snoyman.com-content/posts/posture.md

About five years ago, I decided to start working out at home since I
wanted to get in better shape. About three years ago, I got more
serious about it as I realized my health was slipping (specifically,
recurrence of asthmatic symptoms after 20 years of being clear). But I
only started weight lifting 1.5 years ago, and the reason was simple:
back pain.

Like many people in our industry—our industry being the "sit in
front of a computer all day" industry—I suffered from chronic
lower back pain. I'd been having problems with it on or off since I
was a teenager (yeah, I was sitting in front of a computer then
too). But over the preceeding few years, it got significantly worse. I
had many episodes of waking up unable to get out of bed without
significant pain. I had a few cases of my spine turning S-shaped for
days on end, unable to stand up straight at all.

I have a strong family history of back pain. Like going bald, I'd
taken it as a given for many years that this would happen. I went to
an orthopedist, who prescribed painkillers. And that could have been
the rest of my life: regular pain, popping pills, waiting to see if
I'd kill my liver with the pills before something else got me. And
most likely, inactivity due to back pain could have led to plenty of
other health problems.

Today is a different story. I won't claim that I'm totally back pain
free—problems still crop up from time to time. But the
debilitating level I had previously is gone. And when some negative
event occurs (like getting knocked down and back slammed by a wave
this Sunday), I'm far more resilient to the damage. I'm writing this
blog post since I strongly believe many of my friends, family,
colleagues, and general fellow programmers suffer terribly from back
pain, when they could greatly improve the situation. I'll tell you
what I've done, and what I continue to do.

If you suffer from back pain, I strongly recommend you consider being
proactive about it. Feel free to take my experiences into account, but
also do your own research and determine what you think is your best
course of action. There is unfortunately—like most things in the
health world—quite a bit of contradictory advice out there.

## Two pronged approach

From my research, I decided that there were likely two things I could
do (outside of pill popping) that I could do to improve the situation
with my back:

* Improve the muscles in my posterior chain (lower back, glutes,
  hamstrings) to better support my spine
* Change the way I was moving my back, though I didn't really
  understand yet how

The first bit is easy to explain. I'd been doing bodyweight workouts
at home until then, which—according to
[the program I was following](http://www.startbodyweight.com/), don't
really offer a good alternative to the deadlift for posterior chain
work. That's why I switched to
[Stronglifts 5x5](https://stronglifts.com/) and put a large emphasis
on the deadlift, also focusing on stabilizing my core a lot during the
squat.

I'll be honest: I threw my back out badly a few times on the squat. I
almost gave up. I'm glad I didn't. I (finally) figured out how I was
misusing my back on the exercises, and now can squat and deadlift
almost twice the weight that had previously thrown my back out. I
consider it a huge success.

In addition to the muscle improvements, the other takeaway is:
__lifting weights taught me how to use my back in a safer way__.

## Posture

But now on to the (for me) more complicated bit. I watched tons of
YouTube videos, read articles, browsed forums, and spoke with doctors
and chiropractors about proper posture. The problem is that there are
different schools of thought on what it means to stand or sit
correctly. From my reading, the most contentious point comes down to
pelvic tilt. To demonstrate visually:

<img alt="Pelvic tilt" style="max-width:100%" src="/static/pelvic-tilt.jpg">

There's a basic question: should your pelvis tip slightly forward,
slightly backwards, or be neutral (perfectly vertical). As far as I
can tell, the most mainstream opinion is a neutral pelvis. I'm always
nervous to give anything close to health advice, especially contrary
to mainstream opinion, so instead I'll say: I found a lot of success
with the [Gokhale Method](http://gokhalemethod.com/), and specifically
Esther's book "8 Steps to a Pain Free Back."

The reasoning Esther uses to arrive at her conclusions is solid to
me. Analyzing the shape of the vertebrae, and specifically the L5-S1
joint, does make a good case for the pelvis needing to be slightly
anteverted. In addition, I buy her argument of the source of back
pain being the predominance of slouching introduced in the western
world in the earlier 20th century. The evidence of more uniform
posture among cultures unexposed to this slouching epidemic, and their
relative lack of back problems, is compelling.

I won't try to describe the method here; her book and YouTube videos
do a better job than I ever could. I will, however, comment on some of
the takeaways that I try to keep in mind throughout the day:

* Keep the spine in a stretched position as much as possible
* Stack the bones: try to ensure that your weight is being distributed
  down your spinal column, through your pelvis, and down your legs,
  instead of relying on your muscles or (worse) joints to keep you
  stable

Keep in mind that this is not an overnight change. You'll need to
practice better posture and get it to the point of muscle memory. I
think it's worth every second of investment you can give it. It's not
worth living your life in pain, afraid to move, and constantly doped
up.

## Why now?

Two things happened this week that made me want to write this blog
post. I took my kids to the beach on Sunday, and as I mentioned above,
got knocked down hard by a wave, which twisted my back in a bad
angle. For the next few seconds that I was under water, absolute fear
went through my mind. "Oh no, did my back just go out? How am I going
to drive the kids home? How will I work this week? What if one of the
kids gets pulled under the water and I can't save him/her?"

The wave subsided, my feet touched the floor, I stood up... and
everything was fine. I know in my bones (hah!) that that kind of
impact would have put me out for a week just a few years ago. I'm
sitting at my desk typing this now, after having done a deadlift
session in the gym, and everything is fine.

Yesterday I took a trip to the doctor (not the topic of today's
post). I sat in the patient's chair in his office, and noticed
that&mdash;contrary to prior visits&mdash;I was sitting perfectly
upright. I hadn't thought about it. The chair wasn't really well
designed either: using the back support would have required leaning
back and no longer remaining straight. It was a minor victory, but
I'll take it.