On and Off the Avenue: Is the Pandemic Breaking Our Backs?

Test-driving a batch of posture-enhancing devices that are supposed to make you stand tall.

By Patricia Marx, THE NEW YORKER

March 22, 2021

Ironing boards, coffee tables, and laps pinch-hitting as desks could be taking a toll.

Illustration by Anna Haifisch

Iam sitting with my shoulders scrunched, my feet up on my desk, and my rear end tilted so that I am as close as one can be in a chair to lying down. In a pasta police lineup, I’d be elbow macaroni. “Did you nag me about posture when I was young, back in the sixties?” I asked my mother recently. “Evidently not,” she said. Remarkably, I am not among the estimated eighty per cent of Americans who suffer from back troubles. So far. Can I continue to get away with my saggy posture forever?

“The answer is no, and here’s why,” Robert DeStefano, a chiropractor who works with the New York Giants, told me. “It might take years for bad posture to rear its head, but the effects are cumulative. You might feel fine, fine, fine for a long time, and then you go to bend down and pick something up and your back goes into spasm.” The choice was clear: work on my posture or never bend down to pick anything up again. (I’m thinking about it.) Shani Soloff, the founder of The Posture People, a company of physical therapists based in Stamford, Connecticut, was less dire. After examining my conformation, over Zoom, she said that, “while you like to fold in on yourself,” I had other bad habits that kept me from being hobbled; namely, constant fidgeting and frequently visiting the refrigerator. (My theory is that because I’m short I try to stand as tall as possible in conversation with others.)

“The key thing is that you want a setup where you can change your body position every twenty to thirty minutes,” Tasha Connolly, a physical therapist, told me in a video chat. She explained that a prolonged hold of any position overstretches certain muscles and shortens others, and that that can create asymmetries. A few years ago, the news was full of warnings about the “sitting disease.” Sitting, everyone said, was the new smoking. A study reported in the Annals of Internal Medicine in 2017 found that subjects who interrupted their sitting every half hour reduced their chance of dying by fifty-five per cent. Not long ago, with the reputation of chairs in ruins, standing desks became fashionable—that is, until new studies showed that prolonged standing was just as bad as sitting, leading to muscular fatigue, varicose veins, and a doubled risk of heart disease.

Let’s start at the beginning. The story goes that when Plato was asked for a definition of a human being he came up with “featherless biped.” This prompted Diogenes the Cynic to present Plato with a plucked chicken. Not to be outwitted, Plato modified his definition. “A featherless biped with flat nails,” he said. My point is not that philosophy in the fourth century B.C.E. was a sport for smart-alecks who had a thing for poultry but that standing on two feet, which became habit among our ancestors seven million years ago, according to Ashley Hammond, of the American Museum of Natural History, is a defining aspect of the true human condition. This milestone may have also marked the beginning of slouching, the phrase “stand up straight,” and backache.

More recently, as the coronavirus continues to keep us mostly indoors, working in improvised offices where ergonomically unsound ironing boards, coffee tables, and laps pinch-hit as desks, our sloppy ways of sitting could be taking a toll. Parked in front of a computer, we tend to tuck under our tailbones, candy-cane our spines, scrunch up our shoulders, and crane our necks forward like wilted sunflowers. According to many experts, for every inch that the head lists off kilter, the force impinging on the neck and the back increases by ten pounds. A survey among seven hundred and seventy-eight software workers in lockdown last spring found that shoulder, elbow, and wrist pain had doubled. Bad posture has been blamed for indigestion, constipation, high blood pressure, cracked teeth, infrequent orgasms, negative thoughts, and difficulty performing arithmetic calculations; somewhere, someone has probably implicated it in the Presidential-election results.

Before we work on improving our internal scaffolding, it would be useful to define the ideal. If you are a soldier, G.I. Joe sets the standard, according to Sergeant First Class Erik A. Rostamo, the U.S. Army’s Drill Sergeant of the Year. What if you’re a civilian? When viewed in profile, the average human spine, a stack of twenty-four articulated vertebrae and nine fused ones on the bottom, should be shaped like a seahorse, curving gently inward at the neck (cervical) and lower-back (lumbar) regions and outward in the middle (thoracic) region. These three curves help us maintain balance, facilitate flexibility, and serve as shock absorbers. (Wouldn’t you rather be going down the stairwell as a Slinky than as a pretzel stick?) The curves are supported by muscles. An exaggerated curve—called kyphosis in the upper back and lordosis, or swayback, in the lower back—can lead to discomfort and, in extreme cases, can reduce mobility. Seen from the front, you should be more or less symmetrical. A balanced alignment of your spine, referred to among the posturati as a “neutral spine,” exerts the least amount of strain on muscles, tendons, and the skeleton, allowing us to function efficiently.

