For a bit of fun, I thought I would purchase the ‘Posture Brace’ from posturebrace.co.uk I ordered it after a friend asked what I thought of these things as she was worried about her posture. My instinctive response is that they are not worth their salt and are only good in the short-term if at all. This study would support that statement: https://pubmed.ncbi.nlm.nih.gov/31075089/
But I was curious and perhaps I should try these things out. I ordered the small-medium (32-36in) £38.98 Posture Brace, and as it had a 30 day money back guarantee I thought, what the hell! Even though there was little information on their website about returning the posture brace for a refund… I’ll cross that bridge later.
The Posture Brace is endorsed by the London Spine Clinic on Harley Street and other celebrities. I personally always think twice about buying a product when that product is endorsed by celebrities unless they have specific training or a background in that field.
So this is how I got on... These are my first pictures from wearing and not wearing the Posture Hero.
You can see a slight shift of my elbow backwards in the first photos. You may notice in these pictures with the Posture Hero the elbow is more pointy compared to that without the Posture Hero.
It would also appear that my upper back is straighter but I would argue that is the Posture Hero holding my shirt closer to my body as you can see in the second photos from behind.
I had been wearing the brace no more than a few minutes at this point so cannot make any assumptions but the Posture Hero does seem to have a slight effect on my body positions, albeit in the short term.
Fit and Comfort The brace had to come across the chest and seemed to sit most comfortably under my pecs and around my ribs which created a supportive corset-type look! This seems to be how it is meant to be worn.
On the whole the brace is reasonably comfortable but after a while it begins to chafe under the armpits, especially if you wear it tight. I had to wear it tight despite it being a 32-36inch size (my chest is 37.5inches).
This doesn’t make it ideal to work out in as the flexi-spine section slid up and down, especially during overhead activities (like pull-ups). It felt cumbersome. It could be OK running (I didn’t try) but I imagine the straps would start chafing! I should say, they also sell the ‘Posture Hero Sports’ designed to be worn during sports and activities. It says it is more durable with a wider flexi-spine section for more support, but I’m not sure how this would address the above problems I had.
It can be worn on top of or under your clothes but if your job is active like mine, you may not want to wear it for extended periods due to odours, staining of the brace and general chafing and skin irritation.
Regardless of the effect of the Posture Hero on my posture so far, the usability of it has its limitations but was fine to wear during admin and desk heavy days.
The Experiment
Having worn the Posture Hero daily for several hours for 3 weeks (except weekends, I’m not an animal!) you may notice from these series of photos is that my hair is a mess! I got it cut shortly after these photos!
Onto the serious bit,... the positioning of my shoulders again seem to be drawn back a bit more with the brace than without (slide 3) and makes me look thinner as it draws in my shirt (slide 4). In slide 5 my shoulder blades seem to have come closer together, less prominent and more level than day 1.
Can we ascribe these effects to the Posture Hero?
In a good experiment I would do nothing but wear the posture brace. This would be to ensure that any outcomes measured would be due to the posture brace and nothing else. (also known as a ‘controlled’ experiment) However, as a human being I do a lot of things: I work, drive, play hockey, eat, sleep, run, jump and I also recently took up the gym! A lot of my time at the gym was spent working on my shoulders. These types of exercises would certainly improve the strength of muscles in my shoulders which could also have the same postural effects as seen.
And to be honest, I enjoyed and felt better going to the gym more than wearing the Posture Hero!
Results
With the photos below you can see with your own eyes any changes that my body went through.
As I mentioned previously, the ‘experiment’ was not a particularly good one as I did not control for all the other things that may also influence my posture. I.e. my new gym routine.
The changes you may notice are that my left shoulder seems to drop, my shoulders are more level and the shoulder blades are closer together at week 4. By week 6 this seems to reverse a tad.
Can we consider these changes significant? Not really, because posture is dynamic and constantly changes. Although I tried to be relaxed and not think too much about what my body is doing when taking these pictures, we could literally see different positions if I took photos of me every 1hr throughout the day as my posture would change hour-by-hour. The experiment could be better! Do the changes mean much to me? Nope. I’ve never been an advocate of ‘good’ posture. Just that you should keep moving and active and ‘the best posture is the next posture’. Our postures have been shown time and time again in studies that they are not really important in our pain experiences (as discussed in the paper I’ve referenced in the post).
You may well be self-conscious in how your posture makes you look/feel, but that is somewhat different to how you posture affects pain.
The masses attribute good posture to less pain a great deal. To make you think... people have often said I have great posture, but I still get pain! Go figure...
An exert taken from a paper called ''Sit up Straight'': Time to Re-evaluate:
''A common belief is that spinal pain is caused by sitting, standing or bending 'incorrectly'. Despite the absence of strong evidence to support these common beliefs, a large posture industry has flourished, with many interventions and products claiming to 'correct' posture and prevent pain''
Reflections
For me, I was not expecting much from the back brace apart from some chafing and inconvenience.
But, from the photos, there does seem to be some change in my shoulder posture. However, as discussed previously, is this all down to the back brace? Probably not. Are those changes considered ‘clinically significant’? I can’t really say accurately, but I would say no. Do I think the posture change had any effect on my pain experience? Not really.
As quoted in my last post from the ‘Sit-up Straight: Time to Reevaluate’ paper, there has been a huge focus on devices to help correct posture and improve pain. But there just isn’t evidence around to support this idea. If you think about how many postures your body goes through in a day, which posture is actually ‘bad’? I would say whichever one you are spending too much time in! Even if that is a ‘gold standard’ posture!
Here are some takeaways about posture and pain (the bold writing is the important bits). Some of these things you might even find hard to believe but they are the closest thing we have to the truth as it stands. Oh and as for returning the Posture Hero, I kept it in case anyone would like to try it out for themselves!
There is no single “correct” posture. Despite common posture beliefs, there is no strong evidence that one optimal posture exists or that avoiding “incorrect” postures will prevent back pain.
Differences in postures are a fact of life. There are natural variations in spinal curvatures, and there is no single spinal curvature strongly associated with pain. Pain should not be attributed to relatively “normal” variations.
Posture reflects beliefs and mood. Posture can offer insights into a person’s emotions, thoughts, and body image. Some postures are adopted as a protective strategy and may reflect concerns regarding body vulnerability. Understanding reasons behind preferred postures can be useful.
It is safe to adopt more comfortable postures. Comfortable postures vary between individuals. Exploring different postures, including those frequently avoided, and changing habitual postures may provide symptom relief.
The spine is robust and can be trusted. The spine is a robust, adaptable structure capable of safely moving and loading in a variety of postures. Common warnings to protect the spine are not necessary and can lead to fear.
Sitting is not dangerous. Sitting down for more than 30 minutes in one position is not dangerous, nor should it always be avoided. However, moving and changing position can be helpful, and being physically active is important for your health.
One size does not fit all. Postural and movement screening does not prevent pain in the workplace. Preferred lifting styles are influenced by the naturally varying spinal curvatures, and advice to adopt a specific posture or to brace the core is not evidence based.
📑 Slater et al 2019 Sit up straight: Time to Re-evaluate. J Orthop Sports Phys Ther
Keep on moving.
Nathan, Your Friendly Neighbourhood Osteopath
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