What do we really know about slouching?

For years, my wife has told me to stand up tall and stop slouching. She even has a hand signal she uses to direct me to stand up if she finds me slouching during a social event, cooking in the kitchen, or bent over sitting at my computer writing clinical notes. She has all sorts of reasons that my future health will be harmed if I persist in slouching. Slouching, at least in the minds of people opposed to it, is linked to musculoskeletal disorders, especially back pain, headaches from muscle tension, heart disease, flat feet, and scoliosis. Much of this is not evidence-based but is folklore. 

To be clear, I am not talking about being sedentary, which does affect health. I am talking about posture. 

America became fixated on poor posture about a century ago. People became concerned with slouching not just for health reasons but because it conveyed a message about moral attitude. Slouchers were considered lazy and carefree. Out of this concern about the medical and social evils of slouching grew health interventions, including body braces, the Alexander technique, special chair cushions, and other wearable devices. 

Dr. Beth Linker, a professor at the University of Penn and author of the recent book Slouch: Posture Panic in Modern America, considers slouching a “disease of civilization.” She writes that our hunter-gatherer ancestors were presumed to have stood erect and, as a result, enjoyed great health. Of course, life expectancy during the days of hunter-gatherers was approximately 30 years. 

By 1914, America became fixated on the harms of slouching. School teachers and physicians joined in forming the American Posture League. The league encouraged middle and high schools to focus on hygiene that promoted an erect posture. Schools across the country were encouraged to use a new standard posture test administered by teachers using a rigid rod. Beth Linker suggests that as many as 60% of public school students failed the posture test and were assigned remedial exercises. 

Women, particularly, were taught that standing erect conveyed social status. Slouching was felt to send subliminal messages about class. It was associated with poverty and manual labor and thus was a marker of lower social status. 

But, there was a paradox. Women and some men in parts of Africa carried heavy loads on their heads, yet they had outstanding posture. Realizing this, schools trained women to walk with books on their heads. 

Then there was a backlash. Young women began to throw away their corsets and purposely exhibit what was called the “debutante slouch” as a form of rebellion, to demonstrate independence, and to make a fashion statement. 

So, here we are, at least a century after the formation of the American Posture League. There are lots of opinions on the topic, but I could find no good studies looking at the health impacts of slouching. Yet we still stigmatize the sloucher.

– Dr. Michael Wilkes with a Second Opinion

Further Reading: 

• Getting It Straight
• Why everything you thought you knew about posture is wrong
• Actually, It’s OK to Slouch
• Slouch: Posture Panic in Modern America

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