Toward this end, when sitting, you should have your back touching the chair’s back, derrière scooched into the crook of the seat, shoulders relaxed, legs uncrossed, knees bent at a right angle, feet on the floor, and head erect (it helps if the computer screen in front of you is at eye level and an arm’s length away). When standing, you should have your feet shoulder-width apart and parallel, knees gently bent, arms hanging nonchalantly by your side, stomach pulled slightly in, and shoulders relaxed and pulled back. If this is too many body parts to keep tabs on, perhaps one of the many pointers I found on the Internet will help: imagine there’s a string attached to the top of your head, pulling you upward; walk as if you’re wearing a cape; fantasize that you are being interviewed by Beyoncé and hold yourself accordingly; or pretend that someone’s punching you in the stomach (maybe Beyoncé?).

It’s time to buckle up into a posture corrector. You wouldn’t be the first. The duchess Consuelo Vanderbilt (1877-1964) wrote in her memoir about the “horrible instrument” she was ordered to endure as a child to enforce a plumb stance, describing it as “a steel rod which ran down my spine and was strapped at my waist and over my shoulders—another strap went around my forehead to the rod.” Even more adorable is the neck swing. Invented in France in the eighteenth century, this tackle-and-pulley system, fastened to the ceiling on one end and on the other to a headpiece worn by the user, supposedly stretched the spine and not supposedly left the user dangling with only her toes touching the ground. Today’s so-called posture correctors are spa-like by comparison. The majority fall into two categories: restrictive braces, harnesses, shirts, and bras that encourage the alignment of your torso; or small electronic gizmos, the size of brownies, that ping or vibrate at the inkling of a slump. Amazon sells dozens of varieties; posture is an approximately $1.25-billion industry. Many of the physical therapists, chiropractors, and osteopaths I talked to said that these aids are fine to use in the short term, helping you identify postures you should be emulating. Others regarded them as Rembrandt might a paint-by-numbers kit: gimmickry that gets in the way of learning technique and that might foster dependence.

Tony Pletcher, a Seattle physical therapist, is concerned that these quick fixes could lead to muscle atrophy. “When our bodies are provided constant external support, we often actually lose the ability to perform these movements on our own,” he said in an e-mail. Anil Nandkumar, who works at the Orthopedic Physical Therapy Center, at Hospital for Special Surgery, mentioned that eight out of every ten patients ask him about the correctors, and said, “Long story short, I usually do not recommend these correctors to patients, because they are ‘passive’ tools.”

I chose fifteen devices and sent them to people I know who want to improve their posture. The group included a man who was still traumatized by being punched in the back as a child by his alcoholic mother, whenever she observed him slouching. Another volunteer was motivated by the memory of a seventy-five-year-old actress she’d once seen at Saks—her cosmetically altered face made her look youthful, but when she turned around a severe hunchback exposed the Dorian Grayish truth.

The most common type of corrector on the market is the upper-back brace for clavicle support. This looks like a backpack without the pack, or like an emotional-support-animal harness, and tends to be made from a black stretchy synthetic material. It is worn over or under one’s clothes, with adjustable straps that exert a backward tug on the shoulders, and after prolonged use, according to my volunteers, makes the wearer’s armpits ache. Beginners are advised to wear the brace for five to fifteen minutes a day, and then incrementally progress to an hour or two. Vi Weeks, a college sophomore, appreciated the three inches she estimates she gained in height when her Selbite Posture Corrector ($9.98) was busy doing its job, but, when the brace was off, her spine reverted to its previous convexity, despite the product’s claim to effect “long-term muscle memory.” David Kim, a dermatologist, wore his ComfyBrace ($19.97) on four consecutive workdays, for nine backbreaking hours a day. His once admirable carriage had deteriorated after years of hunching over his patients. Of his brace, Kim said, “It definitely made me more cognizant of my posture. I feel like my lower back was less tired and achy toward the end of the day.” Will Ameringer, an art dealer in Palm Beach, found himself looking at his watch after only ten minutes of wearing his VOKKA corrector ($27.99), whose padded, shield-shaped panel runs the length of the back and looks sturdy enough to joust in. “The directions warn that your back and shoulder muscles ‘may feel stretched.’ They’re not kidding,” he said. “A bit jarring on the kidneys, too.” Ameringer gave up after a week. “It’s designed to pull your shoulders back while pushing a metal plate against your lower back,” he said. “The problem is that it does one or the other.”

