Self Care – Seated Posture

There are a number of posts where I discuss problems created by poor seated posture, so here’s a post about how to sit to avoid creating problems.

In this post, I explore 2 different approaches to minimize the pain and discomfort of sitting at a desk. First, actively sitting in a balanced posture and secondly, passively supporting postural imbalances. I like exercising and getting bodywork so that active sitting is comfortable for hours. Many people need ergonomic supports because sitting without them is distracting to their work or leaves them in pain. I also discuss a few accessories that help people reduce discomfort while working at a desk.

Actively sitting in balanced posture:

This is my setup in my office. I have modular shelving which is easy to adjust for my specific dimensions. I planned it that way because I knew I would spend a lot of time here. The desk top and shelving is adjustable in height and can be bought in different styles. The size and position of the stool, shelves, keyboard and such are set up for a number of tasks; writing posts, watching educational videos, organizing therapy tools, storing laundry, shelving books, etc.

The monitors, keyboard, work area, etc. are setup be comfortable for long periods of work. It is, however, important to move. There are several sources that suggest that you put a timer across the room to remind you to get up and, at the least, reset it once in a while.

When I’m spending a lot of time writing a single post, like this one, I’m sitting with my legs tucked under the keyboard. I can sit and write comfortably for quite a while. I’ve had my Fitbit unexpectedly remind me to move, not realizing that almost an hour has passed.

I’ve noted a few things here with colored lines.
My head is over my hips.
My shoulders are dropped down and back.
My knees are lower than my hips.
The screen is at eye level and about arm’s length away.

For the past 15 years or so, I’ve had dual screens, One is a landscape screen and one is a portrait screen. The landscape screen lends itself to watching training videos and certain types of editing.

The portrait screen is, well, how most things are organized these days: documents, web pages, illustrations of bodies, etc. It is actually a 32″ television turned on its side. It makes a spacious easel for illustrating. It pivots and is great for explaining things to clients. It seems that I use this everyday to reference something on the web and then email it to the client that I’m helping.

I’m usually facing between the two screens. I’m constantly turning back and forth and tilting up and down getting a little movement in my neck and on my swivel stool.

Often, I use books while I’m working, like the one under my screen in this photo. I only lay them there when I am needing to tediously study the book while typing. I might do this if I’m writing about a detailed diagram or interpreting a complex passage. Otherwise, I try to pick it up, turn around to my table and read a little. Then, I come back to the screen trying to incorporate some extra movement in sedentary work.

There are a few different ways to think about supporting yourself when you work. I subscribe to this idea:

When your job is the most strenuous thing
that you do with your body,
your body will be stressed by your job.

Low back muscles begin to atrophy more quickly than any other muscle in the body, starting in your late 30s. I’ve always had an exercise program but started emphasizing low back exercises to keep my core strong. I have much less back pain now than when I started doing bodywork in my 30s.

I prefer to work on a swivel stool. I am mindful of the curve in my low back by keeping my head over my hips and my knees slightly lower than my hips.

This can be problematic if you are in a chair that might press into your hamstrings. This pressure can activate trigger points and generate hip or knee pain. This also happens while driving long distances.

I work with my hands lower than my elbows and my shoulders lower than the base of my neck. This keeps the shoulders relaxed. I do these breathing exercises when they’re bothering me.

The disadvantage to this approach is the time and attention that is required to stay active as well as the time and effort put into exercise to keep your body toned.

Passively supporting postural imbalances:

Ergonomic setup guide from

This is a popular illustration on the web and a different way of going about desk posture. It involves postural supports. It is best when these supports are adjustable so that they can accommodate changing posture.

This person has some Head-Forward Posture. The chair is designed to support her back at a tilt, so that her head pulls slightly forward.

Her chair supports her thighs to be level with her hips. The chair also supports the lumbar curve. I find this support interesting when I’m doing less active things like driving or watching movies.

Her arm rests are high and support her shoulders to be high and tight. It’s more common these days that the shoulders become high and tight from leaning on elbows while working on a laptop.

This is a pretty common approach and requires less work on your part. It may be a better choice if you don’t get much exercise and need more support in your posture.

This is a pretty common approach and requires less work on your part. It may be a better choice if you need more support to stay out of pain while working. The disadvantage of this approach is that the lack of movement perpetuates stiffness and, if you’re not getting exercise, promotes a body that is less able to support itself.

Desks that allow you to Sit or Stand:

A number of my clients are only comfortable if they can shift from seated to standing when one or the other starts bothering them. Table top models like this one from Amazon have made this option more practical and affordable.


Footrests make a real difference in how you feel at the end of the day. Just the tilting motion changes your low back. Try it. Just tilt your foot up and you’ll feel your lumbar curve firm up. I was blessed with Hobbit feet, so it is difficult to find one that is big enough for me. These are the two best footrests on Amazon. I’d get the foam footrest as I like to work in socks. The rubber footrest gets the best ratings if you’re wearing shoes.

Live on your laptop?

Setting up an environment like this to work is great if you have space. Many people work in coffee shops, on a couch or propped up in bed. Laptop stands like this can do a lot to raise the screen and tilt the keyboard so that you’re not hunched over a table, leaning on your elbows, creating high, tight shoulders.

Most are inexpensive and designed to fit in your bag. This one does everything from standing desk to cooling fans. If you mostly work at a table, there are less expensive ones that raise and swivel the laptop. There are elegant ones that stand beside the couch like a TV table. Get one that helps you maintain good posture in your most common setting.

Setting up an environment like this to work is great if you have space. Many people work in coffee shops or on a couch. Poor posture from this kind of work can lead to lasting changes as bones remodel from years of poor posture. If you’re working like that, pick up an exercise program that includes shoulder and core work 3 or more days out of the week.

A good exercise program and some regular bodywork can make your body much more adaptable and resilient so that it is less bothersome when your environment isn’t just right.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

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Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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