Vinh Pham is the go-to posture guru for Hollywood celebrities and the sporting elite. Among those who have the LA-based physical therapist on speed dial for their aches, pains and general niggles are Jennifer Lawrence, Toby Maguire, Lorde, Michael B Jordan, and Sophie Turner.
Raised in Canada and a graduate of McGill University in Montreal, Pham, pictured below, has been a licensed physical therapist for over a decade and founder of the high-end MyoDetox clinic in LA. He has also ironed out the postural problems and muscle and joint complaints of Olympic athletes and top ballerinas and believes he can help us all to “futureproof” our bodies against chronic pain. But first, we need to get rid of our bad habits.
Pham says that most of his clients turn up at his West Hollywood clinic because they are in pain but that the reasons for their throbbing lower back, neck stiffness and shoulder tension are universally the result of using the body in a way that it wasn’t designed for. “Our bodies bear the weight of bad habits and chronic repetitive movement or lack of it, is the most common reason for back, neck and joint problems,” he says.
His A-lister clients are as prone to posture-related niggles as the rest of us. “You might sit at a desk all day but they sit in a make-up chair or on a tour bus which will wreck the body in just the same way,” Pham says. “We all get stuck in postures and positions that we are used to and unless you challenge your body with movement variety, nobody is immune.”
Over time we are all guilty of reducing our movement patterns to a few default positions. We lie on the same side in bed, we lean on the same arm at our desk or we walk with the same stooped posture. “We all assume that sitting for too long with poor posture is the worst news for our bodies,” says Pham. “But it’s how we walk, sleep, stand and move in the same way every day and that adds to accumulated damage.”
Always adopting the same positions places stress on the muscles of the back and neck, as well as on the spine and contributes to discomfort and ultimately to chronic pain. “There’s a limit to how much the body and spine can handle in compromised repetitive positions,” he says.
From a musculoskeletal standpoint, sitting – even slouching – is not inherently bad for you in small doses. “There is no problem slouching a bit if you change position and move around,” Pham says. In fact, there is no single sitting, standing or moving that will prevent pain in isolation. Even what we perceived to be perfect postural alignment – maintaining the natural curves of the neck, middle back, and lower back – is bad news if you strive to attain it all the time.
“I have worked with a lot of top ballet dancers who stand and sit bolt upright yet still have a lot of aches and pains,” Pham says. “I have had to teach them how to slouch in order to introduce different positions and movements for their bodies.”
In his new book, , Pham outlines a movement programme that aims to counteract the effects of problem positions that cause spine stiffness, neck pain, reduced arm and shoulder mobility and tight hips. “As a minimum he says we should avoid sitting in one position for more than 30 minutes, preferably less, and should get up and move on micro-breaks. At least every hour we should stand to perform shoulder squeezes by pulling shoulders back and down towards the spine to offset hunching. And we should walk as often as we can, change position as often as possible and bend down, swing the arms or stretch up whenever we get the opportunity.
“The more you move, the more your posture will improve. The muscles around the pelvis and shoulders will relax and as you feel your body begin to lengthen the better you will breathe, digest, stand and sit.”
Pain-free posture is achievable for us all. “Ultimately, your body will adjust so that it will feel effortless,” Pham says. “At that point, the risk of pain and tension are vastly reduced and your energy levels will soar.”
Vinh Pham, physical therapist and author of Sit Up Straight.
Here are his top posture tips:
After the age of 30, men and women begin losing muscle mass every year, amounting to a loss of 5 to 10% between 24 and 50. For men, who have greater muscle mass to start with, these losses are compounded by a downturn in the production of muscle-strengthening testosterone and growth hormone and the combined effects are significant, resulting in declining strength that leads to poor muscular support for the back.
Pham says that back injuries in middle-aged men often result from tight or weak glutes and hamstrings that make movement difficult and force them to adopt awkward positions. “Reduced muscle mass means less structural support for the spine and that can lead to posture-related pain,” he says. “Men need to pay particular attention not only to strengthening and moving their back muscles, but the glutes and hamstrings which collectively play a role in spine health.”
Hormones play a key role in the development of all postural problems, but women seem to have drawn the short straw. “I’ve noticed in my clinics that women are more prone than men to neck and shoulder symptoms, and research shows that they are twice as likely as men to suffer neck and shoulder issues related to use of phones and tablets, problems which possibly all have hormonal links too.”
Hamstring weakness is often associated with lower back pain in men and women and Pham says there’s some evidence that women struggle more than men to activate and strengthen hamstrings during resistance training.
“All over muscle strength of the core, back and leg muscles is important for everyone, but especially for women prone to back and posture pain,” Pham says. “And the emphasis should continue as you age.”
Any activity is great for improving back mobility and offsetting back pain. But Pham says running places a much greater load on the body than standing still or walking. “As you run, your body is technically falling forward with force and that increases the stress applied to your bones, tendons, muscles, and ligaments with every stride you take,” he says. “If you have any underlying postural, biomechanical, mobility or balance problems, running will uncover them and potentially make those matters worse.”
To reduce the pressure on your joints when running, he suggests shortening your stride. “Increasing your cadence, or taking smaller, quicker steps per minute has been shown to reduce injury risk in runners,” he says. “Aim for around 180 steps per minute, regardless of the speed you’re running.”
So many of us have bad habits when we drive, Pham says. “We put one hand on top of the wheel and twist our upper body in the opposite direction as we steer and drive which causes spinal misalignment,” he says. “Even getting out of a car we tend to favour leading with one leg which causes muscular imbalance over time.”
Simple adjustments when driving can make a difference. “Don’t sit bolt upright with the seat at 90 degrees but tilt it back a bit to about 110 degrees to reduce stress on the spine,” says Pham. “Have your hips slightly higher than your knees and your headrest between the top of your head and your ears for good support.” Above all, take a break and stretch or move at least every hour.
Many of Pham’s clients present with back pain after reaching or twisting for something in a cupboard or after playing tennis or golf. It is not the activity itself that is causing the pain, but the time they spend sitting at a desk which means they have developed tight hip muscles. Once they try to generate the power needed for twisting and turning, they put stress on the low back muscles unless they are well prepared.
“Stretching exercises for the spine, hips and shoulders are essential to increase this rotational mobility and you should do them every day if you play regularly,” Pham says. “It also pays to increase mobility in your feet with ankle circles and raises as this enhances movement up the body through your shoulders, mid back, and hips as you swing.”
We often overlook this group of muscles which form a supportive hammock for our internal organs and help to prevent back pain, improve posture. It is particularly important for women with hormones, childbirth and age all taking their toll on the health of these muscles, but they matter for men too.
Studies suggest that in 90% of cases, women who have back pain also have pelvic floor muscle dysfunction and in men and women a weak pelvic floor can cause incontinence and uncomfortable sex. Training your pelvic floor muscles involves subtle movements best prescribed by a physiotherapist and include Kegel exercises that involve repeatedly contracting and relaxing the pelvic muscles for a couple of seconds in quick succession every day.
- Sit Up Straight: Futureproof Your Body Against Chronic Pain by Vinh Pham (Simon and Schuster).