Is it possible that something could be good for you and also feel good? According to one tester, who is parked at her desk in Los Angeles all day, such is the case with Dr. Toso’s BackRX ($39). This remedial belt loops around your waist and knees, while you are seated, thereby using the weight of your legs to exert a forward tug that supports your lower back, undoing your slouch. “It’s restrictive and weird but really comfortable, sort of like a girdle but just for your back,” she said. “I’ve used it while working and I definitely sit straighter, and my lower back feels better.” It also helps to make you sit ergonomically in any chair—even in a canoe, the Web site brags, because hasn’t the world been crying out too long for a way to paddle without lumbar strain?

“Rapunzel, Rapunzel, your roots are showing.”

Cartoon by Jon Adams

Until a philosophy grad student named Luke tried the AlignMed compression shirt ($95)—a black zippered short-sleeved top that could pass for a wetsuit—only his mother’s nagging had kept him posturally respectable. Aspiring to the silhouette of a four-star general, he wore the shirt on three occasions, a few hours each time (“I can’t say it was comfortable”), and found that he was more upstanding, but not dramatically so. Actually, he realized that his original posture was better than he’d thought. He decided he preferred his natural, relaxed physique to one that hinted at a lifetime of maternal psychological abuse.

Posture is a body language that everyone understands. “People with good posture seem professional and confident,” a friend who fears that her posture may be amoeba-like told me. “They wear suits and heels and don’t complain. They are the kind of people who wink at you.” Lia Grimanis, the founder of Up with Women, an organization that helps recently homeless women and families, regards the ramrod-straight with awe. “They are like the children of gods,” she said. “Doors open easily for them.” Or, as another volunteer confessed, “I could never have good posture, because people might think I have a high opinion of myself.” Among certain types—the rebellious, the avant-garde, hipsters, Oscar Wilde—slouching is cooler than erectitude. (Certain actresses, too. “don’t copy those slouching celebs!” a headline in the Daily Mail read in 2011. “Bad posture won’t just cause a bad back, but depression too!” The droopers listed, spotted slouching at the Golden Globes, included Michelle Williams, Anne Hathaway, and Tilda Swinton.)

Whatever else you might think about breasts, they are on gravity’s side, not yours. That’s where the Leonisa posture-corrector bra comes in ($45). Every day for a week, from nine to five, my friend Jancee wore one. She described the sleek, wireless, lightly padded garment as “a cross between a sports bra and a compression sock.” Initially, it felt “comforting and warm, like a tight hug,” she said, but by afternoon the hug became “creepy and uncomfortable,” and she looked forward to clawing open the hook-and-eye closures. The bra lessened her back pain, pulled her shoulders back, and compelled her to walk tall. She plans to wear it on days that she does not exercise, in order to have something to feel virtuous about.

Must we be pushed and pulled and squeezed into verticality? Isn’t there a more civilized way? Sort of. The Upright Go 2 ($99.95) is an electronic “wearable” the size of a Tic Tac box that sticks to your back with reusable adhesive, or, if attached to the necklace provided, is worn as a pendant. If the device detects that you are orthopedically out of line, it vibrates. It knows when you’ve been bad or good because, at the outset, you calibrate your alignment settings to an app on your phone connected to the device by Bluetooth. The app keeps a tally of your vibrating vs. non-vibrating minutes, along with other stats you won’t care about unless you are writing a Ph.D. dissertation on the topic of your spinal deviations. A casting-director acquaintance sampled an Upright for a couple of weeks. It made her feel like a failure. “I want to go to sleep, but my goal is a hundred and sixty more ‘upright minutes,’ ” she said. She was not sure that watching Netflix in bed counted. Her daily goal, determined by the app, was five hundred minutes. Although she is now more conscious of how she positions herself, she recognizes that the device is fallible. “When I empty the dishwasher, it buzzes like crazy,” she reported.

