Car seats are notorious for promoting problematic positioning. Take a look at the photo with this post. (Just looking at the bucket seat shape makes me, as a PT, cringe!) The bucket seats promote a rounded low back (posterior pelvic tilt and lumbar spine kyphosis), and the headrests promote forward head and shoulder posture. This all contributes to back pain, neck pain, headaches, and many other musculoskeletal problems. Most of us spend time in our cars daily, sometimes hours each day. That repetitive postural strain on our bodies takes a toll and is one of the causes of the fascial restrictions that we treat with Counterstrain. We regularly work with our patients on attaining neutral positioning in the car in order to minimize the postural strain and reduce the likelihood of the same restrictions returning in the future.
Here are some simple tips for achieving neutral positioning in your car:
First, practice achieving a neutral seated posture on a standard chair before you attempt it in your car. This will allow your body to learn what “neutral” feel like before trying it in a place where it can be more difficult to find neutral. Here’s how to achieve a neutral seated posture:
In sitting, rock your pelvis forward and backward until you feel the most pressure through your sit bones. This puts your low back and upper back into a neutral position. Next, make sure your shoulders are pulled back slightly. Think: "Pull your shoulder blades down and in, as if trying to tuck them into your back pockets." Then perform a chin tuck by pulling your chin straight back. Then relax your neck muscles slightly to obtain a neutral position for your neck. (Your positioning should not return to a slouched posture.)
Now, go to your car.
Fold a towel into a wedge shape and place it on your seat with the thick part of the wedge against the seatback. When you sit on this, it will level out your pelvis and place the seat’s built-in lumbar support at the proper area in your back.
Now sit in your car and find a neutral position (using the directions above).
Adjust the seat to cradle you comfortably in this position.
Adjust the seat height, distance from pedals, seat angle, lumbar support, and headrest angle for comfort and to support neutral positioning.
Your head should be no more than two inches from the headrest when you’re in a neutral position.
If possible, adjust the steering wheel position.
You might find that your car isn’t fully adjustable to support (or even permit) your neutral posture. If this is the case, you may need to add some back support. This might mean more towel rolls. There are also various cushions you can purchase to facilitate neutral positioning in the car. Here are a few examples (though there are more out there):
Lastly, we know that safe, comfortable, and neutral positioning in a car isn’t always easy. Stick with it, and ask for help when you need it! Your Physical Therapist will gladly assist you at your next appointment if you have any questions.