headaches and hope they just go away, but resist the urge and be proactive about your health – be stronger than yesterday!