How do the electronic gadgets compare with the glorified rubber bands that yank you upward? Two Brooklyn sisters, nine-year-old Rosie and six-year-old Bella, tried one of each: the Semloo intelligent posture corrector ($12.99) and the Aaiffey back brace ($14.99). The sisters differentiated the two types by calling them Buzzy and Not-Buzzy. “Not-Buzzy is very annoying,” Bella said. “It hurts your shoulders and it’s not tight, but it feels like it’s tight.” Rosie had a different problem: “If you wear Not-Buzzy to school, it could look like you’re wearing a bra.” Also, once, when she was wearing Buzzy and leaned down to snuggle the cat, it buzzed, “so unless you want to snuggle by squatting somehow, it’s very hard.” Do the girls consider posture important? Rosie: “I think it may be important to your body, but I don’t really know, because I don’t know a lot about bone stuff. Whether it’s important to your life, I think, depends on who your parents are and if they care.” Bella: “No.”

Unlike wearables, the Gaiam Classic Balance Ball Chair ($70) wears you. Josie Abugov, twenty, spent an hour a day for two weeks perching on what is essentially a desk chair with a small backrest and a yoga ball substituting for a seat cushion. “While using the device itself, I do have better posture,” she e-mailed. “The contraption forces your back straight and core to be engaged—but I haven’t noticed a marked improvement in my default posture.” The real benefit, she concluded, is that the device makes you think about your posture.

Not everyone agrees that sitting on a sphere is beneficial. And some doubt whether sitting, or even slouching, is toxic. Kieran O’Sullivan, a physiotherapist at the University of Limerick, believes that people today are almost paranoid about posture. When I asked him about the widely touted claim that being immobilized in one position does damage to tissues, he replied, “Yet a baby spends nine months in the womb completely flexed/curled up and doesn’t seem to have irreversible contractures when it comes out.” Gavin Smith, an osteopath in London, goes even further, suggesting that slumping can increase spine length and reduce stiffness in vertebral joints (by increasing the amount of fluid between disks). Smith told me that, in the comments section of an article in which he was quoted, someone had written, “What’s next? ‘Experts say that jumping into a hungry tigers den might be good for your health?’ ”

What is it about posture that evokes such visceral feelings? Beth Linker, a history-of-science professor at the University of Pennsylvania, told me, “If I tell people the title of the book I’m working on”—“Slouch: Fearing the Disabled Body”—“they immediately sit up straight, as if I’m judging them.” She went on, “For a long time, posture was something that only queens and kings and the upper class would talk about. It was seen as a matter of discipline and appearance. Then, in the nineteenth century, Darwin and other evolutionary scientists claimed that human posture led to brain development.” That, she said, led to doctors linking poor posture and poor health. “It gave rise to a lot of aggressive and reductionist public-health campaigns.” In the early nineteen-hundreds, hunching over was said to cause “sinking organs,” and in the nineteen-twenties a poster created by the National Child Welfare Association showed a little boy standing tall in an attempt to defend himself against a baseball-bat-wielding ogre who was labelled—in black letters—“tuberculosis.”

“It is a topic you bring up only if you want to do something about it—namely, improve yours or someone else’s,” the historian Sander Gilman said, over Zoom. In “Stand Up Straight!: A History of Posture,” Gilman looks at posture as a cultural construct, a way to read an individual’s social status, and “a means for society to separate the ‘primitive’ from the ‘advanced’, the ‘ugly’ from the ‘beautiful’, and the ‘ill’ from the ‘healthy’.” At Ellis Island, immigrants’ spinal bumps and bows were thought to indicate moral weaknesses, and provided grounds for denying people entry into the country. In many American colleges, from the nineteen-forties through the seventies, compulsory nude “posture photos” were taken of freshmen. Among the disquieting purposes: studying the connection between personality types and morphological traits, aiming ultimately to create a master race through matchmaking.

It’s hard to be a biped. Yes, it may be easier to send a text standing on two legs than on four, but the advantage comes with a lot of wear and tear on our skeletons. I asked around for ideas about how to redesign the human body so that it might better accommodate our modern needs. Rodney Brooks, a roboticist, suggests that we implant two titanium pegs into our backs, roughly shoulder width, and use them to hang ourselves up on the wall, placing our desks and computers in front of us. Kyle Jensen, a senior lecturer at the Yale School of Management, would move our eyes to stomach level to avoid slouching toward the computer screen. The most radical redesign suggestion came from a ten-year-old named Najya, who said, “I would take out the spine, so you’re lying on the floor.” ♦

Patricia Marx is a staff writer. Her latest book, “You Can Only Yell at Me for One Thing at a Time,” was illustrated by Roz Chast.